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The objective of this study is to determine the prevalence of Fasciola hepatica infection in cattle slaughterhouses, as well as its association with climatic/environmental factors (derived from satellite data), seasonality and climate regions in two states in Mexico. Condemned livers from slaughtered animals were obtained from three abattoirs in the states of Puebla and Veracruz. The overall prevalence of the parasite in cattle between January and December of 2017 was 20.6% (1407 out of 6834); the highest rate of condemnation was observed in Veracruz (26.3%; tropical climate), and the lowest rate was found in Puebla (15.5%; temperate climate). The seasonal prevalence of fluke infection was 18.6%, 14.8% and 28.4% during the wet season, and 17.1%, 12.4% and 22.8% during the dry season in the three abattoir sites, located in the districts of Zacatlán, Teziutlán and Ciudad Alemán, respectively. Liver condemnations due to bovine fasciolosis were prevalent in the Zacatlán, Teziutlán and Ciudad Alemán districts during summer, autumn and summer, respectively. Using generalized estimating equations analysis, we determined six variables - rainfall (wet/dry), land surface temperature day, land surface temperature night, normalized difference vegetation index, seasonality and climate regions (temperate/tropical) - to be significantly associated with the prevalence of condemned livers. Climate region was the variable most strongly associated with F. hepatica infection (odds ratio (OR) 266.59; 95% confidence interval (CI): 241.90-353.34), followed by wet and dry seasons (OR 25.56; 95% CI: 20.56-55.67).

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Resumen: Las lesiones en el complejo articular metatarsofalángico del hallux son vistas con mayor frecuencia en deportistas, su importancia radica en la limitación funcional que genera. El diagnóstico y tratamiento temprano puede disminuir las secuelas; sin embargo, el reconocimiento de lesiones crónicas y con ello la implementación del adecuado manejo terapéutico, generan mejoras en la calidad de vida. Se registra en este documento un caso de luxación inveterada de la articulación metatarsofalángica del hallux de más de un año de evolución con compromiso del ligamento intersesamoideo, la cual fue corregida con artrodesis, se lograron resultados satisfactorios inmediatos, a mediano y largo plazo con la posterior recuperación funcional y disminución total del dolor.

Abstract: Injuries in the metatarsophalangeal joint complex of the hallux are seen with greater frequency in athletes, their importance lies in the functional limitation it generates. Early diagnosis and treatment can reduce the sequelae, however, the recognition of chronic lesions and with it the implementation of adequate therapeutic management generate improvements in quality of life. This document records a case of inveterate dislocation of the metatarsophalangeal joint of the hallux of more than one year of evolution with involvement of the intersesamoid ligament which was corrected with arthrodesis achieving immediate satisfactory results, in the medium and long term with the subsequent functional recovery and total reduction of pain.

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Injuries in the metatarsophalangeal joint complex of the hallux are seen with greater frequency in athletes, their importance lies in the functional limitation it generates. Early diagnosis and treatment can reduce the sequelae, however, the recognition of chronic lesions and with it the implementation of adequate therapeutic management generate improvements in quality of life. This document records a case of inveterate dislocation of the metatarsophalangeal joint of the hallux of more than one year of evolution with involvement of the intersesamoid ligament which was corrected with arthrodesis achieving immediate satisfactory results, in the medium and long term with the subsequent functional recovery and total reduction of pain.

Las lesiones en el complejo articular metatarsofalángico del hallux son vistas con mayor frecuencia en deportistas, su importancia radica en la limitación funcional que genera. El diagnóstico y tratamiento temprano puede disminuir las secuelas; sin embargo, el reconocimiento de lesiones crónicas y con ello la implementación del adecuado manejo terapéutico, generan mejoras en la calidad de vida. Se registra en este documento un caso de luxación inveterada de la articulación metatarsofalángica del hallux de más de un año de evolución con compromiso del ligamento intersesamoideo, la cual fue corregida con artrodesis, se lograron resultados satisfactorios inmediatos, a mediano y largo plazo con la posterior recuperación funcional y disminución total del dolor.

