Neuroendocrine pancreatic tumors are rare and account for 3 % of pancreatic tumors approximately. Almost 85 % of them are non-functioning, generally big, located in the intrapancreatic region and diagnosed at advanced staging. Its highest incidence is found in males over 50 years of age. Its symptoms may include abdominal pain, loss of weight and jaundice. The objective of this article was to present an 18 years-old man affected by increase volume in upper hemiabdomen with no relation with other symptoms. On the conclusion of the studies, he was diagnosed with neuroendocrine carcinoma of the pancreatic body, an unusual entity at this age and sex, and he required to undergo distal pancreatectomy with splenectomy.

Los tumores pancreáticos neuroendocrinos son raros y representan aproximadamente de menos del 3 % de los tumores pancreáticos. Cerca del 85 % de ellos son no funcionantes y son de localización intrapancreática y característicamente grandes, por lo que se diagnostican generalmente en estadios avanzados. Tienen mayor incidencia en el sexo masculino y en mayores de 50 años. Se presentan clínicamente con síntomas debidos al tumor per se, que pueden incluir dolor abdominal, pérdida de peso o hictericia. El objetivo de este trabajo es presentar el caso de una paciente de 18 años que aquejó de aumento de volumen del hemiabdomen superior sin asociarse a otros síntomas, al concluir el estudio se diagnosticó carcinoma neuroendocrino de cuerpo de páncreas, entidad poco frecuente en esta edad y sexo, por lo cual requirió pancreatectomía distal con esplenectomía.

Introduction: pancreatic cancer is one of the most deadly cancers; it ranks the 5th place in frequency in the Western countries and its associated survival is under 20 % annually and lower than 3 % at 5 years. The only chance for healing is surgery, usually complex interventions with high morbidity and mortality rates. Objetive: to characterize patients by demographic features, associated diseases, and clinical manifestations, and to identify more valuable studies for diagnosis and related peroperative variables associated with complications, mortality and evolution. Methods: prospective, longitudinal and observational study was conducted on patients diagnosed with pancreatic and periampular tumors, who were treated at the general surgery service of "Hermanos Ameijeiras" clinical and surgical hospital from January 2006 through December 2011. Results: a total of 215 patients with pancreatic tumors, 178 periampular lesions and 37 injures in the body and the pancreas head. Twenty four distal pancreatic lesions were resected whereas 153 periampular locations, 83 of them were ablated. There were 78 cephalic pancreatoduodenectomies and most frequent localization was Vater ampoule in 36 patients (50.7 %), followed by the head of the pancreas in 26 patients (36.6 %). Complications were found on 66.2 % of cases. Perioperative mortality rate was 4.2 % whereas hospital mortality amounted to 23.9 %. Conclusions: periampular tumors were more common in patients aged 50 to 69 years; the most related disease was high blood pressure and the fundamental symptom was jaundice. Endoscopic retrograde cholangiopancreatography was the most sensible paraclinical test. In-hospital mortality was associated to related diseases, surgical time, blood transfusions and complications.

Introducción. el cáncer pancreático es una de las neoplasias más letales, ocupa el quinto lugar en frecuencia en occidente y tiene una supervivencia asociada inferior al 20 % al año y al 3 % a los 5 años. La única posibilidad de curación la brindan intervenciones quirúrgicas de gran envergadura que conllevan una alta tasa de morbilidad y mortalidad. Objetivo: caracterizar a los pacientes según variables demográficas, enfermedades asociadas y manifestaciones clínicas, e identificar estudios de mayor valor para el diagnóstico y la relación entre las variables perioperatorias y la aparición de complicaciones, mortalidad hospitalaria y evolucion posoperatoria. Métodos. se realizó un estudio observacional, longitudinal y prospectivo con pacientes con tumores pancreáticos y periampulares que fueron tratados en el Servicio de Cirugía General del Hospital Clínico Quirúrgico "Hermanos Ameijeiras" entre enero de 2006 y diciembre de 2011. Resultados. hubo un total de 215 pacientes con tumores de páncreas: 178 lesiones periampulares y 37 lesiones del cuerpo y la cola de páncreas. Se resecaron 24 lesiones pancreáticas distales y fueron intervenidos quirúrgicamente 153 pacientes con lesiones periampulares, de las cuales se resecaron 83. Se realizaron 78 pancreatoduodenectomías cefálicas y la localización más frecuente fue la ampolla de Vater (36 pacientes, 50,7 %), seguida de la cabeza del páncreas (26 pacientes, 36,6 %). Hubo complicaciones en el 66,2 % de los pacientes. La mortalidad perioperatoria fue del 4,2 % y la hospitalaria del 23,9 %. Conclusiones. los tumores periampulares fueron más frecuentes entre los 50 y 69 años. La enfermedad asociada más frecuente fue la hipertensión arterial, y la ictericia, el síntoma fundamental. La colangiopancreatografía retrógrada endoscópica fue el examen de mayor sensibilidad. La mortalidad hospitalaria estuvo relacionada con las enfermedades asociadas, el tiempo quirúrgico, la transfusión sanguínea operatoria y las complicaciones.

