Recent progress in metal assisted multicomponent reactions in organic synthesis.

To prepare complicated organic molecules, straightforward, sustainable, and clean methodologies are urgently required. Thus, researchers are attempting to develop imaginative approaches. Metal-catalyzed multicomponent reactions (MCRs) offer optimal molecular diversity, high atomic efficiency, and energy savings in a single reaction step. These versatile protocols are often used to synthesize numerous natural compounds, heterocyclic molecules, and medications. Thus far, the majority of metal-catalyzed MCRs under investigation are based on metal catalysts such as copper and palladium; however, current research is focused on developing novel, environmentally friendly catalytic systems. In this regard, this study demonstrates the effectiveness of metal catalysts in MCRs. The aim of this study is to provide an overview of metal catalysts for safe application in MCRs.

Understanding cerebellar liponeurocytomas: case report and literature review.

Cerebellar liponeurocytomas were recognized in the 2000 WHO 3rd edition of CNS tumors as a distinct grade I pathological entity, a tumor with a more favorable prognosis than medulloblastoma. But reports of long-term recurrences and some possible aggressive behavior led to an upgrade on the latest WHO 4th edition of CNS tumors. The case of a 64-year-old female patient is reported in this paper. More than 30 cases of this lately recognized pathological entity have been reported to date. The diagnostic, radiological, and pathological features associated with this tumor are discussed through a literature review.

[Epidermoid cyst of the cisterna magna and the fourth ventricle: Report of four cases]. / Kystes épidermoïdes de la grande citerne et du quatrième ventricule : à propos de quatre cas.

INTRODUCTION: Epidermoid cyst is a congenital and benign tumor, developed from ectodermal inclusion. These cysts occur very rarely in the cisterna magna and the fourth ventricle. OBJECTIVE: To report four cases of epidermoid cyst of the cisterna magna and the fourth ventricle in the light of the data of literature. PATIENTS AND METHODS: We report a retrospective study of four cases of epidermoid cysts of the cisterna magna and the fourth ventricle. The data was collected from January 2000 to December 2006 from to series of 18 cases of epidermoid cysts of posterior cranial fossa (14 cases were localised at the cerebellopontine angle). All the patients had a physical examination and a complete neuroradiological imagery. The treatment was surgical. The follow-up was at least 9 months. RESULTS: There were two men and two women. The mean age was 47.75 years. All patients presented with cerebellar syndrome. Three patients had intracranial hypertension. Neuroradiological explorations showed a cystic lesion developed in the cisterna magna in two cases, in the fourth ventricle in one case and in the two locations in one case. Two patients had hydrocephalus. All patients had surgery with a posterior approach and one patient had first ventriculoperitoneal shunt. The diagnosis was confirmed by histological examination. Postoperatory outcome was favourable in all cases. One patient developed bilateral chronic subdural hematoma, which was surgically removed. A long time follow-up was good in all cases. CONCLUSION: Epidermoid cysts are characterized by a long evolution. The diagnosis is relatively characteristic in the imagery. The prognosis was favourable with a complete surgical resection.

[Intramedullary neuroglial cyst: a case report]. / Kyste neuroglial intramédullaire : à propos d'un cas.

BACKGROUND AND PURPOSE: Neuroglial cysts are uncommon congenital lesion with own wall, which can be confined into or outside the central nervous system. In the central nervous system the cyst is located commonly in the brain. Spinal intramedullary neuroglial cyst are exceptional. Our objective is to present a case of intramedullary neuroglial cyst, to discuss the differentiels diagnosis and to show difficulties of its medical taking care. CASE REPORT: A 60 year-old man, without past history, was admitted to the hospital with a compression of conus medullaris since one year. The clinical examination revealed paraparesis and genito-sphincterian disorders. MRI of the spine revealed intramedullary cyst at T12-L1 level. The patient underwent cystic evacuation, a large marsupialization of the cavity and a wall biopsy. Histopathological examination confirmed the diagnosis of neuroglial cyst. The postoperative outcome was favourable with a partial improvement of motor weakness. Postoperative MRI showed a persistent residual cavity. CONCLUSION: Neuroglial intramedullary cyst is uncommon. It is a benign lesion. Complete surgical resection is very difficult seen the absence of defined plan cleavage.

