Associated factors of patients with spinal stenosis who undergo reoperation after a posterior lumbar spinal fusion in a Hispanic-American population.

PURPOSE: The aim of this study was to evaluate the associated factors of patients with LSS who undergo reoperation after a PLSF in a Hispanic-American population. METHODS: A retrospective single-center review was performed from all non-age-related Hispanic-Americans with LSS who underwent one or two-level PLSF from 2008 to 2018. Baseline characteristics were analyzed between the reoperation and no-reoperation group using a bivariate and multivariate analyses. RESULTS: Out of 425 patients who underwent PLSF, 38 patients underwent reoperation. At a two-year follow-up, the reoperation rate was 6.1% (26/425), mostly due to pseudoarthrosis (39.5%), recurrent stenosis (26.3%), new condition (15.8%), infection (10.5%), hematoma (5.3%), and dural tear (2.6%). Patients who underwent reoperation were more likely to have a preoperative history of epidural steroid injection (ESI) (OR 5.18, P = 0.009), four or more comorbidities (OR 2.69, P = 0.028), and operated only with a posterolateral fusion without intervertebral fusion (OR 2.15, P = 0.032). Finally, the multivariable analysis showed that ESI was the only independent associated factor in patients who underwent reoperation after a PLSF in our group. CONCLUSION: Among this population who underwent surgery, a reoperation rate at two years of follow-up was less than ten percent. Our study did not find any associated factor inherent to Hispanic-Americans, as ethnic group, who were reoperated after LSS.

How, when, and to what degree do people with alcohol dependence recover their psychological wellbeing and quality of life? The Madrid Recovery Project.

Introduction: The consensus on recovery from alcohol use disorder (AUD) has shifted toward encompassing psychological wellbeing and quality of life dimensions. However, few studies have explored the long-term recovery process and its dimensions, timing, styles, and modes. The aim of this study was to investigate the extent, timing, and process of psychological wellbeing and quality of life recovery in alcohol use disorder (AUD) patients, as well as the relationship with classic dimensions of AUD recovery. Method: A cross-sectional study has been carried out with 348 participants with AUD, in different abstinence periods (1 month-28 years), and 171 control subjects. Participants underwent a psychological evaluation, which included self-informed measures of psychological wellbeing, quality of life, negative emotionality, and coping strategies related to alcohol consumption avoidance. Statistical analysis included linear and non-linear regression models between psychological dimensions and maintenance of abstinence, as well as matching the scores of the sample with AUD to those of controls. Scatter plots were used to explore inflection points. In addition, mean comparison tests were performed between participants with AUD and controls and by gender. Results: In general, according to the regression models, there were pronounced increases in indices of wellbeing and coping strategies (and pronounced decreases in negative emotionality) during the first 5 years of abstinence, followed by less pronounced improvements. The matching of AUD subjects in wellbeing and negative emotionality indices with controls occurs at different times: (a) 1 year or less: physical health; (b) 1-4 years: psychological health; (c) 4-10 years: social relationships, wellbeing, and negative emotionality; and (d) more than 10 years: autonomy and self-acceptance. There are statistically significant differences by gender for the negative emotionality and physical health variables. Conclusion: Recovery from AUD is a long process that involves improvements in wellbeing and quality of life. Four stages can be described in this process, with the most pronounced changes occurring during the first 5 years of abstinence. However, AUD patients take more time to obtain similar scores to controls in several psychological dimensions.

Effect of sphingosine-1-phosphate on cryopreserved sheep testicular explants cultured in vitro.

Complete spermatogenesis has been achieved in vitro in mouse testicular explants with resulting sperm used to produce pups after Intra Cytoplasm Sperm Injection and Embryo Transfer. In the present study, we evaluated the influence of sphingosine-1-phosphate (S1P) on spermatogenesis of frozen-thawed lamb testis explants in vitro. Thawed testicular pieces were cultured for 12 d on agarose blocks in serum-free growth medium containing 0, 2, 5 or 10 µM S1P. At the end of D6 and D12, some pieces were fixed and processed for histology. Other pieces were processed for RNA isolation and quantitation of proliferation (PCNA, Ki67) and differentiation (PLZF) markers and genes involved in S1P signaling (S1PR1, SGPL1, SGPP1, AKT1 and NFKBIA) by qPCR. Histology revealed an increase (P < 0.05) in seminiferous cord (SC) diameter under all culture conditions, except 5 and 10 µM S1P by D6. In the presence of 5 µM S1P, percentage of gonocytes decreased (P < 0.05) by D6 (control, 24.9% vs. S1P, 10.3%) with a concomitant increase (P < 0.05) in spermatogonia formation (control, 74.4% vs. S1P, 88.1%). S1P induced PCNA or Ki67 expression by D6, whereas PLZF was up-regulated (P < 0.05) by D6 in 2 µM S1P and D12 in 5 & 10 µM S1P. Expression of SGPL1 and SGPP1 increased 4-12-fold in tissues cultured in 10 µM S1P by D12 compared to D12 control. AKT1 and NFKBIA mRNA expression was low (P < 0.05) in 5 and or 10 µM S1P treatments on D6. These results demonstrate that S1P promotes germ cell proliferation during first week of culture and may exert an anti-apoptotic influence on the seminiferous cord in sheep testicular explants in vitro.