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Resumen ANTECEDENTES: La diabetes mellitus tipo 1 es una enfermedad autoinmunitaria causada por la interacción de múltiples factores ambientales y genéticos que conducen a la destrucción autoinmunitaria de células B pancreáticas productoras de insulina. La incidencia y prevalencia de la diabetes mellitus tipo 1 varían considerablemente en todo el mundo. OBJETIVO: Establecer las características clínicas y sociodemográficas de los pacientes con diabetes mellitus tipo 1. MATERIAL Y MÉTODO: Estudio descriptivo de corte transversal y retrospectivo en el que se incluyeron pacientes con diabetes tipo 1 que ingresaron a un hospital universitario de Colombia en el periodo comprendido entre 2012 y 2016. Posteriormente se realizó análisis estadístico según las variables. RESULTADOS: La prevalencia intrahospitalaria de la diabetes mellitus tipo 1 fue de 19 casos por cada 100,000 pacientes mayores de 13 años. Fue más frecuente en mujeres con 61.3%, la edad promedio al diagnóstico fue de 14.89 años. El diagnóstico se estableció de forma clínica sin estudios de autoinmunidad, se trataba de pacientes con enfermedad no controlada con HbA1c promedio de 11.5%, las complicaciones más frecuentes fueron la cetoacidosis diabética con 46.6%, al igual que la hipoglucemia. La insulina más frecuentemente prescrita en este grupo de pacientes fue glargina, glulisina y e insulina regular. CONCLUSIÓN: Los hallazgos sugieren que algunas características de la diabetes mellitus tipo 1 podrían ser similares y algunas diferentes a lo reportado en otros estudios; sin embargo, pueden plantearse algunas posibles investigaciones tomando estos resultados como base.

Abstract BACKGROUND: Diabetes mellitus type 1 is an autoimmune disease caused by the interaction of multiple environmental and genetic factors leading to the autoimmune destruction of pancreatic B cells producers of insulin. The incidence and prevalence of diabetes mellitus type 1 vary considerably all around the world. OBJECTIVE: To establish the clinical and socio-demographic characteristics of diabetes mellitus type 1. MATERIAL AND METHOD: A descriptive, cross-sectional and retrospective study that included patients with diabetes type 1 who entered to a university hospital of Colombia from 2012 to 2016. Then, a statistical analysis was done according to variables. RESULTS: Intrahospitalary prevalence of diabetes mellitus type 1 was of 19 cases for each 100,000 patients older tan 13 years. It was more frequent in women with 61.3%; the mean age at diagnosis was of 14.89 years. Diagnosis was established in a clinical manner without autoimmunity studies, they were patients with not-controlled disease with a mean HbA1c of 11.5%; the frequent complications were: diabetic cetoacidosis with 46.6%, as well as hypoglycemia. The most frequently prescribed insulin in these patients was glargine, glulisine and regular insulin. CONCLUSIONS: The findings suggest that some characteristics of diabetes mellitus 1 could be similar and some different to that reported in other studies; however, some possible investigations may be considered taking these results as basement.

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Es indudable que el cáncer de próstata es objeto de permanente investigación dada su alta prevalencia y morbimortalidad asociada. Sin embargo, el cáncer oligometastásico reconocido como una entidad aparte, es un tópico ha ido ganando interés durante los últimos años. Se ha propuesto que el cáncer oligometastásico podría ser considerado una etapa previa al cáncer metastásico avanzado, dada su evolución más indolente, permitiendo plantear nuevos cursos de tratamiento y nuevos enfrentamientos terapéuticos, que los utilizados en etapas más complejas. En este trabajo se realizó una revisión no-sistemática de la literatura actual respecto al rol de la cirugía en el cáncer oligometastásico, para esto se utilizaron las bases de datos Pubmed y MGH Treadwell Library, con limites dentro de los últimos 10 años además de publicaciones en las revistas Journal of Urology y European Urology. Se revisaron bases de datos chilenas reportadas en Datos Estadísticos e Información en Salud (DEIS). Históricamente, el tratamiento estándar para cáncer de próstata metastásico ha sido el tratamiento paliativo a largo plazo con terapia de deprivación de andrógenos (ADT). Sin embargo, basado en el comportamiento particular que presentaría el cáncer de próstata oligometastásico, se han realizado estudios en los que la cirugía cada vez juega un rol más protagónico. Los nuevos datos son altamente sugerentes que la cirugía podría representar una modalidad terapéutica útil en el manejo de cáncer de próstata oligometastásico. Sin embargo, aún es necesario definir protocolos respecto al manejo de esta entidad y se requieren mayores estudios para definir cuál sería la mejor forma de lograr resultados o si presentaría beneficio asociar el manejo quirúrgico a otras terapias complementarias. AU