Vivencias subjeiivas de adolescentes con obesidad respecto a su tratmmiento / Subjctive experiiences of adolescents with obesity regarding to their trattment

Este estudio pretendió comprender las vivencias subjetivas de adolescentes chilenos con obesidad, respecto a su tratamiento para adelgazar. Se empleó una metodología cualitativa y se realizó un diseno descriptivo. La muestra quedó constituida por nueve participantes entre 13 y 18 anos. Los datos se recogieron con entrevistas focalizadas y se analizaron según los principios de la Grounded Theory. Los resultados indican que para los participantes es importante contar con un tratamiento multidisciplinario en donde también reciban el apoyo del entorno para su realización. La motivación intrínseca para generar el cambio se sindica como relevante y toma gran importancia, sentir que es posible llevar a cabo el tratamiento y ver los efectos positivos de éste. En cuanto a los conflictos que presentan en su realización, se senala la falta de constancia, las dificultades para cambiar hábitos y el ambiente externo, cuando éste no ayuda a mantener el tratamiento.

The objective of this study was to understand the subjective experiences of Chilean adolescents with obesity, regarding their treatment to lose weight. A qualitative methodology and descriptive design was performed. The sample was formed by nine participants between 13 and 18 years old. The data was collected through focused interviews and was analyzed according to the principles of Grounded Theory. Results indicate thatfor participants is important to have a multidisciplinary treatment with environment support to fulfill its realization. Intrinsic motivation to create change is as relevant and feeling that it is possible to carry out the treatment and see the positive effects of it, takes great relevance. As for the conflicts that occur in their implementation, important points are the lack of consistency, difficulty of changing habits and the external environment, when it does not help to maintain treatment.

Mature posterior fossa teratoma mimicking infratentorial meningioma: a case report.

Intracranial teratomas are congenital neoplasms mostly diagnosed in the pediatric hood and usually involve supratentorial midline structures. These teratomas, especially those involving the posterior fossa are an uncommon and representing less than 0.5% of all intracranial tumors. We report a case of mature posterior fossa teratoma in an adult patient diagnosed in the 4th decade of life. This lesion was taken for a huge infratentorial meningioma.

Protocolo prospectivo de pieloplastia laparoscópia pediátrica; del estrés a la tranquilidad / Prospective protocol for laparoscopic pyeloplasty in pediatrics; from stress to tranquility

La resolución quirúrgica de una obstrucción pieloureteral (OPU), con mayor frecuencia se realiza de forma laparoscópica. Siendo un procedimiento difícil per-se, consideramos que para optimizar tiempos, materiales y esfuerzo es necesario involucrar a todo el equipo quirúrgico. Se evalúa protocolo quirúrgico prospectivo, con ajuste de protocolo a mitad del estudio en post de mejorar los tiempos quirúrgicos. Método: Estudio prospectivo de 12 casos de pacientes >5kg con OPU y MA G3 con dificultad de vaciamiento; en quienes se aplicó el protocolo quirúrgico para pieloplastia laparoscópica (pasos quirúrgicos, características de suturas, pig-tail y material quirúrgico). Todos los casos fueron operados por 2 cirujanos con experiencia laparoscópica urológica avanzada (>5 años); un mismo ayudante y dos instrumentistas. Después de los primeros 6 pacientes (grupo A) se analizó y perfeccionó el protocolo quirúrgico, comparando posteriormente resultados y en especial tiempo quirúrgico con los siguientes 6 (grupo B). Resultados: La serie incluyó 9 hombres. La mediana para edad fue de 9.3 meses. El peso promedio fue 16. 7 kg (20.4 vs 13.1 kg respectivamente). En grupo A se realizaron 4 derechas y 2 izquierdas, y el grupo B fue inverso (4 izquierdas). Tres de doce pacientes presentaban OPU secundaria a vasos aberrantes. El tiempo quirúrgico promedio por grupo fue de 171.2 (120-200 min) vs 141.7 (90-210 min) respectivamente. El seguimiento promedio fue 19.6 meses (13-24 meses), todos los pacientes tuvieron buena evolución, con MA G-3 sin obstrucción al vaciamiento y disminución de la hidronefrosis. Conclusiones: Consideramos que la disminución del tiempo quirúrgico en el segundo grupo se debió tanto a la integración del equipo como al perfeccionamiento del protocolo quirúrgico: en la técnica, colocación de un cuarto trocar, forma de colocar pig-tail, tipo y tamaño de suturas, preparación...

