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RESUMEN Introducción: El porcentaje de melanomas asociados histológicamente a nevos (MN(+)) varía del 20,6% al 53%. Distintos estudios demuestran que los MN(+) tienen igual o mejor pronóstico que aquellos melanomas que no se asocian a nevos, también llamados melanomas de novo (MN(-)). Objetivo: Comparar la evolución clínica y la supervivencia de MN(-) y MN(+) en el Hospital Privado Universitario de Córdoba, analizando el estudio de ganglio centinela, la supervivencia libre de enfermedad al año y a 5 años y la mortalidad específica por melanoma a 5 años. Materiales y Métodos :Se realizó un estudio retrospectivo, transversal. Se incluyeron pacientes con diagnóstico de melanoma cutáneo realizado por el Servicio de Anatomía Patológica del hospital o con revisión del taco de biopsia en el hospital, desde enero del año 2000 hasta diciembre del 2015. Resultados: De 554 casos de melanoma, se incluyeron 208 melanomas cutáneos, con un seguimiento promedio de 2,44 (0,66 - 5, 35) años. El 47,1% de melanomas fueron MN(+). Los MN(+) se relacionaron de manera estadísticamente significativa con el tipo extensivo superficial, localización en tronco posterior, regresión, menor Breslow y Clark 2. La supervivencia libre de enfermedad a 5 años fue mayor en MN(+) y la ausencia de asociación a nevo fue un factor de riesgo independiente. No se observaron diferencias en edad, sexo, diámetro tumoral, antecedentes de síndrome de nevo displásico, ulceración, mitosis, resultado del estudio de ganglio centinela, supervivencia libre de enfermedad al año, ni mortalidad por melanoma a 5 años.

ABSTRACT Introduction: The percentage of melanomas associated with nevus (NM(+)) ranges from 20,6% to 53%. Some studies suggested that MN+ have the same or even better prognosis than those melanomas that are not nevus-associated. The latter are also called melanomas de novo (MN(-)). Objective: To compare clinical evolution and survival of patients with MN(-) and MN(+) at the University Private Hospital of Cordoba (Argentina), by analyzing sentinel lymph node status, disease-free survival at 1 and 5 years and 5-year melanoma specific mortality. Methods: This is a retrospective, transversal study of patients who were diagnosed with cutaneous melanoma from 2000 until 2015. The biopsy specimen was analyzed or revised by the hospital´s Department of Pathology. Results: Of 554 melanoma cases, 208 cutaneous melanomas were included in the study. The mean follow up was 2,44 (0,66- 5,35) years. MN(+) represented the 47,1% of cases and were significantly correlated with superficial spreading subtype, posterior trunk localization, regression, lower Breslow and Clark 2. 5-year disease-free survival was longer in patients with MN(+) and the absence of associated nevus was an independent risk factor. There were no differences in age, gender, tumor diameter, history of atypical mole syndrome, ulceration, mitosis, sentinel lymph node status, 1-year disease-free survival or 5-year melanoma specific mortality.

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La púrpura de Schönlein-Henoch, es una vasculitis sistémica de pequeños vasos, con depósitos de IgA en las paredes vasculares, que se caracteriza clínicamente por: púrpura palpable, artritis o artralgias, dolor abdominal y compromiso renal. Es más frecuente en niños pero puede presentarse en adultos. La etiología es desconocida, pero se la ha relacionado a infecciones vacunas, fármacos y en adultos a neoplasias. Presentamos el caso de una mujer de 74 años, que había comenzado a tomar losartán diez días previos al comienzo de los síntomas. Para normalización de la tensión arterial, se suspendió el losartán. Al reiniciar la droga, la paciente presentó nuevamente una púrpura palpable, en miembros inferiores.

Schönlein-Henoch purpura is a systemic vasculitis of small vessels with IgA deposits in vessel walls. It presents with palpable purpura, arthritis or arthralgia, abdominal pain and renal involvement. It is more common in children, but it can also be seen in adults. Although, the etiology is unknown, the illness has been associated with infections, vaccines, drugs and, in adults, with neoplasias, as well. A 74 year-old woman who had started taking losartan ten days before she started with the onset of symptoms are reported. Days after, the arterial tension normalized, so losartan was suspended. When the drug was reintroduced, the patient presented once again a palpable purpura on lower limbs.

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La pitiriasis rubra pilaris es un trastorno de la queratinización infrecuente, que se caracteriza por pápulas hiperqueratósicas y queratodermia palmoplantar. Se presenta con igual frecuencia en ambos sexos y tiene aparición bimodal, en la primera década de la vida y luego en la quinta y sexta. Presentamos el caso de una joven que presentó la enfermedad desde los cinco años, con evolución crónica de la misma y que respondió favorablemente al tratamiento tópico.