There is no doubt that prostate cancer is subject of permanent research because of its high prevalence and associated morbidity and mortality. However, oligometastatic cancer as a particular entity, is a topic that has been gaining interest over the past few years. It has been proposed that oligometastatic cancer could be considered a stage prior to advanced metastatic cancer, given its more indolent course, allowing to consider if there would be benefits in new therapeutic approaches than those used in more advanced stages. In this paper, we performed a non-systematic review of the current literature regarding the role of surgery in oligometastatic cancer, using Pubmed and MGH Treadwell Library databases with limits within the last 10 years. And also, publications in journals as "European Urology" and "Journal of Urology". Chilean databases reported in "Datos Estadísticos e Información en Salud" (DEIS) were reviewed. Historically, the standard treatment for metastatic prostate cancer has been long-term palliative treatment with androgen deprivation therapy (ADT). However, based on the particular behavior of oligometastatic prostate cancer, studies have been performed in which surgical treatment is playing a more prominent role. The new data is highly suggestive that surgery could represent a useful therapeutic modality in the management of prostate cancer. However, it is still necessary to define protocols regarding the management of this entity and more studies are required to achieve this and define what would be the best way to accomplish results or whether it would be beneficial to associate surgical management with other complementary therapies.AU

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INTRODUCCIÓN: La cirugía robótica es una técnica en aumento tanto en Chile como en el mundo. Una de las áreas de la medicina que ha sido pionera en la introducción de esta nueva técnica es Urología, dónde ha crecido el interés en torno a la utilización de la cirugía robótica en cáncer de vejiga músculo invasor(CVMI). El objetivo de esta revisión es examinar la bibliografía disponible sobre el tema. MÉTODOS: Se realizó una búsqueda no sistemática de la literatura utilizando la base de datos de Pubmed y MGH Treadwell library. En estas se utilizaron las palabras claves "Bladder cancer", Muscle-invasive bladder cancer", "Blader cancer epidemiology" , "Radical cistectomy" "Robot-assisted radical cistectomy", ¨Robotic surgery urology¨. Se aplicaron límites de publicaciones dentro de los últimos 10 años. DISCUSIÓN: El cáncer vesical es una enfermedad de alta prevalencia, aproximadamente el 25 % de ellos se presentan con CVMI al momento del diagnóstico. El tratamiento de estándar actualmente para CVMI la cistectomía radical con linfadenectomía pélvica extendida, derivación urinaria y quimioterapia neoadyuvante en ciertos casos. Buscando dar solución a las complicaciones de esta cirugía, surge el interés por utilizar la cirugía robótica en el tratamiento de CVMI a través de la cistectomía radical asistida por robot(CRAR). Actualmente se han publicado estudios con resultados que indican disminución de la morbilidad perioperatoria y menor estadía hospitalaria, manteniendo la eficacia oncológica de este procedimiento versus la cistectomía radical abierta(CRA). Otros estudios no han encontrado diferencias significativas entre las dos técnicas en cuanto a complicaciones. CONCLUSIÓN: Aún existe insuficiente experiencia y evidencia del uso de esta en cáncer de vejiga músculo-invasor pero los resultados actuales tienden a resultados no inferiores y positivos en cuanto a la CRAR versus la CRA.AU

