Angiocentric glioma: report of clinico-pathologic and genetic findings in 8 cases.

Angiocentric glioma has recently been described as a novel epilepsy associated tumor with distinct clinico-pathologic features. We report the clinical and pathologic findings in 8 additional cases of this rare tumor type and extend its characterization by genomic profiling. Almost all patients had a history of long-standing drug-resistant epilepsy. Cortico-subcortical tumors were located in the temporal and parietal lobes. Seizures began at 3 to 14 years of age and surgery was performed at 6 to 70 years. Histologically, the tumors were characterized by diffuse growth and prominent perivascular tumor cell arrangements with features of astrocytic/ependymal differentiation, but lacking neoplastic neuronal features. Necrosis and vascular proliferation were not observed and mitoses were sparse or absent. MIB-1 proliferation indices ranged from <1% to 5%. Immunohistochemically, all cases stained positively for glial fibrillary acidic protein, vimentin, protein S100B, variably for podoplanin, and showed epithelial membrane antigen-positive cytoplasmic dots. Electron microscopy showed ependymal characteristics in 2 of 3 cases investigated. An analysis of genomic imbalances by chromosomal comparative genomic hybridization revealed loss of chromosomal bands 6q24 to q25 as the only alteration in 1 of 8 cases. In 1 of 3 cases, a high-resolution screen by array-comparative genomic hybridization identified a copy number gain of 2 adjacent clones from chromosomal band 11p11.2 containing the protein-tyrosine phosphatase receptor type J (PTPRJ) gene. All patients are seizure free and without evidence of tumor recurrence at follow-up times ranging from 1/2 to 6.9 years. Our findings support 2 previous reports proposing that angiocentric glioma is a novel glial tumor entity of low-grade malignancy.

[Open vs. closed abdomen in acute peritonitis. A comparative study]. / Abdomen abierto vs cerrado en peritonitis grave por traumatismo. Estudio comparativo.

INTRODUCTION: Open abdomen is a management alternative that, however, is not exempt from complications. We evaluated, in a comparative manner, the handling with open abdomen (OA) against closed abdomen (CA) in treatment of patients with severe peritonitis for traumatic lesion. MATERIAL AND METHODS: We carried out an observational, retrospective, longitudinal, and comparative study. It included patients managed with diagnosis severe peritonitis due to abdominal trauma between 1998 and 2000. They were divided into two groups, according to management with OA or CA. We compared age, sex, trauma type, severity of lesion, morbility and mortality. RESULTS: 12 patients were managed with OA, which presented longer hospitalization and 24 with CA who in turn presented a greater lesion severity. There were statistical differences in other parameters, including complications and mortality. However, patients managed with OA frequently presented more complications. DISCUSSION: OA does not improve morbility and mortality of patients, although they presented less severe lesions that those managed with CA.

Abdomen abierto vs cerrado en peritonitis grave por traumatismo: Estudio comparativo / Open vs. Closed Abdomen in Acute Peritonitis: A comparative Study

Introducción: el abdomen abierto es una alternativa de manejo que, sin embargo no está exento de complicaciones. Se evaluó de forma comparativa el manejo con abdomen abierto (AA) contra el cerrado (AC) en el tratamiento de pacientes con peritonitis grave por lesión traumática. Material y métodos: se realizó un estudio observacional, retrospectivo, longitudinal y comparativo, incluyó los pacientes con diagnóstico de peritonitis grave por traumatismo abdominal manejados entre 1998 y2000. Se dividieron en dos grupos, de acuerdo al manejo con AA o AC. Se compararon edad, sexo, tipo de traumatismo, gravedad de la lesión, morbilidad y mortalidad. Resultados: se manejaron 12 pacientes con AA, los cuales presentaron mayor tiempo de hospitalización y 24 con AC, que a su vez presentaron una mayor gravedad de lesión. No existieron diferencias estadísticas en los demás parámetros, incluyendo complicaciones y mortalidad. Sin embargo, los pacientes manejados con AA presentaron complicaciones más frecuentemente. Discusión: el uso del AA no mejoró la morbilidad y mortalidad de los pacientes en los que se usó, a pesar de que presentaron lesiones menos graves que los manejados con AC.

Introduction: Open abdomen is a management alternative that, however, is not exempt from complications. We evaluated, in a comparative manner, the handling with open abdomen (OA) against closed abdomen (CA) in treatment of patients with severe peritonitis for traumatic lesion. Material and methods: We carried out an observational, retrospective, longitudinal, and comparative study. It included patients managed with diagnosis severe peritonitis due to abdominal trauma between 1998 and 2000. They were divided into two groups, according to management with OA or CA. We compared age, sex, trauma type, severity of lesion, morbility and mortality. Results: 12 patients were managed with OA, which presented longer hospitalization and 2 4 with CA who in turn presented a greater lesion severity. There were statistical differences in other parameters, including complications and mortality. However, patients managed with OA frequently presented more complications. Discussion: OA does not improve morbility and mortality of patients, although they presented less severe lesions that those managed with CA.

