Utility of basic clinical and laboratory parameters to predict Serious Bacterial Infection in children younger than 3 months old hospitalized for Febrile Syndrome without Source. / Utilidad de los parámetros clínicos y de laboratorio básicos para predecir infección bacteriana seria en menores de 3 meses que se hospitalizan por síndrome febril sin foco.

INTRODUCTION: In 20% of children with febrile syndrome, it appears as fever of unknown origin (FUO) syndrome. Management strategies in this group have high sensitivity but low specificity. OBJECTIVES: To cha racterize serious bacterial infections (SBI) in children younger than three months old hospitalized because of FUO syndrome and to evaluate the utility of clinical and laboratory parameters in the identification of patients that are at high risk of SBI. PATIENTS AND METHOD: Prospective study in patients aged < 3 months hospitalized due to FUO syndrome between January 2014 and November 2015 in two pediatric hospitals in the Metropolitan Region. INCLUSION CRITERIA: age 4 days - 3 months, fever > 38°C longer than 72 hours after onset without demonstrable cause. EXCLUSION CRITERIA: anti microbial use up to 7 days before admission, preterm infants < 34 weeks, birth weight < 2 kg, and im munocompromised. Demographic, clinical, and laboratory tests data were recorded as well as blood count and CRP, discharge diagnosis, and ruled out, probable or confirmed SBI. RESULTS: 32% of the patients were discharged with diagnosis of SBI, 28% with diagnosis of viral or probably viral infec tion, 34% with diagnosis of not specified FUO syndrome, and 6% due to other causes. There were no significant differences in the CRP value, altered WBCs count, toxic aspect, or hours of fever at the admission when comparing groups with and without SBI (p < 0.05). The combination of clinical and laboratory parameters showed 27% of sensitivity, 90% of specificity, 60% of PPV, and 71% of NPV. CONCLUSION: It was not possible to establish clinical and laboratory parameters that allow the identifi cation of children younger than 3 months old at high risk of SBI, however, they maintain their value as low risk indicators. It is necessary further investigation of other clinical and laboratory elements that allow discriminating SBI from viral infections.

Utilidad de los parámetros clínicos y de laboratorio básicos para predecir infección bacteriana seria en menores de 3 meses que se hospitalizan por síndrome febril sin foco / Utility of basic clinical and laboratory parameters to predict Serious Bacterial Infection in children younger than 3 months old hospitalized for Febrile Syndrome without Source

Resumen: Introducción: Un 20% de los niños con síndrome febril se presenta como síndrome febril sin foco (SFSF). Las es trategias de manejo en este grupo presentan alta sensibilidad, pero baja especificidad. Objetivos: Ca racterizar las infecciones bacterianas serias (IBS) en menores de 3 meses hospitalizados por SFSF, y evaluar utilidad de parámetros clínicos y de laboratorio en la identificación de pacientes con alto riesgo de IBS. Pacientes y Método: Estudio prospectivo en pacientes < 3 meses hospitalizados entre enero 2014 y noviembre 2015 por SFSF en dos hospitales pediátricos de la Región Metropolitana. Criterios de inclusión: edad 4 días - 3 meses, fiebre > 38°C de < 72 h de evolución sin causa demostra ble. Criterios de exclusión: uso de antimicrobianos hasta 7 días previo a su ingreso, prematuros < 34 semanas, peso de nacimiento < 2 kg e inmunocomprometidos. Se registraron datos demográficos, clínicos, y exámenes de laboratorio, hemograma y PCR, diagnóstico de egreso, IBS descartada, IBS probable o confirmada. Resultados: 32% de los pacientes egresó con diagnóstico de IBS, 28% con diagnóstico de infección viral o probablemente viral, 34% con diagnóstico de SFSF no especificado y 6% SFSF por otras causas. No se encontraron diferencias significativas en PCR, leucocitosis, aspecto tóxico ni horas de fiebre al ingreso al comparar los grupos con y sin IBS (p > 0,05). La combinación de parámetros clínicos y de laboratorio mostro sensibilidad de 27%, especificidad de 90%, VPP 60% y VPN 71%. Conclusión: No fue posible establecer que parámetros clínicos y de laboratorio permitan identificar menores de 3 meses con alto riesgo de IBS, manteniendo su utilidad como indicadores de bajo riesgo. Es necesario contar con otros elementos clínicos y de laboratorio que permitan discrimi nar IBS de infecciones virales.