Pityriasis rubra pilaris is a rare disorder of keratinization, characterized by hyperkeratotic papules and palmoplantar keratoderma. It occurs equally in both sexes and has a bimodal appearance, in the first decade of life and then in the fifth and sixth decade. The classification of this disease represents a challenge due to the variability of the clinical findings. We present the case of a young woman who presented the disease in early age, had a chronic evolution and responded favorably to topical treatment.

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La enfermedad de Hailey-Hailey es un trastorno autosómico dominante, caracterizado por acantólisis de los queratinocitos. Se produce por mutaciones en el gen ATP2C1, que codifica la bomba de Ca++/Mn++ del aparato de Golgi. Clínicamente, se presenta como placas eritematosas con erosiones y fisuras principalmente en pliegues. Es una enfermedad crónica que cursa en brotes. No existen tratamientos específicos ni totalmente efectivos. Se utilizan corticoides y antibióticos tópicos, terapias sistémicas, quirúrgicas y físicas. Se presenta el caso de una paciente con enfermedad auto-limitada y otra, con lesiones extensas con mala adherencia al tratamiento y poca respuesta al mismo.(AU)

Hailey-Hailey disease is an autosomal dominant disorder characterized by acantholysis. It is caused by mutations of ATP2C1 gene encoding the secretory pathway Ca++/Mn++ ATPase localized in Golgi apparatus. It usually presents as erythematous, erosive plaques with fissures at folds and sites of friction. The course is chronic, with relapses and remissions. Treatment options are neither specific nor totally effective for this disease. Topical corticosteroids in combination with antibiotics, systemic, surgical and physical therapy can be used. We report a female patient with self-limited disorder and another one with extensive disease, poor adherence and little response to treatment.(AU)

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La enfermedad de Hailey-Hailey es un trastorno autosómico dominante, caracterizado por acantólisis de los queratinocitos. Se produce por mutaciones en el gen ATP2C1, que codifica la bomba de Ca++/Mn++ del aparato de Golgi. Clínicamente, se presenta como placas eritematosas con erosiones y fisuras principalmente en pliegues. Es una enfermedad crónica que cursa en brotes. No existen tratamientos específicos ni totalmente efectivos. Se utilizan corticoides y antibióticos tópicos, terapias sistémicas, quirúrgicas y físicas. Se presenta el caso de una paciente con enfermedad auto-limitada y otra, con lesiones extensas con mala adherencia al tratamiento y poca respuesta al mismo.

Hailey-Hailey disease is an autosomal dominant disorder characterized by acantholysis. It is caused by mutations of ATP2C1 gene encoding the secretory pathway Ca++/Mn++ ATPase localized in Golgi apparatus. It usually presents as erythematous, erosive plaques with fissures at folds and sites of friction. The course is chronic, with relapses and remissions. Treatment options are neither specific nor totally effective for this disease. Topical corticosteroids in combination with antibiotics, systemic, surgical and physical therapy can be used. We report a female patient with self-limited disorder and another one with extensive disease, poor adherence and little response to treatment.

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We carried out experiments using long-term (5-7 days) exposure of marine phytoplankton species to solar radiation, in order to assess the joint effects of ultraviolet radiation (UVR) and temperature on the photochemical responses and photoprotective mechanisms. In the experiments, carried out at Atlantic coast of Patagonia (43°18.7'S; 65°2.5'W) in spring-summer 2011, we used three species as model organisms: the dinoflagellate Prorocentrum micans, the chlorophyte Dunaliella salina and the haptophyte Isochrysis galbana. They were exposed under: (1) two radiation quality treatments (by using different filters): P (PAR, >400 nm) and PAB (PAR+UV-A+UV-B, >280 nm); (2) two radiation intensities (100% and 50%) and (3) two experimental temperatures: 18 °C and 23 °C during summer and 15 °C and 20 °C in spring experiments, simulating a 5 °C increase under a scenario of climate change. In addition, short-term (4h) artificial radiation exposure experiments were implemented to study vertical migration of cells pre- and non-acclimated to solar radiation. We observed species-specific responses: P. micans displayed a better photochemical performance and a lower inhibition induced by UVR than D. salina and I. galbana. In accordance, P. micans was the only species that showed a synthesis of UV-absorbing compounds (UVACs) during the experiment. On the other hand, non-photochemical quenching (NPQ) was activated in D. salina at noon throughout the exposure, while I. galbana did not show a regular NPQ pattern. This mechanism was almost absent in P. micans. Regarding vertical migration, I. galbana showed the most pronounced displacement to deepest layers since the first two hours of exposure in pre- and non-acclimated cells, while only non-acclimated D. salina cells moved to depth at the end of the experiment. Finally, temperature partially counteracted solar radiation inhibition in D. salina and I. galbana, whereas no effect was observed upon P. micans. In particular, significant UVR and temperature interactive effects were found in I. galbana, the most UVR sensitive species. The joint effects on UVR and temperature, and the species-specific photoprotective responses will affect the trophodynamics and production of aquatic ecosystems in a way that is difficult to predict; however the specificity of the responses suggests that not all phytoplankton would be equally benefited by temperature increases therefore affecting the balance and interaction among species in the water column.