Succinate in dystrophic white matter: a proton magnetic resonance spectroscopy finding characteristic for complex II deficiency.

A deficiency of succinate dehydrogenase is a rare cause of mitochondrial encephalomyopathy. Three patients, 2 sisters and 1 boy from an unrelated family, presented with symptoms and magnetic resonance imaging signs of leukoencephalopathy. Localized proton magnetic resonance spectroscopy indicated a prominent singlet at 2.40ppm in cerebral and cerebellar white matter not present in gray matter or basal ganglia. The signal was also elevated in cerebrospinal fluid and could be identified as originating from the two equivalent methylene groups of succinate. Subsequently, an isolated deficiency of complex II (succinate:ubiquinone oxidoreductase) was demonstrated in 2 patients in muscle and fibroblasts. One of the sisters died at the age of 18 months. Postmortem examination showed the neuropathological characteristics of Leigh syndrome. Her younger sister, now 12 months old, is also severely affected; the boy, now 6 years old, follows a milder, fluctuating clinical course. Magnetic resonance spectroscopy provides a characteristic pattern in succinate dehydrogenase deficiency.

[Traumatic subarachnoid-pleural fistula secondary to non-penetrating thoracic gunshot wound]. / Fístula subaracnoidea-pleural traumática por herida de bala no penetrante en tórax.

INTRODUCTION: Traumatic subarachnoid-pleural fistula (TSPF) is very unusual and is due to the anomalous communication between the pleural and subarachnoid space. We report a TSPF by Bullet wound that was not penetrating to the thoracic cavity. CLINICAL CASE: Masculine of 34 years-old that receives wounded by bullet in the posterior face of thorax. A pleural effusion was identified and medullar wound with fracture of the fifth thoracic vertebra. The effusion is persist and also added headache appear. TSPF was diagnosed for myelography. The patient die before carrying out the surgical treatment. A massive tromboemboly of lug was the cause. The autopsy confirmed the diagnosis. DISCUSSION: The TSPF should be suspected by the association of medullar lesion with a persistent pleural effusion. The diagnosis should be confirmed by radiology. The treatment can be medical or surgical.

Fístula subaracnoidea-pleural traumßtica por herida de bala no penetrante en tórax / Traumatic subarachnoid-pleural fistula secondary to non-penetrating thoracic gunshot wound

INTRODUCTION: Traumatic subarachnoid-pleural fistula (TSPF) is very unusual and is due to the anomalous communication between the pleural and subarachnoid space. We report a TSPF by Bullet wound that was not penetrating to the thoracic cavity. CLINICAL CASE: Masculine of 34 years-old that receives wounded by bullet in the posterior face of thorax. A pleural effusion was identified and medullar wound with fracture of the fifth thoracic vertebra. The effusion is persist and also added headache appear. TSPF was diagnosed for myelography. The patient die before carrying out the surgical treatment. A massive tromboemboly of lug was the cause. The autopsy confirmed the diagnosis. DISCUSSION: The TSPF should be suspected by the association of medullar lesion with a persistent pleural effusion. The diagnosis should be confirmed by radiology. The treatment can be medical or surgical.

Colección biliar extraductal psotraumática intrahepática / Posttraumatic intrahepatic extraductal bibliary collection

Antecedentes. Las colecciones biliares extraductales intrahepáticas son una complicación rara en casos de trauma abdominal. Objetivo. Describir dos pacientes con diagnóstico de colección biliar extraductal intrahepática postraumática. Informe de los casos. Se trató de dos hombres politraumatizados, uno por trauma cerrado y el segundo por trauma penetrante; en los dos casos las manifestaciones clínicas más frecuentes fueron fiebre e ictericia. La tomografía computada fue el método de diagnóstico más utilizado, que demostró las colecciones intrahepáticas. En los dos pacientes las colecciones biliares fueron drenadas quirúrgicamente, y solo uno evolucionó satisfactoriamente. Conclusiones. Las colecciones biliares extraductales intrahepáticas postraumáticas son una complicación rara de los traumatismos abdominales, y deben ser sospechadas cuando en el paciente con lesión hepática aparezcan ictericia, fiebre y/o dolor en hipocondrio derecho entre la segunda y sexta semana posterior al trauma abdominal