Abstract: Introduction: In 20% of children with febrile syndrome, it appears as fever of unknown origin (FUO) syndrome. Management strategies in this group have high sensitivity but low specificity. Objectives: To cha racterize serious bacterial infections (SBI) in children younger than three months old hospitalized because of FUO syndrome and to evaluate the utility of clinical and laboratory parameters in the identification of patients that are at high risk of SBI. Patients and Method: Prospective study in patients aged < 3 months hospitalized due to FUO syndrome between January 2014 and November 2015 in two pediatric hospitals in the Metropolitan Region. Inclusion criteria: age 4 days - 3 months, fever > 38°C longer than 72 hours after onset without demonstrable cause. Exclusion criteria: anti microbial use up to 7 days before admission, preterm infants < 34 weeks, birth weight < 2 kg, and im munocompromised. Demographic, clinical, and laboratory tests data were recorded as well as blood count and CRP, discharge diagnosis, and ruled out, probable or confirmed SBI. Results: 32% of the patients were discharged with diagnosis of SBI, 28% with diagnosis of viral or probably viral infec tion, 34% with diagnosis of not specified FUO syndrome, and 6% due to other causes. There were no significant differences in the CRP value, altered WBCs count, toxic aspect, or hours of fever at the admission when comparing groups with and without SBI (p < 0.05). The combination of clinical and laboratory parameters showed 27% of sensitivity, 90% of specificity, 60% of PPV, and 71% of NPV. Conclusion: It was not possible to establish clinical and laboratory parameters that allow the identifi cation of children younger than 3 months old at high risk of SBI, however, they maintain their value as low risk indicators. It is necessary further investigation of other clinical and laboratory elements that allow discriminating SBI from viral infections.

Molecular design of high performance zwitterionic liquids for enhanced heavy-oil recovery processes.

Branched gemini zwitterionic liquids, which contain two zwitterionic moieties of linked quaternary-ammonium and carboxylate groups, are proposed as chemicals to be applied in the Enhanced Oil Recovery (EOR) from fractured carbonate reservoirs. The zwitterionic moieties are bridged between them through an alkyl chain containing 12 ether groups, and each zwitterionic moiety has attached a long alkyl tail including a CC double bond. A theoretical molecular mechanism over which EOR could rest, consisting on both the disaggregation of heavy oil and the reservoir-rock wettability alteration, was suggested. Results show that chemicals can both reduce the viscosity and remove heavy-oil molecules from the rock surface.

Contribution of polymorphisms in the LEP, LEPR and RETN genes on serum leptin and resistin levels in young adults from Mexico.

Polymorphisms in the LEP (G-2548A and A19G), LEPR (A326G, A668G and G3057A) and RETN (C-420G and G+62A) genes were documented according to their association with alterations in biochemical parameters such as glucose, insulin and lipid profiles, along with serum leptin and resistin concentrations. The aim of the study was to establish any contribution of the G-2548A and A19G polymorphisms of the LEP gene, the A326G, A668G and G3057A polymorphisms of the LEPR gene, and the C-420G and G+62A polymorphisms of the RETN gene to serum leptin and resistin levels in Mexican young adults. Clinical and biochemical variables, serum leptin and resistin levels, and genotype profiles were analysed in 66 Mexican young adults. Seven polymorphisms in the LEP, LEPR and RETN genes were genotyped using polymerase chain reaction-restriction fragment length polymorphisms analysis. Individuals carrying allele 3057A of the G3057A polymorphism in the LEPR gene showed significantly higher leptin concentrations than those bearing the genotype G/G (43.78 ± 39.11 vs 28.20 ± 14.12 ng/mL; p = 0.021). There were no associations of serum leptin or resistin levels according to the genotype of the other six analysed polymorphisms. Our results suggest that the allele 3057A of the LEPR G3057A polymorphism contributes to increased serum leptin levels in Mexican young adults.