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La plasmocitosis cutánea y sistémica, es un raro trastorno que se caracteriza por infiltración de células plasmáticas policlonales en piel y otros órganos. A continuación, presentamos el caso de un paciente de sexo masculino, de 31 años de edad con antecedentes de infección por HIV, con compromiso óseo frontal y cutáneo. El estudio histopatológico confirmó el diagnóstico, mostrando un infiltrado dérmico perivascular a predominio de células plasmáticas kappa y lambda positivas. En sangre periférica se evidenció una hipergammaglobulinemia policlonal. El paciente presentó remisión espontánea de su enfermedad.(AU)

Cutaneous and systemic plasmocytosis is a rare disorder characterized by a polyclonal plasma cell infiltration in skin and other organs. We report a case of a 31 year old man with a medical history of HIV infection. He had frontal bone and skin involvement. Histopathological examination revealed a perivascular infiltrate composed predominantly of plasma cells expressing kappa and lamba light chains. Laboratory test demonstrated polyclonal hypergammaglobulinemia. The patient had spontaneus remission of his disease.(AU)

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La plasmocitosis cutánea y sistémica, es un raro trastorno que se caracteriza por infiltración de células plasmáticas policlonales en piel y otros órganos. A continuación, presentamos el caso de un paciente de sexo masculino, de 31 años de edad con antecedentes de infección por HIV, con compromiso óseo frontal y cutáneo. El estudio histopatológico confirmó el diagnóstico, mostrando un infiltrado dérmico perivascular a predominio de células plasmáticas kappa y lambda positivas. En sangre periférica se evidenció una hipergammaglobulinemia policlonal. El paciente presentó remisión espontánea de su enfermedad.

Cutaneous and systemic plasmocytosis is a rare disorder characterized by a polyclonal plasma cell infiltration in skin and other organs. We report a case of a 31 year old man with a medical history of HIV infection. He had frontal bone and skin involvement. Histopathological examination revealed a perivascular infiltrate composed predominantly of plasma cells expressing kappa and lamba light chains. Laboratory test demonstrated polyclonal hypergammaglobulinemia. The patient had spontaneus remission of his disease.

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The aim of this study was to assess the combined effects of temperature and UVR on the photosynthesis performance of two diatoms -Chaetoceros gracilis and Thalassiosira weissflogii. In particular, we evaluated the role of UVR in inducing photoinhibition and the potential mitigation of this negative effect by an increase in temperature. Cultures were pre-acclimated at two temperatures - 18°C and 23°C - and exposed to different radiation treatments - UVR+PAR (280-700nm); UV-A+PAR (315-700nm) and PAR only (400-700nm) under two temperatures: 18°C (local surface summer water temperature) and 23°C (simulating a potential increase estimated by the year 2100). Exposure to natural solar radiation resulted in UVR-induced photoinhibition that was significantly higher in T. weissflogii than in C. gracilis. Both species benefited from the higher temperature (23°C) resulting in a lower photoinhibition as compared to samples exposed at 18°C. Inter-specific differences were determined in regard to the heat dissipation processes (NPQ) which were higher at high temperatures, and much more evident in C. gracilis than in T. weissflogii. The analyses of inhibition and recovery rates under different irradiances indicate that the balance between negative (inhibition) and positive (repair-dissipation) effects shifted towards a more positive balance with increasing temperature. Our results highlight for a beneficial effect of temperature on photosynthesis performance during exposure to UVR, although important inter-specific differences are found, probably due to differences in cell size as well as in their distribution within the oceanic realm (i.e., coastal versus oceanic species).