METHODS: We performed a non-systematic literature search using the Pubmed and MGH Treadwell library database. Key words "Bladder cancer", Muscle-invasive bladder cancer", "Bladder cancer epidemiology" , "Radical cystectomy" "Robot-assisted radical cystectomy", ¨Robotic surgery urology¨. were used. Limits of publications were applied within the last 10 years. DISCUSSION: Bladder cancer is a highly prevalent disease. Approximately 25% of patients present with MIBC at the time of diagnosis. The standard treatment currently for CVMI is radical cystectomy with extended pelvic lymphadenectomy, urinary diversion and neoadjuvant chemotherapy in certain cases. In order to solve the complications of this surgery, there is an interest in the use of robotic surgery in the treatment of MIBC through robot assisted radical cystectomy (RARC). Studies with results indicating decreased perioperative morbidity and shorter hospital stay have been published, maintaining the oncological efficacy of this procedure versus open radical cystectomy (ORC). Other studies have found no significant difference between the two techniques in terms of complications. CONCLUSION: There is still insufficient experience and evidence of its use in m

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Leucine aminopeptidase (LAP) and cathepsin L1 (CL1) are important enzymes for the pathogenesis and physiology of Fasciola hepatica. These enzymes were analysed in silico to design a chimeric protein containing the most antigenic sequences of LAP (GenBank; AAV59016.1; amino acids 192-281) and CL1 (GenBank CAC12806.1; amino acids 173-309). The cloned 681-bp chimeric fragment (rFhLAP-CL1) contains 270 bp from LAP and 411 bp from CL1, comprising three epitopes, DGRVVHLKY (amino acids 54-62) from LAP, VTGYYTVHSGSEVELKNLV (amino acids 119-137) and YQSQTCLPF (amino acids 161-169) from CL1. The ~25 kDa rFhLAP-CL1 chimeric protein was expressed from the pET15b plasmid in the Rosetta (DE3) Escherichia coli strain. The chimeric protein rFhLAP-CL1, which showed antigenic and immunogenic properties, was recognized in Western blot assays using F. hepatica-positive bovine sera, and induced strong, specific antibody responses following immunization in rabbits. The newly generated chimeric protein may be used as a diagnostic tool for detection of antibodies against F. hepatica in bovine sera and as an immunogen to induce protection against bovine fasciolosis.

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La combinación de hemangioma capilar (HC) lobulado testicular con hiperplasia de células de Leydig es excepcional. Presentamos un caso en un varón de 72 años, con antecedente de seminoma testicular izquierdo hace 34 años, que consultó por asimetría mamaria. El estudio ultrasónico testicular mostró en el testículo derecho una lesión sólida, hipoecogénica, de 0,6 cm, con flujo vascular central y periférico. Los niveles de β-HCG, LH, estradiol y testosterona fueron normales. Mediante cirugía conservadora, con enucleación de la lesión, y biopsia intraoperatoria se confirmó la benignidad de la lesión. De acuerdo con lo revisado en la literatura, el presente caso sería el primer HC asociado a hiperplasia de células de Leydig en un adulto mayor (AU)

Lobulated capillary hemangioma with Leydig cell hyperplasia in the same nodule is exceptional. We report a case of a 72 year old male presenting with mammary asymmetry. Thirty seven years previously he had had a left sided testicular seminoma. Testicular ultrasonography of the right testicle revealed a 0.6 cm hypoecogenic nodule, which was solid with central and peripheral vascular flux. Beta-HCG, LH, estradiol and total testosterone levels were normal. Enucleation of the lesion was performed and an intraoperatory biopsy confirmed a benign lesion. The definitive diagnosis was lobulated capillary hemangioma with Leydig cell hyperplasia. To our knowledge, this is the first case reported in an adult (AU)