Síndrome de Laugier-Hunziker, reporte de un caso y revisión de la literatura / Laugier-Hunziker syndrome, case report and literature review

El síndrome de Laugier-Hunziker (SLH) es un trastorno de hiperpigmentación macular benigno adquirido que se caracteriza por la presencia de máculas hiperpigmentadas policrómicas, de superficie plana, con morfología lenticular oval, de márgenes definidos; parte importante de éste es el desarrollo de melanoniquia longitudinal. Su principal diagnóstico diferencial es el síndrome de Peutz-Jeghers, ya que este último tiende a desarrollar neoplasias malignas en el tracto digestivo. Es importante que el estomatólogo conozca el SLH, con la finalidad de poder diagnosticarlo y diferenciarlo de otras entidades, particularmente de aquellas de carácter maligno (AU)

Laugier-Hunziker syndrome (LHS) is an acquired benign macular hyperpigmentation disorder, characterized by the presence of polychromic hyperpigmented macules, with a smooth surface, with oval lenticular morphology, with defined margins; An important part of this is the development of longitudinal melanonychia. Its main differential diagnosis is Peutz-Jeghers syndrome, since it tends to develop malignant neoplasms in the digestive tract. It is important that the Stomatologist knows the LHS, in order to be able to diagnose it and differentiate it from other entities, even those of a malignant nature (AU)

Abnormal hepatobiliary and circulating lipid metabolism in the Long-Evans Cinnamon rat model of Wilson's disease.

Long-Evans Cinnamon (LEC) rats exhibit a genetic defect in Atp7b gene, which is homologous to the human Wilson's disease gene, resulting in an inability to mobilize copper from the liver. This study was undertaken to gain insight into the relationship between liver copper accumulation and plasma lipid profile, circulating lipoprotein composition, hepatic sterol metabolism and biliary lipid secretion rates in 12-week-old LEC rats compared to control Long-Evans rats. Concomitant with hepatic copper deposition, LEC rats displayed increased content of triglycerides (TGs), free cholesterol (FC) and cholesteryl ester (CE) in the liver. Hepatic concentrations of malondialdehyde (MDA), an index of lipid peroxidation were also significantly elevated in LEC rats (50%). This steatosis was associated with aberrant microsomal apolipoprotein (apo) B-100 and microsomal triglyceride transfer protein (MTP) content, hypotriglyceridemia, hypocholesterolemia and abnormalities in both circulating lipoprotein composition and size. Atypical hepatobiliary sterol metabolism was established by the assessment of the activity of key intracellular enzymes for cholesterol homeostasis, which demonstrated, with respect to controls, a 40% reduction in 3-hydroxy-3-methylglutaryl coenzyme A reductase, a 30% reduction in cholesterol 7alpha-hydroxylase, and a 54% reduction in acyl CoA:cholesterol acyltransferase. During a 6-h biliary drainage, a decline in the bile acid output was recorded and might be linked to the low protein expression of the bile salt export pump (BSEP or ABCB11). Our data emphasize the crucial role of copper balance in hepatic sterol homeostasis and lipoprotein metabolism in LEC rats. Additional studies are needed to delineate the mechanisms of these disorders.

Ruptura de aguja dental con migración al espacio pterigomaxilar. Resolución mediante abordaje intrabucal laterofaríngeo / Rupture of dental needle with migration to the pterygomaxillary space. Resolution by intraoral lateropharyngeal approach