Dielectric spectroscopy of ionic microgel suspensions.

The determination of the net charge and size of microgel particles as a function of their concentration, as well as the degree of association of ions to the microgel backbone, has been pursued in earlier studies mainly by scattering and rheology. These methods suffer from contributions due to inter-particle interactions that interfere with the characterization of single-particle properties. Here we introduce dielectric spectroscopy as an alternative experimental method to characterize microgel systems. The advantage of dielectric spectroscopy over other experimental methods is that the polarization due to mobile charges within a microgel particle is only weakly affected by inter-particle interactions. Apart from electrode polarization effects, experimental spectra on PNIPAM-co-AA [poly(N-isopropylacrylamide-co-acrylic acid)] ionic microgel particles suspended in de-ionized water exhibit three well-separated relaxation modes, which are due to the polarization of the mobile charges within the microgel particles, the diffuse double layer around the particles, and the polymer backbone. Expressions for the full frequency dependence of the electrode-polarization contribution to the measured dielectric response are derived, and a theory is proposed for the polarization resulting from the mobile charges within the microgel. Relaxation of the diffuse double layer is modeled within the realm of a cell model. The net charge and the size of the microgel particles are found to be strongly varying with concentration. A very small value of the diffusion coefficient of ions within the microgel is found, due to a large degree of chemical association of protons to the polymer backbone.

Presión negativa multinivel en cobertura tisular compleja / Multilevel negative pressure in complex skin coverage

La pérdida de cobertura cutánea compleja secundaria a traumatismos, úlceras por presión, desforramientos cutáneos, etc, plantea un desafío a la hora de elegir la técnica quirúrgica que solucione el problema. Cualquiera que sea la elegida, conlleva un riesgo asociado de mayor pérdida cutánea, hematoma o seroma. En base a un estudio experimental sobre medición de presiones bajo y sobre colgajos sometidos a aplicación de presión negativa, decidimos aplicar el método a diferentes planos anatómicos de profundidad en pacientes con defectos complejos de cobertura tisular. Presentamos nuestra experiencia con el uso de presión negativa externa e interna (multinivel) como técnica de apoyo y prevención de complicaciones en la resolución de 19 casos de cobertura tisular compleja: desforramientos de piel, hematomas disecantes del tejido celular subcutáneo, úlceras por presión, colgajos complejos, cicatrices extensas y loxocelismo cutáneo, obteniendo resultados satisfactorios (AU)

Complex tissue loss secondary to traumatisms, pressure sores, degloving, etc, are a challenge when we try to choose the surgical technique to solve the problem. Every technique brings a risk of major skin coverage defect, hematoma or seroma. Based on an experimental study to measure pressure over and below a flap submitted to negative pressure, we decided to apply a vacuum system in different anatomic planes in patients with complex tissue loss. We report our experience with the use of negative pressure as external and internal (multilevel) technical support and prevention of complication in resolving 19 clinical cases of complex tissue loss: degloving, subcutaneous hematoma, pressure sores, complex flaps, extensive scarring skin loss, loxoscelism, with successful results (AU)

Modulation of PPAR-γ by Nutraceutics as Complementary Treatment for Obesity-Related Disorders and Inflammatory Diseases.

A direct correlation between adequate nutrition and health is a universally accepted truth. The Western lifestyle, with a high intake of simple sugars, saturated fat, and physical inactivity, promotes pathologic conditions. The main adverse consequences range from cardiovascular disease, type 2 diabetes, and metabolic syndrome to several cancers. Dietary components influence tissue homeostasis in multiple ways and many different functional foods have been associated with various health benefits when consumed. Natural products are an important and promising source for drug discovery. Many anti-inflammatory natural products activate peroxisome proliferator-activated receptors (PPAR); therefore, compounds that activate or modulate PPAR-gamma (PPAR-γ) may help to fight all of these pathological conditions. Consequently, the discovery and optimization of novel PPAR-γ agonists and modulators that would display reduced side effects is of great interest. In this paper, we present some of the main naturally derived products studied that exert an influence on metabolism through the activation or modulation of PPAR-γ, and we also present PPAR-γ-related diseases that can be complementarily treated with nutraceutics from functional foods.