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Con el fin de disminuir el tiempo de isquemia durante la nefrectomía parcial, se han diseñado distintas opciones como clampeo arterial selectivo, técnica sin clampeo con hipotermia corporal y técnica de des clampeo precoz (DP). El objetivo del presente trabajo es analizar el resultado y complicaciones de un grupo de pacientes sometidos a nefrectomía parcial laparoscópica (NPL), aplicando la técnica de DP. Materiales y métodos: A través de una base de datos que se mantiene prospectivamente, se analizó los datos clínicos de los pacientes sometidos a nefrectomía parcial laparoscópica con técnica de desclampeo precoz entre los años 2010 y 2011.Resultados: Once pacientes fueron sometidos a NPL con técnica de DP entre agosto de 2010 y diciembre de 2011. Seis hombres y 5 mujeres, mediana de edad 59 (43-76) años. El tiempo operatorio fue de 180 min (180-220), con tiempo de clampeo 19,5 min (11-23). El sangrado total fue 300 ml (180-2.500). No hubo necesidad de conversión a cirugía abierta, pero un paciente requirió nefrectomía radical por sangrado importante. Márgenes positivos se encontró en un solo caso. Conclusión: El desclampeo precoz permite disminuir el tiempo de isquemia en la nefrectomía parcial laparoscópica, sin aumentar el riesgo de sangrado. Además, podría disminuir las complicaciones vasculares. Sin embargo, técnicamente es una cirugía compleja que requiere entrenamiento adecuado...

To decrease the time of ischemia during partial nephrectomy, various options were designed as selective arterial clamping, unclamping technique with body hypothermia and early unclumping technique (EU). The aim of this paper is to analyze the results and complications of a group of patients undergoing laparoscopic partial nephrectomy (LPN), using the EU technique. Materials and Methods: Using a prospective database, the clinical data of patients undergoing laparoscopic partial nephrectomy with early uncclamping technique between 2010 and 2011 is analyzed. Results: 11 patients underwent LPN with EU technique between August 2010 and December 2011. 6men and 5 women, median age 59 (43-76) years. The operative time was 180 min (180-220), with clamping time 19.5 min (11-23). The total estimated bleeding was 300 ml (180-2500). There was no need for conversion to open surgery, but one patient required radical nephrectomy due major bleeding. Positive margins were found in one case Conclusion: Early unclamping technique decreases the ischemia time in laparoscopic partial nephrectomy without increasing the risk of bleeding. Furthermore, it may reduce vascular complications. However, this is a technically demanding surgery that requires proper training...

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Oleoylethanolamide (OEA) is an endogenous molecule related to endocannabinoids (eCBs) that induces satiety. It binds to the peroxisome-proliferator-activated receptor alpha (PPAR alpha). PPAR alpha is involved in feeding regulation and it has been proposed to play a role in sleep modulation. The objective of the present work is to show if this molecule modifies the sleep-waking cycle through central mechanisms. We have found that the peripheral administration of OEA reduces food intake and increases waking with a concomitant reduction of rapid eye movement sleep. Additionally, this treatment produces deactivation of the lateral hypothalamus, as inferred from the c-Fos expression evaluation. Finally, intra-lateral hypothalamus injection of OEA has mirrored the effects induced by this molecule when it is peripherally administered. In conclusion, we show for the very first time that OEA can modify the sleep-waking cycle and food intake, apparently mediated by the lateral hypothalamus.

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INTRODUCTION: Sleep is a non-learned adaptive strategy that depends on the expression of several neurotransmitters and other molecules. The expression of some of these molecules depends on a number of different genes. Sleep disorders are associated with an inadequate expression of some molecules, which therefore indicates that these genes that code for these molecules participate in the regulation of normal sleep. AIM: To discuss the evidence on gene regulation over the occurrence of sleep and its architecture, as well as of sleep disorders, which supports the participation of specific genes. DEVELOPMENT: We describe the evidence on sleep in mammals, particularly in humans, in addition to studies with twins that demonstrate the influence of genes on sleep regulation. We also discuss several sleep disorders, which in this study only serves to emphasise how certain specific genes, under normal conditions, participate in the expression of sleep. Furthermore, evidence is also provided for other molecules, such as endocannibinoids, involved in sleep regulation. Lastly, we report on studies conducted with different strains of mice that show differences in the amount of sleep they express, possibly as an epiphenomenon of their different genetic loads. CONCLUSIONS: A number of different genes have been described as those responsible for making us sleep, although sleeping also depends on our interaction with the environment. This interaction is what makes us express sleep at times that are best suited to favouring our survival.