Introducción: La ruptura de una aguja dental es una complicación infrecuente y sucede generalmente por el movimiento repentino y/o cierre bucal inesperado del paciente, por doblar la aguja en forma inadecuada, por insertarla completamente o moverla dentro del tejido blando, por elegir agujas de calibre y longitud inadecuados y al realizar técnicas anestésicas inapropiadas. Cuando la aguja no puede ser recuperada al instante, debe establecerse su ubicación imagenológica tridimensional y decidir el manejo. Ante tal situación, su eliminación quirúrgica es la propuesta más recomendable por la posibilidad de que migre y lesione estructuras anatómicas importantes. Objetivo: Realizar una revisión de la literatura y presentar un caso clínico de ruptura de aguja dental localizada en el espacio pterigomaxilar, resuelto con un abordaje intrabucal laterofaríngeo. Presentación de caso: Paciente masculino de 8 años de edad, que acude a consulta por presentar ruptura de una aguja dental. Para obtener su ubicación se utilizó una tomografía computarizada de haz cónico con reconstrucción tridimensional a boca cerrada y abierta. Esta prueba ofreció mayor precisión y correspondencia anatómica, considerando que la eliminación quirúrgica podría realizarse mediante un abordaje intrabucal. Así fue hecho y durante la intervención quirúrgica se advirtió que la aguja había migrado a una ubicación superior y posterior, al espacio pterigomaxilar. Ante tal situación, resultó de mayor complejidad su recuperación, que ya presentaba riesgos por el procedimiento complejo al que se sometió. Conclusiones: La anestesia local intrabucal no está exenta de complicaciones propias como la ruptura de la aguja dental. Cuando este evento se presenta, el resultado puede ser de muy difícil manejo(AU)

Introduction: The rupture of a dental needle is an uncommon complication and usually happens due to the sudden movement and / or unexpected oral closure of the patient, by bending the needle improperly, by inserting it completely or moving it into the soft tissue, by choosing needles of inadequate caliber and length and by performing inappropriate anesthetic techniques. When the needle cannot be recovered instantly, its three-dimensional imaging location must be established and handling decided. In such a situation, its surgical elimination is the most recommended proposal due to the possibility of migrating and injuring important anatomical structures. Objective: Conduct a literature review and present a clinical case of dental needle rupture located in the pterygomaxillary space, resolved with a lateropharyngeal intraoral approach. Case presentation: An 8-year-old male patient, who comes to the consultation for a ruptured dental needle. To obtain its location, a cone-beam computed tomography with three-dimensional reconstruction was used at closed and open mouth. This test offered greater precision and anatomical correspondence, considering that surgical removal could be performed by an intraoral approach. This was done and during the surgical intervention it was noticed that the needle had migrated to an upper and posterior location, to the pterygomaxillary space. Faced with this situation, his recovery was more complex, in addition to the one that this procedure represents by itself. Conclusions: Intraoral local anesthesia is not exempt from its own complications such as the rupture of the dental needle. When this event occurs, the result can be very difficult to manage(AU)

Presencia de lesiones quísticas en sacos pericoronarios de terceros molares mandibulares / Presence of cystic lesions in pericoronary sacs of mandibular third molars

Introducción: a pesar de que un tercer molar no erupcionado repre- senta un riesgo de formación quística, la práctica clínica desestima el análisis histopatológico de los folículos de dichos molares. Objetivo: identificar la frecuencia de lesiones quísticas en los sacos pericoronarios de terceros molares mandibulares. Material y métodos: estudio des- criptivo, transversal, analítico y observacional, en donde se incluyeron sacos pericoronarios de terceros molares mandibulares para su análisis histopatológico, descripción de características clínico-radiográficas y su asociación con la presencia de cambios histológicos o lesiones quís- ticas. Resultados: se incluyeron 48 muestras de sacos pericoronarios, la histopatología de los sacos pericoronarios mostró que 83.3% tenían algún tipo de alteración: 13 quistes paradentales (27.1%), cuatro quistes dentígeros (8.3%), 12 folículos hiperplásicos (25.0%) y 11 folículos inflamados (22.9%). La presencia de lesiones quísticas en la población fue de 35.4%. Se detectó asociación estadísticamente significativa entre el sexo y la presencia de lesiones quísticas (p = 0.039) y entre el nivel de erupción y la presencia de cambios histológicos (p = 0.046). Con- clusiones: la frecuencia de lesiones quísticas o cambios histológicos en folículos de terceros molares mandibulares es alta, principalmente en molares parcialmente erupcionados o submucosos y sin importar la ausencia de sintomatología o alteraciones radiográficas (AU))