Laparoscopic surgical resolution for an ureteropelvic junction obstruction (UPJO) is being widely used around the world. lt is considered as a hard and difficult procedure per-se, we considered for time, materials and effort Optimization; to involve every single member of the surgical team. A surgical protocol was developed and revised, with some adjustments in the middle looking forward to reduce surgical time. Method: Prospective study including 12 patients <5kg weight with UPJO and difficult emptying MA G-3; to whom a surgical protocol for laparoscopic pyeloplasty was applied (surgical steps, suture characteristics, stent and surgical material). All cases were operated by 2 advanced skilled laparoscopic surgeons (>5 year experience); same assistant surgeon and two different surgical assistants. After the first 6 cases (group A) the protocol was revised and improved, comparing results especially surgical time with group B (n=6). Results: The series included 9 male, median ages was 9.3 months. Average weight was 16. 7 kg (20.4 vs 13.1 kg for each group). Four right-sided pyeloplasties and 2 left-sided were performed in group A, and opposite in group B (4 left-side). Three of twelve patients had UPJO secondary to polar vessels. The mean surgical time was 171.2 ( 120-200 min) vs 141. 7 (90-210 min) respective/y. Mean follow-up was 19.6 months (13-24 mo), all patients had good outcome, without obstruction in the MA G-3 study and regression of the hydronephrosis...

Tuberculoma of the cavernous sinus mimicking a meningioma: case report and review of the literature.

Cavernous sinus involvement of tuberculosis is rare; only seven cases have been reported in the literature to date. Many factors make the diagnosis difficult in this location, necessitating a surgical procedure. We report the case of a 45-year-old man who presented with a left cavernous sinus syndrome clinically. The lesion mimicked a meningioma of the cavernous sinus in radiological examinations. It was entirely excised through a subtemporal approach. Histopathological examination revealed caseating granuloma and the diagnosis of tuberculoma was established. Postoperative antituberculous drugs completed the treatment and led to complete resolution of neurological symptoms. In our paper, we emphasize the rarity of the lesion in this location, we review all the cases previously published underlining the main epidemiological, clinical, radiological, therapeutic and prognostic features.

[Multiple intracranial ganglioglioma. Case report]. / Gangliogliomes multiples intracrâniens. A propos d'un cas.

Multiple intracranial ganglioglioma (GG) is an extremely rare condition, generally associated with van Recklinghausen neurofibromatosis. We report the case of a 26-year-old woman who presented with progressive tetraparesis, raised intracranial pressure and visual loss. The neuroradiologic workup demonstrated a multiple lesion involving the temporal lobe, the diencephalomesencephalon and the optical pathways. Computed tomography-guided stereotactic biopsy of a right temporal lesion led to the diagnosis of GG. In light of this case and the literature review, we discuss morphologic aspects, differential diagnosis and therapeutic options of GG. In patients with multiple cerebral tumors, search for multiple ganglioglioma is particularly important because of the therapeutic implications and the good prognosis of this tumor.

Multiple infected cerebral hydatid cysts.

We report an unusual patient with multiple infected cerebral hydatid cysts. A 20-year-old man presented with a 2-month history of headache and progressive left-sided hempiparesis. A cerebral CT scan showed a large and heterogeneous parieto-occipital lesion. During surgery an infected hydatid cyst was discovered with multiple daughter vesicles. Post-operatively the patient was treated with albendazol, cefotaxime and metronidazole. The clinical course was good with total recovery of the hemiparesis. A follow-up CT scan showed persistence of some small deep-seated cysts. Multiple infected cerebral hydatid cyst is uncommon and can be confused with other cystic brain lesions. The aim of surgery is to remove the cyst unruptured and this should be followed by antihelminthic and antibiotic treatment in order to avoid recurrences.

[Double localization of a cerebral germinoma. Case report]. / Double localisation d'un germinome cérébral. A propos d'un cas.

A germinoma located in both the pineal and suprasellar regions remains rare. The clinical expression can be polymorphic, although brain imaging reveals specific signs. We report the case of a 16-year-old boy who presented with diabetes insipidus of six months' standing, associated with visual loss and Parinaud's syndrome. Brain MRI showed a tumor in both the pineal and suprasellar regions. A stereotaxic biopsy targeting the infundibular growth confirmed the diagnosis of ectopic germinoma, which was successfully treated by radiotherapy and chemotherapy. The incidence of bifocal germinoma, its clinical and radiological characteristics as well as the therapeutic strategies to adopt are discussed.

[Infected cervical epidural Ewing's sarcoma (case report)]. / Sarcome d'Ewing épidural cervical infecté (à propos d'un cas).

