Aspectos de mi ideario personal : una conversación filosófica con Juan Schobinger

Fil: Vázquez, Juan Adolfo. Universidad Nacional de Cuyo

Androgen receptors are differentially expressed in Gleason patterns of prostate cancer and down-regulated in matched lymph node metastases

Androgen receptor (AR) expression profile in the different Gleason patterns (GP) of primary prostate cancers and nodal metastases is unknown. More information about AR distribution is needed to optimize evaluation methods and to better understand the role of AR in development and progression of prostate cancer.

How reliable is Ki-67 immunohistochemistry in grade 2 breast carcinomas? A QA study of the Swiss Working Group of Breast- and Gynecopathologists

Adjuvant chemotherapy decisions in breast cancer are increasingly based on the pathologist's assessment of tumor proliferation. The Swiss Working Group of Gyneco- and Breast Pathologists has surveyed inter- and intraobserver consistency of Ki-67-based proliferative fraction in breast carcinomas. Methods Five pathologists evaluated MIB-1-labeling index (LI) in ten breast carcinomas (G1, G2, G3) by counting and eyeballing. In the same way, 15 pathologists all over Switzerland then assessed MIB-1-LI on three G2 carcinomas, in self-selected or pre-defined areas of the tumors, comparing centrally immunostained slides with slides immunostained in the different laboratoires. To study intra-observer variability, the same tumors were re-examined 4 months later. Results The Kappa values for the first series of ten carcinomas of various degrees of differentiation showed good to very good agreement for MIB-1-LI (Kappa 0.56–0.72). However, we found very high inter-observer variabilities (Kappa 0.04–0.14) in the read-outs of the G2 carcinomas. It was not possible to explain the inconsistencies exclusively by any of the following factors: (i) pathologists' divergent definitions of what counts as a positive nucleus (ii) the mode of assessment (counting vs. eyeballing), (iii) immunostaining technique, and (iv) the selection of the tumor area in which to count. Despite intensive confrontation of all participating pathologists with the problem, inter-observer agreement did not improve when the same slides were re-examined 4 months later (Kappa 0.01–0.04) and intra-observer agreement was likewise poor (Kappa 0.00–0.35). Conclusion Assessment of mid-range Ki-67-LI suffers from high inter- and intra-observer variability. Oncologists should be aware of this caveat when using Ki-67-LI as a basis for treatment decisions in moderately differentiated breast carcinomas.

Consensus Document of the International Union of Angiology (IUA)-2013. Current concept on the management of arterio-venous management

Arterio-venous malformations (AVMs) are congenital vascular malformations (CVMs) that result from birth defects involving the vessels of both arterial and venous origins, resulting in direct communications between the different size vessels or a meshwork of primitive reticular networks of dysplastic minute vessels which have failed to mature to become 'capillary' vessels termed "nidus". These lesions are defined by shunting of high velocity, low resistance flow from the arterial vasculature into the venous system in a variety of fistulous conditions. A systematic classification system developed by various groups of experts (Hamburg classification, ISSVA classification, Schobinger classification, angiographic classification of AVMs,) has resulted in a better understanding of the biology and natural history of these lesions and improved management of CVMs and AVMs. The Hamburg classification, based on the embryological differentiation between extratruncular and truncular type of lesions, allows the determination of the potential of progression and recurrence of these lesions. The majority of all AVMs are extra-truncular lesions with persistent proliferative potential, whereas truncular AVM lesions are exceedingly rare. Regardless of the type, AV shunting may ultimately result in significant anatomical, pathophysiological and hemodynamic consequences. Therefore, despite their relative rarity (10-20% of all CVMs), AVMs remain the most challenging and potentially limb or life-threatening form of vascular anomalies. The initial diagnosis and assessment may be facilitated by non- to minimally invasive investigations such as duplex ultrasound, magnetic resonance imaging (MRI), MR angiography (MRA), computerized tomography (CT) and CT angiography (CTA). Arteriography remains the diagnostic gold standard, and is required for planning subsequent treatment. A multidisciplinary team approach should be utilized to integrate surgical and non-surgical interventions for optimum care. Currently available treatments are associated with significant risk of complications and morbidity. However, an early aggressive approach to elimiate the nidus (if present) may be undertaken if the benefits exceed the risks. Trans-arterial coil embolization or ligation of feeding arteries where the nidus is left intact, are incorrect approaches and may result in proliferation of the lesion. Furthermore, such procedures would prevent future endovascular access to the lesions via the arterial route. Surgically inaccessible, infiltrating, extra-truncular AVMs can be treated with endovascular therapy as an independent modality. Among various embolo-sclerotherapy agents, ethanol sclerotherapy produces the best long term outcomes with minimum recurrence. However, this procedure requires extensive training and sufficient experience to minimize complications and associated morbidity. For the surgically accessible lesions, surgical resection may be the treatment of choice with a chance of optimal control. Preoperative sclerotherapy or embolization may supplement the subsequent surgical excision by reducing the morbidity (e.g. operative bleeding) and defining the lesion borders. Such a combined approach may provide an excellent potential for a curative result. Conclusion. AVMs are high flow congenital vascular malformations that may occur in any part of the body. The clinical presentation depends on the extent and size of the lesion and can range from an asymptomatic birthmark to congestive heart failure. Detailed investigations including duplex ultrasound, MRI/MRA and CT/CTA are required to develop an appropriate treatment plan. Appropriate management is best achieved via a multi-disciplinary approach and interventions should be undertaken by appropriately trained physicians.