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A method for comparing the relative abilities of different hyperthermia heating modalities to properly heat tumors has been developed using solutions of the bio-heat transfer equation. A single measure, the range of absorbed powers that gives acceptable tissue temperature distributions, is used to characterize the ability of a given heating technique to heat a given tumor. An acceptable tissue temperature distribution is one for which (a) the temperatures in the coolest regions of the tumor are above a minimum therapeutic value, (b) the temperatures in the hottest regions of the tumor do not exceed a maximum clinically acceptable value, and (c) the normal tissue temperatures do not exceed maximum clinically acceptable levels. This measure can be interpreted directly in clinical terms as the range of power settings on the power indicator of a heating device for which acceptable tumor heatings will occur. This paper describes the basis of the method and investigates the role of tumor blood perfusion patterns in determining the size of the acceptable power range. Three tumor perfusion patterns are investigated: uniform tumor perfusion, a concentric annulli perfusion model in which the tumor consists of a necrotic core surrounded by two concentric layers of increased perfusion, and a random perfusion distribution model. The results show that, in general, the uniform and annular perfusion models serve as bracketing case patterns. That is, they give acceptable power range values that are upper and lower limits of the acceptable power ranges obtained for the random perfusion patterns. The method is applied to heating patterns that simulate those obtained from a variety of different available heating techniques, and it is found to be valid for all cases studied. The role of normal tissue limiting conditions is also investigated.

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The acceptable power range technique previously described in a companion paper [R. B. Roemer, T. C. Cetas, J. R. Oleson, S. Halac, and A. Y. Matloubieh, Radiat. Res. 100, 450-472 (1984)] is applied to two heating modalities to demonstrate its application to simulated clinical situations. Comparisons of the abilities of the different modalities to heat given tumors are made using the relative sizes of the acceptable power ranges obtained for each modality. Similar comparisons are also possible for determining the efficacy of physiological manipulations and adjustments in power deposition patterns for a given heating modality. Predictions of the ability of modalities and configurations to properly heat tumors are made using the bracketing nature of the uniform and annular tumor perfusion models. These comparisons and predictions are possible because a single measure of the ability of any heating technique to heat an arbitrary tumor in any location is utilized (the size of the acceptable power range). While relatively simple models are presently utilized, this approach can be extended to take into account a host of physical and biological conditions that model the patient-device interaction to an arbitrarily high degree of detail. These refinements will be based on extended clinical and experimental data, particularly as tumor and normal tissue blood perfusion characteristics either become better known in general cases or can be specified for each real tumor. The applications of this approach should be far-reaching and complementary to clinical hyperthermia, especially as further model refinements are incorporated. Additional data are presented which reinforce the bracketing nature of the uniform and annular tumor perfusion models presented in the companion paper.

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The temperature distributions in deep seated tumors resulting from uniform heating of the abdominal and pelvic regions of the trunk are predicted from a one dimensional numerical solution of the bio-heat transfer equation. The effect of tumor size and location are investigated for two tumor perfusion models: uniform perfusion and a concentric annulus perfusion model. Tumor temperature distributions are considered acceptable if the range of temperatures in the tumor lie between 42 degrees C and 60 degrees C. This range of tumor temperatures is defined as Tave +/- 2 sigma where sigma is the population standard deviation of tumor temperatures from the average computed at the nodal points in the finite difference array. To simulate practical clinical restrictions, muscle and fat temperatures are not allowed to exceed 44 degrees C, significant portions of the viscera are not allowed to exceed 42 degrees C, and the total absorbed power required to maintain steady state cannot exceed two kilowatts. Over 100 possible cases are presented in a compact form. From this study it appears that heating systems with power deposition patterns approximately uniform are promising for heating deep-seated tumors. Small, detectable tumors (approximately 2 cm in size) are adequately heated for a wider range of conditions than are larger tumors. Excessively high temperatures in deep-seated, normal tissue could be a significant limitation for this technique.

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A one dimensional (radial) numerical model based on the bioheat transfer equation has been developed and applied to the abdomen and pelvis heated by a concentric magnetic induction electrode. This model consists of four normal tissue regions: viscera, muscle, fat and skin. Each region is assigned thermal properties characteristic of that region and power deposition values consistent with those for this mode of heating. Tumors of 2, 4 and 7 cm thicknesses are positioned in five different radial locations ranging from the central axis to the skin surface. Two blood perfusion models of the tumor are considered: the uniformly perfused model and an annular model. Tumor temperature distributions are considered acceptable if the average tumor temperature plus and minus two standard deviations lie between 42 degrees C and 60 degrees C. To stimulate practical clinical restrictions, muscle and fat temperatures are not allowed to exceed 44 degrees C, significant portions of the viscera (except for a 1 cm thick band) are not allowed to exceed 42 degrees C, and the total absorbed power required to maintain steady state cannot exceed one kilowatt. Over 100 possible cases are presented in a compact form. A conclusion drawn from this study is that with few exceptions, only small tumors in the muscle annulus are heated adequately with this modality. Large tumors will have significant unheated portions if the specified limitations are not exceeded. While this heating modality can raise the necrotic core of a tumor to high temperatures, it cannot adequately heat well perfused regions of a deep seated tumor. These conclusions are borne out clinically and are discussed in a companion paper.

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