Extragonadal germ cell tumors: prognostic factors and long-term follow-up

The records of 23 patients (22 male and 1 female, median age 28 years) with extragonadal germ cell tumors (EGCT) treated between 1974 and 1993 were reviewed retrospectively to investigate long-term survival and prognostic factors. Treatment consisted of cisplatin-based chemotherapy plus local irradiation or surgery. There were 7 seminomas, 5 poorly differentiated carcinomas (PDC) with elevated biomarkers, and 11 nonseminomatous germ cell tumors (NSGCT). The primary sites were retroperitoneum (10 cases), mediastinum (5 cases), pineal gland (4 cases) and other (4 cases). Two partial and 14 complete responses (69.6% overall) were achieved with primary therapy. After a median follow-up of 63 months, 10 (43.5%) patients live disease-free and 5-year survival is 55%. Seminomas showed an excellent outcome. Retroperitoneal NSGCT behaved like testicular neoplasms. Between nonseminoma patients, PDC histology and mediastinal primary were associated with the worst prognoses. EGCT patients should be treated and reported separately according to histology and primary site.

[The use of sublingual captopril in hypertensive crises]

The purpose of this study was to evaluate the antihypertensive efficacy of captopril (C) and its correlation with body mass index (BMI), age and initial blood pressure (BP) in hypertensive crises. The time of the beginning of the antihypertensive effect of C and its side effects were evaluated. Twenty patients, aged between 22 and 59 years, were included in this investigation. BP was measured after 15 min of rest; age, weight and height were recorded and BMI was calculated using the standard formula (Kg/m2). Patients were not taking antihypertensive medications. After the placebo was given to the patients, BP was measured at 30 and 60 min. Sublingual captopril 25 mg was administered and BP was again measured at 5, 10, 15, 30, 60, 120 y 240 min. There was not statistically significant difference between the values of BP before and after placebo. A significant decrease was observed post C, from 182.6/123.6 to 174.6/117.3 (p:SN/p < 0.02) in 10 min., to 169.9/114.9 (p < 0.04/p < 0.001) in 15 min., to 167.7/112.2 (p < 0.02/p < 0.0001) in 30 min., to 164.3/108.8 (p < 0.002/p < 0.0001) in 60 min., to 156.9/106.5 (p < 0.0001/p < 0.0001) in 120 min., to 161.3/107.0 (p < 0.0002/p < 0.0001) in 240 min. In 15 patients there was a decrease in diastolic BP > or = 5 mmHg, 10 min. post C. No correlation was found between decrease in BP and age, nor with BMI. Pearson r correlation index between the decrease in systolic BP and initial systolic BP was 0.63 (p < 0.003) and between the decrease in diastolic BP and initial diastolic BP, 0.59 (p < 0.005). Secondary effects were mild and well tolerated. In conclusion, C effectively reduced BP in hypertensive crises. Because the efficacy of C, its rapid onset of action and minimal side effects, sublingual Captopril should be considered a first line drug for hypertensive crises.

[Cardiovascular risk factors in a population of schoolchildren in Asturias]

A transversal epidemiological study was carried out to discover the most important cardiovascular risk factors in the child population of Asturias, Spain. The study took place over a period of 4 years (1987-91) and consisted of a representative sample of boys and girls (6-13 years of age) from different socioeconomic and cultural backgrounds. Biochemical factors (serum total cholesterol, HDL-cholesterol, serum triglycerides and glucose) and anthropometric measures to evaluate obesity were analysed. Hypercholesterolemia appeared to be the most prevalent risk factor with a prevalence of 38.27% and a mean value of 178.31 mg/dl, followed by obesity (15.58%), hypertriglyceridemia (14.05%) and hyperglycemia (0.77%). Risk factors were more frequent in girls than boys, and in younger children in relation to older ones. Hypercholesterolemia and obesity were more prevalent in children from an urban environment while hypertriglyceridemia was the main risk factor in those from a rural one. Considering the high prevalence of the evaluated risk factors, the prevention and control of such is of extreme importance in leading children to becoming healthy adults.

[The nuclear roundness factor as a parameter in the anatomoclinical correlation of prostatic carcinoma]

This paper correlates the nuclear roundness factor to clinical stage, patient's age and acid phosphatase level at the time of diagnosis in a group of 48 patients with prostate carcinoma and a minimal follow-up of 5 years. It has been demonstrated that, from an anatomo-clinical point of view, the nuclear roundness factor is a good indicator because it presents increasing values as the clinical stage of tumoral extension worsens, and in those stages where the number of patients was relatively high the average of deaths was always higher than that of survivors. On the other hand, a direct correlation to total acid phosphatase, and an inverse correlation to age at the time of diagnosis was shown in patients with changes in these values.

[Evaluation of nuclear roundness as a tool for prostatic carcinoma grading]

The microscopic patterns adopted by prostate carcinomas are extraordinarily variable making its histopathological classification and grading extremely complicated. There are numerous systems for prostatic tumours' grading, but many of them lack a truly reproducible character and an acceptable degree of reliability; for this reason, we have studied a series of nuclear microscopic parameters, from a quantitative point of view, in a series of prostatic carcinomas with a minimum follow-up of five years. It was observed that of the morphometric values obtained--area, perimeter, projection on the X- and Y-axis as well as the nuclear roundness factor--the most useful and representative is the latter. Besides, this is an objective parameter to evaluate nuclear anaplasia and can also be considered as a prognostic factor since, in our series, those who died had a greater mean nuclear roundness factor than those who survived.

A simple method for gender verification based on PCR detection of Y-chromosomal DNA and its application at the Winter Universiade 1991 in Sapporo City, Japan

A simple and reliable screening method for gender verification at international sports competitions was developed on the basis of detection of Y-chromosomal DNA which was specifically amplified by polymerase chain reaction (PCR). Total DNA obtained from buccal mucous membrane cells by digestion with proteinase K followed by boiling treatment was directly used for the PCR. The amplified product was electrophoresed on an agarose gel staining with ethidium bromide. We adopted three sets of the PCR primer, identifying different regions of Y-chromosome, of which sensitivity and specificity were preliminary evaluated for 228 (112 male, 116 female) DNA samples from lymphocytes. This new method was first applied for the gender verification test at the Winter Universiade 1991 Sapporo, accompanied by traditional microscopic tests for X- and Y-chromatins. No positive results were obtained for 155 female competitors using both the PCR and the microscopic methods. The superiority of the proposed method was clearly shown in the reliability of the results and also in the saving on instrumental and personnel costs as compared to previous cytologic methods.

[Colon and rectum ameboma. Clinico-pathological experience with 3 patients]

Amebas are an uncommon complication of amebic colitis. The specific medical treatment rely on the suspicion and a secure diagnosis that permits to the patient, a better clinical course.

The effects of cyclophosphamide on the gonadotrophic cells of the normal rat

The effects of the administration of cyclophosphamide to male rats at doses of 400 mg/m2 for a period of 5 days and of 200 mg/m2 over two five-day cycles interrupted by a 21-day break reveal differences in the ultrastructural morphology of gonadotrophic cells between treated animals and normal controls. The ultrastructural data obtained coincide with the results obtained from the measurement of serum FSH and LH levels, indicating hypofunction. A significant fall was also recorded in blood testosterone levels. The two types of treatment did not give rise to morphological or functional differences.