Primary and secondary liver resections have transoperative bleeding as one of its major dilemmas. The introduction of radiofrequency equipment, mainly Surtron SB, begins to bring about encouraging results. The first eight cases of minor and major resections in Cuba by using this piece of equipment were presented. Seven patients had metastasis and one hepatocarcinoma. Two standard and 6 atypical resections were performed with no complications and just one patient needing blood transfusion.

Las resecciones primarias y secundarias del hígado tienen como uno de sus mayores dilemas el sangrado transoperatorio. La introducción de los equipos de radiofrecuencia, en particular el Surtron SB, comienza a dar resultados alentadores. Se presentan las primeras 8 experiencias cubanas con resecciones menores y mayores realizadas con este equipo. Siete de estos pacientes tenían metástasis y uno un hepatocarcinoma. Se practicaron 2 resecciones regladas y 6 atípicas, durante las cuales no hubo complicaciones y solo un paciente necesitó transfusión sanguínea.

Pseudomyxoma peritonei, a disease of recurrent progression with variable malignant potential, is characterized by pressing gelatinous ascytis and frequently by generalized peritoneal invasion. During many years, it was considered as untreatable and incurable disease; however, in the last few decades, very specialized centers have focused on the radical and multimodal treatment of this disease with a view to curing it. Here is the case of a 43 years-old patient with advanced appendicealpseudomyxoma that recovered well after an aggressive treatment.

El pseudomixoma peritoneal es una enfermedad de evolución recurrente y potencial maligno variable, caracterizada por ascitis gelatinosa disecante y, habitualmente, invasión peritoneal generalizada. Durante muchos años fue considerada una enfermedad intratable o incurable, y solo en las últimas décadas -y en centros muy especializados- se ha enfocado con un tratamiento radical y multimodal con miras a lograr la curación. Se presenta el caso de un varón de 43 años con un pseudomixoma de apéndice avanzado, que evolucionó bien después de un tratamiento agresivo.

The first kidney transplantation performed in Cuba in an adult recipient that was implanted both kidneys from a 2-year-old donor who died of a cranioencephalic trauma was presented. Data of the transplantation as well as the technique of implant and the immunosupression used and the satisfactory clinical, humoral and imaging evolution of the immediate postransplant were explained. The admission of a female patient due to megalovirus that complicated her further evolution, its satisfactory solution, and the present state of the patient that is attended at the outpatient department were also taken into account. It was proved that the dual transplantation of pediatric kidneys into an adult recipient is a valid option for treating patients with end-stage kidney failure in our environment.

Se presentó el primer trasplante renal realizado en Cuba a un receptor adulto al cual se le injertaron ambos riñones de un donante de 2 años de edad fallecido por un trauma craneoencefálico; se expusieron los datos del trasplante así como la técnica de implante, inmunosupresión utilizada y la evolución clínica, humoral e imagenológica del postrasplante inmediato, que fue satisfactoria. Se tuvo en cuenta, además, un ingreso por enfermedad por citomegalovirus que complicó la evolución ulterior de la enferma, resuelto satisfactoriamente, así como el estado actual de la misma atendida en consulta externa. Se demostró que el doble trasplante renal de injertos procedentes de niños a un receptor adulto constituye en nuestro medio una opción valedera para el tratamiento de enfermos con insuficiencia renal terminal.

Pancreatic cancer is the fifth cause of death from cancer. Pancreaticoduodenectomy is considered as the only possibility of cure for this disease at present. A prospective study conducted among 18 patients with the diagnosis of periampullar tumor that were operated on from October, 1996, to January, 2000, is presented. It was found that the affection is frequently associated with diabetes mellitus and that the most diagnosed histic types were pancreatic adenocarcinoma and ampuloma. The endoscopic retrograde cholangiopancreatography was the most useful complementary study and reached a sensitivity of 94 % in the diagnosis. It was observed a direct relationship between the perioperatively transfused blood volume and mortality. Total morbidity was 50 %. Mortality has decreased in comparison with pevious years. Long-term survival is still low.