INTRODUCTION: Ewing's sarcoma is a relatively rare osseous malignant tumour. The age of onset is generally in the youth. Epidural localisation of the malignant osseous tumour Ewing's sarcoma is exceptional. Only 29 cases were reported in surgical literature including only one infected case. OBSERVATION: We report a case of a 24 years old patient who displayed a complete flaccid tétraplégia with T1 sensitive level. Spinal cord MRI documented a cervical posterior epidural process with peripheric gadolinium enhancement. Patient was operated in emergency. A C6 and C7 laminectomy allowed complete tumour resection with its purulent intratumoural collection revealed during the operation. A total tumour removal was performed. The immediate postsurgical evolution was remarkable, with a quasi complete recovery in the upper limbs. DISCUSSION: Firstly described by James Ewing in 1921, the spinal epidural locations of the Ewing's sarcoma are rare without specific clinical signs generally presenting as a radiculo-medullary compression. Our case is the second infected epidural Ewing sarcoma reported in the literature. However the cause remains unexplained. For this spinal epidural extraosseous tumour, X-ray radiography failed to show any osseous lesions. On MRI, the usually found aspect is a T1 and T2 isosignal with gadolinium enhancement. CONCLUSION: Through our observation, we underlined the scarcity of this pathology in the cervical epidural localization and the association with infection. We also emphasized on the complete removal, in order to give the best functional and vital outcome.

Spinal Langerhans' cell histiocytosis in a young adult: case report and therapeutic considerations.

We report an unusual case of spinal Langerhans' cell histiocytosis of the cervicothoracic junction in a young adult man. A 17-year-old male was referred to our institution with a 3-week history of cervicothoracic pain associated to a weakness of his right upper limb. Computed tomography and magnetic resonance imaging showed a collapsed T1 vertebral body with epidural soft tissue showing mass effect on spinal cord. The patient underwent a classic anterior cervicotomy. Complete removal of the lesion could be achieved, but the soft consistency of C7 and T2 body precluded a solid anterior fixation and an extended resection of C7 and T2 body had to be performed. Then a C6 - T3 stabilisation using an anterior plate fixation and cyanomethylacrylate graft was performed. Postoperative course was uneventful. At 2 years follow-up, the patient was asymptomatic and radiological workup showed a perfect stability of anterior fixation system. Aggressive surgical management of eosinophilic granuloma should be considered in some selected cases particularly when spinal instability or neurological deficit occurs. In this young patient a modified anterior cervicotomy allowed a comfortable approach to the anterior aspect of T3 vertebra for spinal fixation.

Implicancias del diagnóstico antenatal de dilatación ureteral / Prenatal diagnosis of ureteral dilation

Muchos de los hallazgos del diagnóstico antenatal de patología urológica son inespecíficos y sólo nos permiten diferenciar pacientes con un mayor riesgo de infección urinaria o de perder función renal. El hecho de identificar un uréter en la ecografía prenatal es un hallazgo inespecífico, que aún no tenemos claro qué significa y qué pronóstico tiene para nuestros pacientes. A partir de noviembre de 1999, tenemos un protocolo prospectivo para el seguimiento y manejo de pacientes con diagnóstico antenatal de patología urológica. Se revisó en forma retrospectiva los pacientes en que hubo dilatación ureteral en la ecografía prenatal.180 pacientes han sido referidos y seguidos según protocolo. En 21 pacientes (11.7 por ciento) se ha hecho diagnóstico de dilatación ureteral en la ecografía prenatal. Once hombres y 10 mujeres. Los diagnósticos postnatales de estos pacientes fueron: 4 pacientes con doble sistema pieloureteral; 2 pacientes con megauréteres; 1paciente con una cloaca; 5 pacientes con dilataciones transitorias; 2 pacientes con ureterocele en sistemaúnico; 1 paciente con reflujo vesicoureteral en un sistema único y con un riñón multicístico en el contralateral; 1 paciente con valvas de uretra posterior y 5 pacientes con obstrucción pieloureteral. Un total de 13 pacientes de los 21 requirieron cirugía (62por ciento) y 8 se manejaron médicamente (38.09 por ciento).El hecho de identificar el uréter dilatado en la ecografía prenatal nos permite identificar una población prenatal de riesgo, ya que un 57,1 por ciento de nuestros pacientes requirieron de cirugía. Llama la atención que 5 pacientes en que se vio el uréter dilatado en la ecografía prenatal, terminaron operándose de obstrucción pieloureteral. Esto apoya la hipótesis de que estas obstrucciones sean secundarias a dilataciones ureterales prenatales. El consejo prenatal tiene que ser dado con cautela y por gente con experiencia, ya que a pesar de existir un riesgo elevado de cirugía...

