Influencia de la concentración de ácido hialurónico, citosólico y de membrana, sobre ciertas propiedades clinicobiológicas de los carcinomas ductales infiltrantes de mama CD44v6 positivos / Influence of cytosolic and membrane hyaluronic acid on certain clinical and biological properties of CD44v6-positive infiltrating ductal breast carcinomas

Introducción. El CD44v6 es una isoforma de la molécula de adhesión CD44 cuyo principal ligando es el ácido hialurónico. Hemos querido estudiar la posible asociación entre las concentraciones de ácido hialurónico, citosólico y de membrana, y ciertas propiedades clinicobiológicas de los carcinomas ductales infiltrantes de mama (CDI) CD44v6 positivos. Pacientes y métodos. Hemos estudiado, en 63 casos y con métodos inmunológicos, las concentraciones citosólicas de receptores de estrógenos, de progesterona, pS2, activador del plasminógeno tipo tisular (t-AP) y catepsina D, así como las del receptor del factor de crecimiento epidérmico y proteína erbB2/neu en las membranas celulares. Asimismo, tuvimos presente el estado menopáusico, tamaño, afectación ganglionar, ploidía, fase de síntesis celular y grado histológico. Resultados. Los tumores de membrana negativos para ácido hialurónico (< 1.500 ng/mg de proteína) presentaron menores concentraciones (p = 0,005) y porcentaje de positividades (p = 0,000) para los receptores de estrógenos, no se asociaron al estado premenopáusico (p = 0,044), fueron más frecuentemente aneuploides (p = 0,022), proliferativos (p = 0,008) y cursaron con invasión axilar superior a 3 ganglios (p = 0,048). Los tumores citosólicos negativos para ácido hialurónico (< 4.800 ng/mg de proteína) mostraron menores concentraciones de t-AP (p = 0,005) y de los receptores del factor de crecimiento epidérmico (p = 0,028), y fueron más frecuentemente aneuploides (p = 0,028). Conclusiones. Los resultados anteriores sugieren que la concentración de ácido hialurónico, tanto en membrana como en citosol, parece asociarse a ciertas propiedades clinicobiológicas de los CDI/CD44v6 positivos reflejando las menores concentraciones del proteoglicano, un fenotipo más indiferenciado y hormonoindependiente. Asimismo, resaltan el valor del ácido hialurónico y su receptor como una unidad funcional, y podrían explicar las discrepancias descritas en la bibliografía cuando se consideran aisladamente cada uno de ellos (AU)

[Estimating the angiographic risk from isotopic ventriculography in ischemic heart disease]. / Estimación del riesgo angiográfico a partir de la ventriculografía isotópica en cardiopatía isquémica.

The objective of this study was to determine the diagnostic accuracy of the ejection fraction (EF) measurement, calculated by isotopic ventriculography, to predict the angiographic risk in a group of patients with previous acute myocardial infarction and significant segmentary disturbance of wall motility. A total of 125 patients were studied (100 males and 25 females, aged 23 to 78 years). Isotopic EF showed positive and negative predictive values of 85% and 93.3%, respectively, for the low risk group. The corresponding values for the moderate risk group (angiographic EF from 31% to 54%) were 80.3% and 79.6%. And for the high risk group (angiographic EF < 31%) 89.4% and 83%. In conclusion, from the present work we state that with a high probability isotopic EF places each patient in his/her corresponding high, moderate, or low angiographic (biological) risk.

[Relation between frontal lobe blood flow and cognitive performance in Huntington's disease]. / Relación entre flujo sanguíneo cerebral frontal y rendimiento cognitivo en la enfermedad de Huntington.

The aim of this study was to trace the possible relation between degree of cognitive impairment in Huntington's disease (HD) and cortical cerebral blood flow. We studied 18 patients with genetically confirmed HD, evaluating clinical signs and performance on neuropsychological tests. SPECT with 99mTc-HMPAO was used to quantify regional cerebral blood flow (rCBF) in 8 regions in each hemisphere. We found no correlation between clinical or cognitive variables and rCBF in temporal, parietal or occipital areas. Cognitive performance on several tasks correlated significantly with rCBF (p < 0.05 or p < 0.01) in numerous frontal areas with the exception of orbital gyri. These data suggest that frontal lobe dysfunction is implicated in the pathogenesis of cognitive impairment in HD, and that such impairment can be explained by the involvement of frontal-subcortical loops.