El cáncer de páncreas constituye la quinta causa de muerte por cáncer. En la actualidad se considera que la única posibilidad de curación para la enfermedad es la pancreatoduodenectomía. En el trabajo se expone un estudio prospectivo realizado con 18 pacientes operados, desde octubre de 1996 hasta enero del 2000, con el diagnóstico de tumor periampular. En la serie se halló que la afección se asocia frecuentemente con la diabetes mellitus y que los tipos hísticos más diagnosticados fueron el adenocarcinoma de páncreas y el ampuloma. La colangiopancreatografía retrógrada endoscópica fue el estudio complementario más útil, y alcanzó una sensibilidad del 94 % en el diagnóstico. Se encontró una relación directa entre el volumen de sangre trasfundido perioperatoriamente y la mortalidad. La morbilidad global fue de 50 %. La mortalidad ha disminuido en relación con años anteriores. La supervivencia a largo plazo sigue siendo baja.

No presente trabalho estudaram-se dois processos de semeadura, a direta e a convencional, para as culturas de soja (Glycine max (L.) Merrill) e trigo (Triticum aestivum L.) plantadas num mesmo ano. Ênfase especial foi dada ao problema das máquinas utilizadas nos dois sistemas de semeadura, caracterizando-se os diversos parâmetros envolvidos. Montou-se um ensaio de campo na Fazenda Canadá, município de Assis, no período 1979-82, com três safras para as duas culturas. Para o trigo, os tratamentos foram: preparo convencional (grade pesada e grade niveladora) e semeadura direta. Para a soja: convencional mais escarificação; convencional; aração e gradeação; aração e gradeação mais escarificação e semeadura direta. Os resultados mostraram que a interação entre os tratamentos aplicados numa cultura e os aplicados na cultura seguinte não foi significativa, não havendo também influência de preparo de solo para soja sobre a produção de trigo, exceto no ano agrícola 1981/82, em que as produções de soja sofreram influência do tipo de preparo de solo para a semeadura do trigo. A economia de combustível foi bastante significativa na semeadura direta das duas culturas. As máquinas para semeadura direta devem ser articuladas para que possam acompanhar as irregularidades do terreno.

In a field experiment set up in Assis county, State of São Paulo, Brazil, two seeding processes namely no-till and conventional tillage systems for soybean (Glycine max (L.) Merrill) and wheat (Triticum aestivum L.) (double cropping) were studied. Special emphasis was given to the different seeding machines. Three crop yields were obtained. For wheat the treatments were: conventional seeding (heavy disking and leveling disking) and no-till. For soybean we had: conventional seeding plus chiseling; conventional seeding; plowing and disking; plowing and disking plus scarifying and no-till. The results showed that the interaction among the treatments were not significant, and that the soil management for soybean did not affect the wheat production. Fuel saving was significant for both crops in the no-till system. Machine articulation was essential to fit the roughness of soil surface in no-till.

Em amostras representativas de oito unidades de solos do Estado de São Paulo, mediu-se quantitativamente a fixação de fósforo em função da concentração da solução fosfatada, do tempo de contato da amostra com essa solução, do umedecimento e secagem da amostra, e da ausência de matéria orgânica e de ferro. Duas foram as concentrações das soluções fosfatadas: 0,03 e 0,03N em PO4(3-). Excetuando o Grande Grupo Podzolizado de Lins e Marília, var. Marília, todas as unidades fixaram significativamente mais fósforo com a solução mais concentrada. Com respeito ao tempo de contato com a solução, a fixação foi maior no maior tempo, exceto na amostra do referido Grande Grupo de Solos (P 902). A secagem e o umedecimento alternados das amostras só causaram incremento na fixação de fósforo no latossolo vermelho-escuro, fase arenosa, e podzolizado de Lins e Marília, var. Lins. A oxidação da matéria orgânica propiciou aumento da fixação de fósforo nos solos podzólico vermelho-amarelo e podzolizado de Lins e Marília, var. Lins; ocorreu menor fixação no latossolo roxo. Os solos cujos óxidos de ferro haviam sido removidos fixaram menos fósforo do que os solos integrais e os solos sem matéria orgânica.

Eight different soils of the State of São Paulo were studied as to their phosphorus fixation capacity. The effect of concentration of the phosphate solution, time of contact of the solution with the soil and alternatively drying and wetting the sample was also evaluated. Fixation tests were performed with undisturbed soil samples as well as with samples of which organic matter and iron oxides had been removed. Phosphorus fixation was higher in latosols and "terra roxa estruturada" than in podzolic soils but decreased in all soils upon removal of iron oxides. Removal Of organic matter and the drying-and-wetting process increased fixation in some cases and decreased it in others.