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Resumen. Introducción. El sueño es una estrategia adaptativa no aprendida que depende de la expresión de diversos neurotransmisores y otras moléculas. La expresión de varias de estas moléculas depende de diversos genes. Alteraciones del dormir se asocian con una inadecuada expresión de algunas moléculas, que indican entonces que estos genes que codifican estas moléculas participan en la regulación del sueño normal. Objetivo. Discutir la evidencia de la regulación de los genes sobre la ocurrencia del sueño y su arquitectura, así como de alteraciones del sueño, que sustenta la participación de genes específicos. Desarrollo. Se describe la evidencia sobre el sueño en mamíferos, particularmente en humanos, así como estudios con gemelos que evidencian la influencia genética en la regulación del sueño. Posteriormente, se discuten algunas alteraciones del sueño, que en esta revisión sólo sirven para enfatizar cómo ciertos genes específicos, en condiciones normales, participan en la expresión del sueño. Además, se da evidencia sobre otras moléculas, como los endocannabinoides, que participan en la regulación del sueño. Por último, se describen los estudios con diferentes cepas de ratones que manifiestan diferencias en la cantidad de sueño que expresan, posiblemente como epifenómeno de sus diferentes cargas genéticas. Conclusiones. Se han descrito diversos genes que nos hacen dormir, aunque dormir también depende de la interacción con el medio ambiente. Esta interacción es la que nos hace expresar el sueño en los momentos más convenientes para sobrevivir (AU)

Summary. Introduction. Sleep is a non-learned adaptive strategy that depends on the expression of several neurotransmitters and other molecules. The expression of some of these molecules depends on a number of different genes. Sleep disorders are associated with an inadequate expression of some molecules, which therefore indicates that these genes that code for these molecules participate in the regulation of normal sleep. Aim. To discuss the evidence on gene regulation over the occurrence of sleep and its architecture, as well as of sleep disorders, which supports the participation of specific genes. Development. We describe the evidence on sleep in mammals, particularly in humans, in addition to studies with twins that demonstrate the influence of genes on sleep regulation. We also discuss several sleep disorders, which in this study only serves to emphasise how certain specific genes, under normal conditions, participate in the expression of sleep. Furthermore, evidence is also provided for other molecules, such as endocannibinoids, involved in sleep regulation. Lastly, we report on studies conducted with different strains of mice that show differences in the amount of sleep they express, possibly as an epiphenomenon of their different genetic loads. Conclusions. A number of different genes have been described as those responsible for making us sleep, although sleeping also depends on our interaction with the environment. This interaction is what makes us express sleep at times that are best suited to favouring our survival (AU)

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El manejo de la vena renal derecha en la nefrectomía laparoscópica del donante vivo puede en ocasiones representar un problema como consecuencia de la longitud limitada de este vaso. El caso clínico que se presenta muestra una técnica de extensión de la vena renal utilizando la vena gonadal del donante.

Vascular management of the right renal vein during laparoscopic living donor nephrectomy is still an unsolved problem. This short vessel has limited the use of right kidneys. However, the right kidney should be harvested in some instances. A renal vein enlargement technique using the donor gonadal vein is presented which may facilitate the use of right kidneys in this setting.

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INTRODUCTION: Interstitial cystitis is clinically diagnosed entity, characterized by irritative bladder symptoms and suprapubic pain. It is reported that up to 10% of patients are refractory to conservative management. In these patients' supratrigonal cystectomy and bladder enlargement enterocystoplasty has been used. OBJECTIVE: To evaluate the results of our series of patients that underwent this surgical technique due they were suffering interstitial cystitis refractory to conservative treatment. MATERIALS AND METHODS: We reviewed the medical records of patients that underwent supratrigonal cystectomy and bladder enlargement enterocystoplasty in our hospital between 1999 and 2006. Mictional rhythm, pre and postoperative bladder capacity measured by cystodistention, postoperative bladder capacity measured as mictional volume, surgical complications and the degree of satisfaction of patients measured by means of application of a survey were recorded. Mictional rhythms and pre and postoperative bladder capacity were compared. RESULTS: 15 interventions were performed. Mean preoperative bladder capacity was 125 cc, Mean preoperative mictional rhythm was 30.5 times a day. There were perioperative complications in 5 patients. The mean postoperative mictional volume was 355 cc and mean frequency was 8.26. When comparing pre and postoperative rythms and urinary volume there were statistically significant differences (p:0.0008 y p:0.0007 respectively). Regarding the survey, 13 patients were satisfied in terms of mictional frequency and 11 patients were satisfied in terms of suprapubic pain.