Proximal amputation of inferior extremity secondary to recurrent pressure ulcers in patients with spinal cord injuries.

STUDY DESIGN: Descriptive case series study. OBJECTIVE: To describe the course of five spinal cord injury (SCI) patients who underwent proximal amputation of the inferior extremity, secondary to recurrent, complicated pressure ulcers (PU) and the clinical impact this intervention had in these patients. PLACE: Trabajador Hospital in Santiago, Chile. METHOD: Revision of five clinical cases of patients who underwent partial hemipelvectomy or hip disarticulation with amputation of the extremity as treatment for pelvic recurrent PU with chronic secondary osteomyelitis. The clinical impact was quantified as days of hospital stay, number of surgeries and previous and post surgery PU. RESULTS: After the proximal amputation of the extremity, patients significantly decreased number of days of hospital stay (P=0.035), number of surgeries (P=0.015) and PU (P=0.0065). CONCLUSION: Partial hemipelvectomy and hip disarticulation with proximal amputation of the inferior extremity are rescue procedures that can be last resource treatment for chronic recurrent pelvic PU secondary to chronic osteomyelitis.

Ruptura prematura de membranas ovulares: incidencia y manejo en el Hospital Dr. Patrocinio Peñuela Ruíz IVSS 2001-2004 / Ovular premature rupture of membranes: incidence and management in the Hospital Dr. Patrocinio Peñuela Ruíz IVSS 2001-2004

Se realizó un estudio retrospectivo, longitudinal, descriptivo en la maternidad del Hospital “Dr. Patrocinio Peñuela Ruíz” durante el período 2001-2004, basado en la revisión de 132 historias clínicas con diagnóstico de RPM. Encontrándose los siguientes resultados: el grupo etáreo predominante fue 25-29 años (36,36 por ciento), la edad gestacional 37-41 semanas (72,72 por ciento), se presentó principalmente en nulíparas (53,03 por ciento), el inicio de trabajo de parto fue predominantemente menos de 24 horas (68,18 por ciento), el apgar del RN al 1° y 5° minuto fue 7-10 pts (89,35 por ciento) el 53,03 por ciento de las madres no presentó enfermedad asociada, ni complicaciones postparto (90,90 por ciento). La conducta tomada en la mayoría de los casos fue inducción del trabajo de parto (56,06 por ciento), sin embargo terminaron en cesárea segmentaría (88,63 por ciento), de las cuales 13,63 por ciento por SFA, 25,75 por ciento DCP y 50 por ciento distocia de dilatación y descenso post-inducción fallida. El uso de cefalosporinas (78,03 por ciento) favoreció la evolución clínica satisfactoria de madres con diagnóstico de PRM y la triple cura en los casos de corioamnioitis (2,27 por ciento). Se concluye que no existe ninguna controversia cuando la RPM se acompaña de sufrimiento fetal o corioamnioitis clínica, en cuyo caso la terminación del embarazo es la conducta indicada. Sin embargo, cuando ésta se produce sin signo alguno de trabajo de parto, corioamnionitis clínica o sufrimiento fetal, el resultado perinatal está sometido a un delicado equilibrio entre prematuridad e infección corioamniótica (sepsis materna o fetal). El tiempo juega entonces un papel preponderante y todos los esfuerzos médicos se derigen a obtener una rápida madurez fetal con un mínimo de riesgo séptico. Con el manejo actual de la ruptura prematura de membranas que se hace en el HPPR se obtuvo en general un resultado aceptable, ya que la frecuencia de infección materna fue muy baja.