Prognostic factors in lymph node metastases of prostatic cancer patients: the size of the metastases but not extranodal extension independently predicts survival

AIMS: To analyse tumour characteristics and the prognostic significance of prostatic cancers with extranodal extension of lymph node metastases (ENE) in 102 node-positive, hormone treatment-naive patients undergoing radical prostatectomy and extended lymphadenectomy. METHODS AND RESULTS: The median number of nodes examined per patient was 21 (range 9-68), and the median follow-up time was 92 months (range 12-191). ENE was observed in 71 patients (70%). They had significantly more, larger and less differentiated nodal metastases, paralleled by significantly larger primary tumours at more advanced stages and with higher Gleason scores than patients without ENE. ENE defined a subgroup with significantly decreased biochemical recurrence-free (P = 0.038) and overall survival (P = 0.037). In multivariate analyses the diameter of the largest metastasis and Gleason score of the primary tumour were independent predictors of survival. CONCLUSIONS: ENE in prostatic cancer is an indicator lesion for advanced/aggressive tumours with poor outcome. However, the strong correlation with larger metastases suggests that ENE may result from their size, which was the only independent risk factor in the metastasizing component. Consequently, histopathological reports should specify the true indicator of poor survival in the lymphadenectomy specimens, which is the size of the largest metastasis in each patient.

Survival in surgically treated, nodal positive prostate cancer patients is predicted by histopathological characteristics of the primary tumor and its lymph node metastases

BACKGROUND: Histopathological risk factors for survival stratification of surgically treated nodal positive prostate cancer patients are poorly defined as reflected by only one category for nodal metastases. METHODS: We evaluated biochemical recurrence-free survival (RFS), disease-specific survival (DSS), and overall survival (OS) in 102 nodal positive, hormone treatment-naïve prostate cancer patients (median age: 65 years, range: 45-75 years; median follow-up 7.7 years, range: 1.0-15.9 years) who underwent radical prostatectomy and standardized extended lymphadenectomy. RESULTS: A significant stratification was possible, with the Gleason score of the primary and virtually all nodal parameters favoring patients with better differentiated primaries and metastases, lower nodal tumor burden, and without extranodal extension of metastases. In multivariate analyses, diameter of the largest metastasis (< or =10 mm vs. >10 mm) was the strongest independent predictor for RFS (P < 0.001), DSS (P < 0.001), and OS (P < 0.001) with a more than quadrupled relative risk of cancer related deaths for patients with larger metastases (Hazard ratio: 4.2, Confidence interval: 2.0-8.9; 5-year RFS/DSS/OS: 18%/57%/54%). The highest 5-year survival rates were seen in patients with micrometastases only (RFS/DSS/OS: 47%/94%/94%). CONCLUSION: The TNM classification's current allocation of only one category for nodal metastases in prostate cancers is unsatisfactory since subgroups with significantly different prognoses can be identified. The diameter of the patient's largest metastasis (< or =10 mm vs. >10 mm) should be used for substaging because of its independent prognostic value. The substage "micrometastasis only" is also useful in nodal positive prostate cancer since it designates the subgroup with the most favorable outcome.