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La nefrectomía parcial por laparoscopia es una de las opciones de tratamiento conservador de nefronasutilizada en urología. Es una técnica quirúrgica compleja, que se asocia a mayores riesgos de complicacionesen omparación a otras de las técnicas urológicas. Nuestro objetivo fue revisar la serie, la técnica, las complicaciones operatorias y los resultados oncológicos en nuestra experiencia inicial denefrectomía parcial laparoscópica.Se consignan características epidemiológicas de los pacientes, detalles de la técnica quirúrgica,características de los tumores y resultados anátomo-patológicos de las 26 intervenciones realizadas.No hubo conversión de la técnica en esta revisión y 4 pacientes presentaron complicaciones post operatorias. La biopsia intraoperatoria resultó con bordes negativos en todos los pacientes.Palabras claves: Tumor renal, cirugía renal conservadora, laparoscopia.

Laparoscopic partial nephrectomy is an option of nephron sparing surgery used in urology. It is a complex surgical procedure, which is associated with increased risk of complications compared to other techniques urological. Our objective was to review the series, the technique, the operative complications and oncologic results in our initial experience of laparoscopic partial nephrectomy. We analyzed the epidemiological characteristics of patients, details of surgical technique, characteristics of the tumors and surgical pathology results of 26 surgeries. There was no conversion, but 4 patients had post-operative complications. Intraoperative biopsy was negative in all patients.

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Objetivo: La mitomicina C es un antibiótico con capacidad antimitótica que ha demostrado su eficacia como inhibidor de la proliferación fibroblástica y su uso se ha extendido en la cirugía del glaucoma. En el presente estudio se evaluó el efecto de la mitomicina sobre cultivos monocapa de endotelio corneal de conejo albino. Métodos: La fuente de células endoteliales para los cultivos fueron ojos de conejo albino raza New Zealand. El aislamiento de las células se realizó mediante disociación mecánico-enzimática a partir del complejo endotelio corneal-membrana de Descemet. El medio de cultivo empleado fue EMEM. Se realizó el tratamiento de tres grupos de placas expuestas a mitomicina C a tres concentraciones de 2x10 (AU)

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PURPOSE: Mitomycin C is an antibiotic with a demonstrated antiproliferative capacity as an inhibitor of fibroblastic cells proliferation. Its use has been extended in glaucoma surgery. In the present study, we evaluated mitomycin C effect on cell culture monolayer of rabbit corneal endothelium. METHODS: The source of corneal endothelium for cell culture was New Zealand albino rabbit eyes. Desegregation of cells was carried out with mechanic and enzymatic dissociation from corneal endothelium and Descemet membrane. Culture medium was EMEM. Three treatment groups of plates were exposed to three different concentrations of mitomycin C 2x10(-3) mg/ml, 2x10(-2) mg/ml and 2x10(-1) mg/ml. Control and witness plate groups were also established. The morphometric study was performed through quantitative analysis with a video system connected to the light microscope. RESULTS: Different morphological changes related with cell size, cytoplasm and dyeing were seen at the morphological study and several degenerative signs were established indicating cellular death and a very decrease of the cellular population. In the groups treated with minimal dose (2x10(-3) mg/ml) and 3 days evolution time, cellular population was 434 cels/mm(2), 7 evolution days group cell density was 300.97cels/mm(2), and at 14 days it was 201.88 cels/mm(2). The percentage of survival in all the groups of treated cells was under 50%. CONCLUSIONS: Mitomycin C in concentrations and exposure time as used in this study has a potent lethal effect on this cellular type that compromises to a greater or smaller extent their function and integrity.