Epidemiología del embarazo ectopico en el Hospital "Dr. Patrocinio Peñuela Ruíz": IVSS 2005 / Epidemiology of ectopic pregnancy at the Hospital Dr. Patrocinio Peñuela Ruíz: IVSS 2005

El embarazo ectópico es la implantación del huevo fertilizado fuera de la cavidad uterina. Se presenta en el 2 por ciento de los embarazos en Estados Unidos, en nuestro país en un 0,007 a 4,4 por mil y es la segunda causa de morbimortalidad en el primer trimestre del embarazo. Conocer la relación de algunos factores epidemiológicos, clínicos diagnósticos y terapéuticos en esta entidad. Estudio retrospectivo de 18 pacientes con diagnóstico embarazo ectópico periodo enero-diciembre 2005, en la maternidad del Hospital “Dr. Patrocinio Peñuela Ruíz” IVSS, Estado Táchira. Se utilizó el porcentaje como método estadístico. El grupo etáreo predominante fue 30-34 años (38,88 por ciento), la edad gestacional 5-9 semanas (66,66 por ciento), se presentó principalmente en nulíparas (38,88 por ciento), los antecedentes mayormente relacionados fue el aborto (33,33 por ciento) y la esterilización quirúrgica (27,77 por ciento). La clínica al momento del ingreso fue dolor abdominal más sangrado activo (77,77 por ciento) con fondo de saco de Douglas abombado y doloroso (77,77 por ciento) en los casos de Embarazo ectópico accidentado (72,22 por ciento). El diagnóstico definitivo se obtuvo por medio de la ecografía más cuantificación de HCG (66,66 por ciento). La forma de presentación fue accidentado 72,22 por ciento y no accidentado u organizado en 27,77 por ciento. La localización tubárica 94,44 por ciento fue la mayormente reportada en los hallazgos operatorios y de ellas la ampullar 61,11 por ciento. La conducta tomada en todos los casos fue procedemiento quirúrgico de las cuales se realizó 77,77 por ciento salpingectomia total. Para disminuir la morbilidad y mortalidad que produce el Embarazo Ectópico es preciso diagnósticarlo precozmente. En las últimas décadas ha aumentado la frecuencia de embarazo ectópico, relacionado este incremento principalmente con conductas sexuales no responsables o no protegidas, que llevan entre otros problemas a padecer infecciones de transmisión.

Tema de revisión: ruptura prematura de membranas ovulares / Tema de review: rupture premature of the membranes ovular

Actualmente existe una alta proporción de RPM (2-22 por ciento) y es una de las patologías obstétricas más frecuentes, considerada un problema de salud pública, por ser responsable de la mayoría de partos pretermino (30 por ciento); tiene estrecha relación con la morbi-mortalidad materno-perinatal. Su incidencia es muy variable y depende en gran parte de la situación socioeconómica de la embarazada debido a la menor probabilidad de recibir cuidados médicos prenatales adecuados. Puede presentarse al final del embarazo causada por un debilitamiento natural de las membranas y por la fuerza de las contracciones; también ocurre en etapas tempranas del embarazo y fundamentalmente se asocia a infecciones locales (cervicovaginitis) e infecciones del tracto urinario; mala nutrición y sobredistensión uterina. Otros factores vinculados son los antecedentes de parto pretermino, hemorragia vaginal y tabaquismo. Produce numerosas complicaciones en el binomio materno-fetal como infecciones (corioamnioitis), parto pretermino, compresión del cordón umbilical y prolapso del cordón provocando sufrimiento fetal e incluso muerte fetal. Existen 2 tipos de manejo: activo (culminación del embarazo por cesárea o inducción del trabajo de parto) y expectante (espera del inicio espontáneo del trabajo de parto).