[The potential usefulness of MIBI-99mTc SPECT at rest in identifying viable myocardium after a myocardial infarct]. / Utilidad potencial del SPECT con MIBI-99mTc en reposo en la identificación de miocardio viable tras un infarto de miocardio.

We present a 65 years-old female with a silent anterior myocardial infarction. A coronary angiogram showed a left ventricle with akinesia of segments anterior, lateral and apex. Left anterior descending artery showed a unique 95% lesion. The patient was discharged with medical treatment. Two months later the patient was readmitted with atypical angina. She was submitted to tomographic study (SPECT), with 99mTc-hexakis-2-methoxy-isobutyl-isonitrile (MIBI-99mTc) at rest. The images showed a wide area of hypocaptation in the territory of the left anterior descending artery but with differences among the different segments. This image was interpreted as suggestive of necrotic and viable myocardium. A second coronary angiogram yielded the same findings as in the first study. It was performed a successful PTCA on the left anterior descending artery lesion. A new SPECT study was performed 9 days later that showed a significant improvement of perfusion in some of the myocardial segments and a significant decrease of the internal left ventricular diameter. Isotopic left ventricular ejection fraction showed an increase from 25 to 35%. The present case suggests that the study with SPECT and MIBI-99mTc at rest may be potentially useful in the identification of viable myocardium after a myocardial infarction and assesses the importance of revascularization of the culprit artery with severe residual narrowing.

[Hematologic significance of erythrocytic macrocytosis: prospective analysis of 109 successively studied cases]. / Significación hematológica de la macrocitosis eritrocítica: análisis prospectivo de 109 casos sucesivamente estudiados.

The aim of the present work was to perform a prospective analysis of the significance of macrocytic red cells through the study of all patients with MCV higher than 105 fl (those treated with cytotoxic or immunosuppressing drugs were excluded). Conventional clinical, haematologic and biochemical studies were carried out on every patient, along with B12 and folate levels, bone marrow examination and bone marrow karyotype and, whenever B12 deficiency was present, complete Schilling's test. Special attention was paid to the aetiological inquiry and post-therapeutical course. A series of 109 patients was collected. Decreased serum B12 rates with abnormal Schilling's test and response to parenteral therapy were present in 26 cases (24%). Of them, 22 fulfilled the diagnostic criteria for Biermer's anaemia, while in the remaining 4 there was impaired intestinal absorption. Serum or red-cell folate deficiency was found in 34 other cases (31%). Alcoholism was present in 20 of them, abnormal diet in 10, malabsorption syndrome in 2, and excessive demands in 2 others. Hence, vitamin deficiency underlay macrocytosis in 60/109 cases (55%). In the remaining 49 cases (45%) macrocytosis was not accompanying folate or B12 deficiency. Of these, severe liver disease was found in 16 patients (alcoholic in 15 and post-hepatitis in 1 case), with increased serum B12 in 10 cases and increased serum or erythrocytic folate in 3 others. Nineteen patients within this group had primary myelodysplastic syndromes (RA, 8; SRA, 4; RAEB, 7), and the remaining 14 cases had several haematological (AIHA, 4; CLL, 1, T-cell lymphoma 1, M-6, 1, and myelofibrosis with myeloid metaplasia, 2) or non-haematological diseases (heart insufficiency, 2; COPD,3).(ABSTRACT TRUNCATED AT 250 WORDS)

[Hormone dependence in functional thyroid cancers, survival after total thyroidectomy combined with radioactive iodine and thyroid extract therapy]. / Hormonodependenica en los cánceres tiroideos fwctionales. Supervivencia con tiroidectomía total asociada a terapéutica con iodo radiactivo y extractos tiroideos

The authors reviewed current criteria on hormone-dependence in functional thyroid cancers, presenting data of compared disease evolution based on the casuistics of thyroid carcinomas from the files of the Fundación Jiménez Díaz, with 5 and 10 year follow-up studies in some of the cases. They found a higher number of survivors among the patients with papilliferous carcinoma in both 5 and 10 year follow-up groups whom, aside total surgical removal of the gland and the administration of thyroid extracts, those who had thyroid residues left were given 100 mc of 131I. Among the patients with follicular adenocarcinoma, under the same comparative conditions, differences were not very clear in the 5 year follow-up group, while the 10 year follow-up group showed marked differences. The authors conclude that an adequate combination of the three therapeutic procedures may allow a higher survival rate.