Prenatal diagnosis is usually non specific and only allows for early detection of patients with a higher risk of developing urinary tract infections or loss of renal function. The identification of the ureter in a prenatal ultrasound is a nonspecific finding. The relevance of this is unknown. A prospective protocol for the management and follow up of patients with antenatal diagnosis of urologicmal formations was started in 1999. We retrospectively review our patients who presented a ureteral dilatation in the antenatal ultrasound.180 patients were referred and follow up was carried out according to protocol. 21 patients (11.7 percent) had ureteral dilatation on the prenatal ultrasound, 11 male and 10 female. The following post natal diagnoses were registered: 4 patients had a duplex kidney, 2 patients had megaureter, 1 patient had a cloaca, 5 patients had transitory dilatations, 2 patients had ureterocele in an single system, 1 patient had VUR in a single system and a contralateral muticystic kidney, 1 patient had posterior urethral valves, and 5 patients had ureteropelvic obstruction.13 of 21 patients required surgery (62 percent), the other 8 required only prophylaxis and follow up (38.09 percent). Being able to identify a dilated ureter in an prenatal ultrasound allowed us to define a high risk group, in which 62 percent required surgery. Of the patients in this group, it is noteworthy that 5 patients in whom a dilated ureter was visualized were operated on for ureteropelvic obstruction. This fact supports the idea that obstructions are secondary to antenatal ureteral dilations. Antenatal advice should be given carefully and by experienced personnel because, although there was a high percentage of surgery in this group, there was also a group of patients that only required antibiotics prophylaxis and image monitoring.

[Late cervicodorsal metastasis of thyroid adenocarcinoma treated by anterior cervicotomy]. / Métastase cervico-dorsale tardive d'un adénocarcinome thyroïdien opérée par cervicotomie antérieure.

Metastasis from a thyroid adenocarcinoma is a rare entity with high mortality. We describe an unusual case in a woman displaying tetraparesis due to a late cervico-dorsal metastasis operated on via a simple anterior cervicotomy. Outcome was good at eighteen months follow-up. The histological diagnosis was follicular adenocarcinoma. The development of a vertebral metastasis from a thyroid adenocarcinoma 11 years after the treatment of the primitive cancer is rare. The anterior cervico-dorsal location in this patient required decompression via an anterior approach. Surgical treatment of the tumor and spinal stabilization were possible via a simple anterior cervicotomy which allowed adequate access to the third thoracic vertebra, without sternotomy or thoracotomy.

Criptorquidia y malformaciones de epidídimo / Cryptochidism and epidymis malformations

Se realizó un estudio retrospectivo en 28 pacientes operados de criptorquídia,incluyendo 6 casos de bilateralidad,o sea se analizaron 34 testículos para identificar malformaciones del epidídimo.8 testículos tenían anatomía anormal del epidídimo,2 eran testículos evanescentes y 24 normales.La presencia del conducto peritoneo vaginal permeables resultó más frecuente en los testes anómalos.Es importante constatar estas anomalías que tendrían relación con el pronóstico de fertilidad testicular

[Age of menarche and genetic blood markers]. / Edad de menarquia y algunos marcadores geneticos sanguineos.

In 160 girls from low and middle socio-economic class of Santiago we correlated the age at menarque with genetic markers such as ABO blood group, Rh, MN, Xg, haptoglobins, Esterase D and Phosphoglucomutase. No significant association of these markers and age at menarque was found.

[Growth of girls and boys at puberty]. / Crecimiento de mujeres y varones en etapa puberal.

Growth at puberty varies according to age and individual maturity. Changes in height and weight of girls (aged 10 to 16 years) and boys (aged 11 to 17 years) which participate in a follow-up study at northern metropolitan Santiago, Chile, are described. Sexual maturity seems more determinant than chronological age on weight and height at puberty. For instance height of the whole sample of boys from 12 to 15.5 years of age ranged from 141 to 164 cm in contrast to 147 to 160 for those of the same age range but in the third stage of public hair development (Tanner). Sexual maturity should be taken into account for appropriate growth evaluation at puberty.