Fibroma odontogénico: a propósito de un caso / Odontogenic fibroma: a purpose of a case

El fibroma Odontogénico es una neoplasia que se presenta como masa pediculada, de color similar al tejido conectivo que la rodea. La forma periférica presenta una agrandamiento gingival que puede confundirse con otras lesiones gingivales. El diámetro varia entre 1 a 3 cm. Se presenta a cualquier edad, aunque tiene predilección por niños y adultos jóvenes y se observa más en mujeres que en hombres. Se presenta caso de escolar femenina de 7 años quien se lleva a consulta por presentar aumento de volumen y dolor a nivel de hemicara derecha de 45 días de evolución intrahospitalaria tórpida. Es intervenida quirúrgicamente, extirpándose tumor en región maxilar inferior derecha cuya biopsia reportó fibroma odontogénico.

Estrogen and progesterone receptors in murine models of systemic lupus erythematosus.

Estrogens are believed to play a role in the etiology of both human and murine systemic lupus erythematosus (lupus; SLE), presumably through the agency of their cellular receptor proteins. There is now considerable interest in the molecular mechanism of action of estrogens in immune tissues, particularly with regard to autoimmune disorders, which are generally more prevalent in women. In this laboratory, an attempt is being made to characterize estrogen receptors in murine models of SLE and to try and relate this to estrogen receptor function in vivo. The initial aim was to compare binding properties of estrogen receptors in brain, reproductive and immune tissues of BALB/c and MRL/MP-lpr/lpr mice. The latter strain spontaneously develops an autoimmune disease resembling human systemic lupus erythematosus (lupus; SLE). It is hypothesized that estradiol, through its receptors, mediates the progression of murine SLE, and that in autoimmune disease, the estrogen receptor is functionally and/or structurally changed. Initial studies suggest that there are differences in estrogen receptors between BALB/c mice, which do not get autoimmune disease, and two strains that do, MRL/MP-lpr/lpr and NZB/W mice. In MRL mice, these differences may be reflected in impaired priming of the progesterone receptor.

Helicobacter pylori asociado a vasculitis complicada con lesiones ulcerosas en piel: reporte de un caso / Helicobacter pylori associated with vasculitis cutaneus and with the presence of ulcerous lesions: a case report

Paciente femenina de 16 años de raza blanca y procedente de la ciudad de Maracaibo que inicia su enfermedad actual, en noviembre de 1999 presentando lesiones papulares eritematosas en tobillo izquierdo, que aumentan de tamaño y se ulceran, posteriormente aparecen en tobillo derecho con similares características, en febrero del 2000 acude a medico dermatólogo quien indica tratamiento con esteroide tópico y oral, se practica biopsia de lesión ulcerosa, que reporta vasculitis con necrosis fibrinoide. La paciente no presenta mejoría por lo que se decide suspender tratamiento y realizar pruebas inmunoserológicas las cuales resultan negativas, sin embargo los anticuerpos IgM anti-helicobacter pylori resultan positivos, por lo que se indica tratamiento con metronidazol mas claritromicina, el cual cumple por una semana, con desaparición de lesiones ulcerosas. La relación entre H. pylori y lesiones en piel ha sido reportado por otros autores Neri y col. lo asociaron con prurigo nodularis mientras que Mozrzymas y col. encontraron anticuerpos contra H. pylori en pacientes con púrpura de henoch scholein, en ambos casos los pacientes mejoraron con tratamiento antibiótico. Por lo tanto H. pylori debe ser descartado como agente desencadenante de fenómenos inmunológicos como la vasculitis cuando nos encontramos con una enfermedad inmunológica sin explicación aparente

Evidence for pleomorphism of estrogen receptor capacity and affinity in liver and thymus of immature BALB/c and (NZBxNZW) F1 mice, a model of systemic lupus erythematosus.