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We previously reported (Gray, T. E., K. Guzman, C. W. Davis, L. H. Abdullah, and P. Nettesheim. 1996. Mucociliary differentiation of serially passaged normal human tracheobronchial epithelial cells. Am. J. Respir. Cell Mol. Biol. 14:104-112) that retinoic acid (RA)-deprived cultures of normal human tracheobronchial epithelial (NHTBE) cells became squamous, failed to produce mucin, and instead secreted or released large amounts of lysozyme (LZ). The purpose of the studies reported here was to elucidate the relationship between RA deficiency-induced squamous differentiation and increased LZ, and to determine what mechanisms were involved. We found that intracellular LZ began to accumulate in RA-deficient NHTBE cultures early during squamous differentiation. Between Days 10 and 18 of culture, cellular LZ levels were more than 10 times higher in RA-deficient than in RA-sufficient cultures. On Day 12, large numbers of cells began to exfoliate in RA-deficient cultures and extracellular LZ appeared at the apical surface, presumably released from the exfoliated cells. Metabolic labeling studies showed that the rate of LZ synthesis was not increased in RA-deficient cultures over that in RA-sufficient cultures; however, intracellular LZ half-life was much longer in RA-deficient cultures. We concluded that the increased accumulation of both intra- and extracellular LZ in RA-deficient cultures was due to increased LZ stability and was not the result of increased LZ synthesis. When RA-deficient cultures were treated on Day 7 with 10(-6) M RA, intracellular LZ levels did not substantially decrease until 3 d later, coinciding with a marked increase in mucin secretion. LZ messenger RNA levels were unchanged at 24 h, but were modestly increased (rather than decreased) at all subsequent time points. We concluded that RA does not directly regulate LZ, and that the excessive accumulation of LZ in RA-deprived NHTBE cells is a consequence of vitamin A deficiency-induced abnormal differentiation.

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El sarcoma estromal de esófago es una patología poco frecuente. El objetivo de este trabajo es la comunicación de un caso tratado en nuestro Servicio de Cirugía. Se trata de un paciente de 52 años, sexo masculino con antecedentes de úlcera péptica y tabaquismo. Consultó por historia de seis meses de disfagia, baja de peso de seis kilogramos y hematemesis. Al examen físico no había hallazgos de importancia. Se realizó un estudio endoscópico alto, que mostró una lesión ulcerada de tercio distal de esófago. La radiografía de tórax mostró una imagen retrocardíaca de aproximadamente 8 cm de diámetro, que se correlacionó con un TAC tóraco-abdominal que mostró una lesión esofágica tumoral de ocho centímetros de diámetro. Se operó con abordaje por tóraco-freno-laparotomía. El hallazgo fue de un gran tumor de esófago distal, y de una metástasis única en el segmento seis del hígado. Se realizó una esofagectomía con ascenso gástrico y anastomosis esofagogástrica cervical, colecistectomía y resección de la lesión hepática. La histología mostró un tumor gastrointestinal estromal. Los sarcomas estromales del tubo digestivo son poco frecuentes, sus características histológicas y ultraestructurales sólo se han aclarado recientemente. La cirugía sigue ocupando un rol central en su tratamiento

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En la era de la cirugía mínimamente invasiva el manejo de la coledocolitiasis asociada a colelitiasis es aún motivo de controversia. Presentamos a continuación los resultados de un protocolo de manejo de estos pacientes de acuerdo al riesgo estimado de presentar coledocolitiasis asociada a colelitiasis. Se incluyeron en el estudio 605 pacientes candidatos a colecistectomía laparoscópica (CL). De acuerdo a criterios clínicos, bioquímicos y radiológicos se dividió a los pacientes en tres grupos de acuerdo al riesgo de presentar coledocolitiasis. A los pacientes con diagnóstico ecográfico de coledocolitiasis y a aquellos ictéricos al ingreso, se les practicó una CPRE previa a la CL. A aquellos sin sospecha para coledocolitiasis se les estudió mediante colangiografía endovenosa e intraoperatoria. Se analizan los resultados obtenidos en el tratamiento de la coledocolitiasis asociada a colelitiasis mediante la combinación CPRE + CL versus colecistectomía clásica y coledocostomía. Se concluye que el uso juicioso de los criterios para estimar el riesgo de coledocolitiasis ayuda en el uso selectivo de la CPRE y que está combinada con la CL representa una buena alternativa para el tratamiento clásico

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