Breve curriculum vitae de Juan Adolfo Vázquez

Fil: Schobinger, Juan. Universidad Nacional de Cuyo

Las últimas publicaciones de Juan Adolfo Vázquez : breve comentario

Se menciona brevemente la producción escrita de Juan Adolfo Vázquez, y se presentan sus dos libros editados recientemente en Mendoza: Ensayos Humanistas (2001) y The Sacred (2004). El primero es una recopilación de artículos sobre temas diversos publicados en revistas y órganos periodísticos de la Argentina; el segundo reproduce artículos y reseñas bibliográficas (algunas muy extensas) que formaron parte originalmente de dos revistas fundadas por Vázquez durante sus décadas de labor en la Universidad de Pittsburgh (Latin American Indian Literatures Journal y Naos, dedicada ésta al “estudio lingüístico de lo Sagrado"). Aunque no se dice expresamente, ambos libros constituyen de algún modo un reflejo de lo que el autor ha llamado “Filosofía antropológica".

Las culturas nativas de Mendoza

Con el fin de conocer las últimas interpretaciones acerca de nuestro pasado regional, los videos de la serie "Mendoza, crónica de nuestra identidad", pretenden llevar adelante la tarea constante de construir y reconstruir una identidad que se mantenga abierta a los valores del pasado, pero también a la inevitable reformulación crítica de los mismos principios. La propuesta es generar un proceso de actualización y perfeccionamiento en el campo de la historia regional. En el video CULTURAS NATIVAS DE MENDOZA, se describe como la provincia formó su identidad a partir del trabajo de sus primeros habitantes, los huarpes, hasta la composición de su economía. El desierto mendocino, ha impuesto su hostilidad natural, condicionando al hombre y haciendo necesaria una cultura de lucha contra la adversidad de vastas tierras secas y calientes, por lo cual la creatividad, el sacrificio y la afición al trabajo han sido imprescindibles para desarrollar diversas tecnologías, como los sistemas de riego, las acequias, que transformaron el desierto en un lugar apto para vivir: la Mendoza actual. Los 3 bloques del documental, abordan los siguientes temas: - Los antiguos habitantes del continente. - Los cazadores y recolectores. - Los primeros agricultores. - La influencia del imperio incaico en la región. - Las diferentes culturas de la región.

El simbolismo de las figuras circulares

Dado que las formas circulares se encuentran en innumerables representaciones simbólicas de la cultura material que ha dejado el ser humano a su paso, y se encuentran en diferentes tiempos, espacios y culturas, en este trabajo se aborda el tema del simbolismo de estas formas circulares y del círculo en particular, analizando cada una de sus partes constitutivas y lo que ellas simbolizan como manifestaciones y símbolos de una realidad trascendente. Moray, un yacimiento arqueológico ubicado en el Área Andina, construido según la forma de los círculos concéntricos, es el ejemplo tomado como construcción circular. Se abordan, además, temas afines que tienden a ampliar la exposición del tema central, como son el de los de espacios sagrados, los templos escalonados y la cosmovisión indígena americana.

Gestión del patrimonio arqueológico rupestre de la margen sur del Río Negro

Esta tesis propone la gestión cultural del patrimonio arqueológico rupestre de la margen sur del Río Negro. Para la elaboración se han tenido en cuenta los debates que se plantearon a partir de los años ochenta, en relación a la necesidad de abordar el patrimonio cultural a través de nuevas formas de gestión, dando lugar, como consecuencia, al surgimiento de ideas como la de difusión de los valores del patrimonio y de diferentes formas de uso turistico, como una herramienta que posibilita su revalorización y por consiguiente una apreciación desde el punto de vista social que involucra un reclamo de protección y valorización del recurso. Se toma como caso el sitio Cañadón El Arenoso, y el paisaje que lo circunda, considerando que el valor del arte en él encontrado y el deterioro al que se halla expuesto explica la necesidad de estudios sitemáticos dentro de un marco de desarrollo sustentable, para lo cual se propone un plan de manejo.

Die Philosophie des 17. Jahrhunderts /

"Gesamtvorwort" (xx p.) inserted in v. 2, pt. 1 and v. 3, pt. 1.