Binding properties of estrogen receptors in liver, thymus and uterus of BALB/c and (NZBxNZW) F1 mice were compared. (NZBxNZW) F1 mice spontaneously develop an autoimmune disease resembling human systemic lupus erythematosus (SLE). It is hypothesized that estradiol, through its receptors, mediates the progression of murine SLE. High-speed cytosols were prepared from liver, thymus and uterus and incubated with the synthetic estrogen 3H-moxestrol (NEN). Scatchard plots were derived from binding isotherms obtained. Rectilinear Scatchard plots were obtained from all tissues, which is consistent with the presence of only one class of binding sites, or of more than one class but with the same affinity. There were, however, strain differences in that the affinity of the binding reaction was significantly higher in cytosols from BALB/c liver in males and females. In thymus, the situation was reversed in that the affinity was significantly higher in cytosols from (NZBxNZW) F1 mice. Thymic cytosols from BALB/c mice contained significantly more estrogen receptors per mg cytosol protein than did those from (NZBxNZW) F1 mice. The exacerbation of murine SLE may be due, at least in part, to these properties of estrogen receptors in liver and thymus.

Evaluation of three larval instars of the midge Chironomus petiolatus as bioassay tools using a computationally intensive statistical algorithm.

Sensitivity to toxicants is a major criterion for selecting organisms for bioassay testing. If a sensitive species is also abundant and occupies a role as prey for many other species within a community, then the species become a valuable tool in environmental monitoring. These features apply to larval midge Chironomus petiolatus in freshwater environments of central Chile. The youngest larval instar is the most sensitive and presents the additional feature of lower survival within control arenas, making it more difficult to discern toxicant-related mortality from background mortality. In this work, we perform acute bioassays with the three larval stages of C. petiolatus and K2Cr2O7 as reference toxicant, with the goal of selecting a particular instar as the best bioassay tool using two criteria: sensitivity and background mortality. Sensitivity is evaluated through Monte Carlo estimation of LC50 and background mortality through bootstrap resampling, and a final Bioassay Performance Index as the product of LC50 and background mortality. For this task we developed a new computationally intensive statistical algorithm. Results show that the best bioassay tool is not the youngest and most sensitive instar but an intermediate one.

Tumor-associated glycoprotein expression in salivary gland mucoepidermoid carcinomas: an immunohistochemical study using the monoclonal antibody B72.3.

The monoclonal antibody B72.3 recognizes a mucin-like glycoprotein which is expressed in a variety of human malignancies including adenocarcinomas of the breast, colon, lung, endometrium, pancreas, and ovary. The antibody, an immunoglobulin G (IgG1) subclass monoclonal antibody, was generated from membrane-enriched fractions of metastatic mammary carcinoma. Because the antigen detected by B72.3 is expressed in a broad spectrum of human neoplasms, B72.3 is a potentially useful marker for glandular neoplasms. Despite its potential usefulness, there is only one previous comprehensive study which has examined the distribution of the tumor-associated glycoprotein (TAG-72), as detected by B72.3, in salivary neoplasms. We examined 21 mucoepidermoid carcinomas with the antibody. Twenty (95%) of the 21 carcinomas stained positively. The only carcinoma that did not stain was initially thought to be a high-grade mucoepidermoid carcinoma based on immunohistochemical staining. Further review, however, indicated that this lesion was most likely a pure squamous cell carcinoma, and the absence of TAG-72 antigen expression was helpful in this regard. Among those neoplasms which stained with B72.3, the strongest staining was seen in the low-grade carcinomas. These results suggest that B72.3 may be a useful marker for glandular differentiation in mucoepidermoid carcinomas.

The incidence of p53 mutations increases with progression of head and neck cancer.

To establish a genetic model of the progression of head and neck squamous carcinoma we have defined the incidence and timing of p53 mutations in this type of cancer. We sequenced the conserved regions of the p53 gene in 102 head and neck squamous carcinoma lesions. These included 65 primary invasive carcinomas and 37 noninvasive archival specimens consisting of 13 severe dysplasias and 24 carcinoma in situ lesions. The incidence of p53 mutations in noninvasive lesions was 19% (7/37) and increased to 43% (28/65) in invasive carcinomas. These data suggest that p53 mutations can precede invasion in primary head and neck cancer. Furthermore, the spectrum of codon hotspots is similar to that seen in squamous carcinoma of the lung and 64% of mutations are at G nucleotides, implicating carcinogens from tobacco smoke in the etiology of head and neck squamous carcinoma.