Introduction: although a non-erupted third molar represents a risk of cystic formation; clinical practice rejects the histopathological analysis of the follicles of said molars. Objective: identify the frequency of the histopathological changes in pericoronary sacs of mandibular third molars. Material and methods: descriptive cross- sectional, observational and analytic study, where pericoronary sacs of mandibular third molars were included for histopathological analysis, description of clinical-radiographic characteristics and their association with the presence of histological changes or cystic lesions. Results: 48 samples of pericoronary sacs were included, the histopathology of the pericoronary sacs showed 83.3% had some type of alteration: 13 paradental cysts (27.1%), four dentigerous cysts (8.3%), 12 hyperplastic follicles (25.0%) and 11 inflamed follicles (22.9%). The presence of cystic lesions in the population was 35.4%. A statistically significant association was detected between sex and the presence of cystic lesions (p = 0.039); and between the level of eruption and the presence of histological changes (p = 0.046). Conclusions: the frequency of cystic lesions or histological changes in mandibular third molar follicles is high, mainly in partially erupted or submucosal molars and regardless of the absence of symptoms or radiographic alterations (AU)

Lipoma de la cavidad oral: descripción de casos / Lipoma of the oral cavity: cases description

El lipoma es un tumor benigno derivado de tejido adiposo maduro que se presenta con poca frecuencia en la cavidad oral, pero de interés para el clínico estomatológico por su distintiva presentación en esta región. A continuación se reportan dos casos clínicos de lipoma simple localizados en la mucosa vestibular y piso de boca que fueron tratados mediante eliminación quirúrgica (AU)

Lipoma is a benign neoplasm derived of mature adipose tissue that occurs infrequently in the oral cavity, but of interest to the stomatologic clinician for its distinctive presentation in this region. Next, two cases of simple lipoma located in the vestibular mucosa and floor of the mouth that were treated by surgical excision are presented (AU)

Fusión del tercer molar inferior con un cuarto molar: reporte de tres casos / Fusion of the lower third molar with a fourth molar: report of three cases

Los dientes supernumerarios y la fusión dental son anomalías del desarrollo dental cuyas causas aún no se han dilucidado con certeza. El cuarto molar inferior, también denominado distomolar, es uno de los dientes supernumerarios con menor frecuencia de aparición clínica y su fusión con el tercer molar es una condición todavía menos común. A continuación, se reportan los casos clínicos de tres pacientes masculinos que presentaron fusión del tercer molar inferior derecho con un distomolar tratados mediante odontectomía (AU)

Supernumerary teeth and dental fusion are abnormalities of dental development whose causes have not yet been elucidated with certainty. The lower fourth molar, also called distomolar, is one of the supernumerary teeth with the least frequency of clinical appearance and its fusion with the third molar is an even less common condition. Next, the clinical cases of three male patients who presented fusion of the right lower third molar with a distomolar treated by odontectomy are reported (AU)

Slow freezing, but not vitrification supports complete spermatogenesis in cryopreserved, neonatal sheep testicular xenografts.

The ability to spur growth of early stage gametic cells recovered from neonates could lead to significant advances in rescuing the genomes of rare genotypes or endangered species that die unexpectedly. The purpose of this study was to determine, for the first time, the ability of two substantially different cryopreservation approaches, slow freezing versus vitrification, to preserve testicular tissue of the neonatal sheep and subsequently allow initiation of spermatogenesis post-xenografting. Testis tissue from four lambs (3-5 wk old) was processed and then untreated or subjected to slow freezing or vitrification. Tissue pieces (fresh, n = 214; slow freezing, then thawing, n = 196; vitrification, then warming, n = 139) were placed subcutaneously under the dorsal skin of SCID mice and then grafts recovered and evaluated 17 wk later. Grafts from fresh and slow frozen tissue contained the most advanced stages of spermatogenesis, including normal tubule architecture with elongating spermatids in ~1% (fresh) and ~10% (slow frozen) of tubules. Fewer than 2% of seminiferous tubules advanced to the primary spermatocyte stage in xenografts derived from vitrified tissue. Results demonstrate that slow freezing of neonatal lamb testes was far superior to vitrification in preserving cellular integrity and function after xenografting, including allowing ~10% of tubules to retain the capacity to resume spermatogenesis and yield mature spermatozoa. Although a first for any ruminant species, findings also illustrate the importance of preemptive studies that examine cryo-sensitivity of testicular tissue before attempting this type of male fertility preservation on a large scale.

Apósito adhesivo facial para el control de la inflamación de la odontectomía del tercer molar / Facial adhesive dressing for the control of inflammation of the third molar surgery

Introducción: La odontectomía del tercer molar produce una respuesta metabólica al trauma quirúrgico caracterizada por una importante infl amación del área, por lo que para su control se cuenta con diferentes opciones terapéuticas como la farmacoterapia, crioterapia y laserterapia, así como otras alternativas como la compresión de la región, cuya propuesta presentada en este trabajo es a través de la utilización de un apósito adhesivo facial. Objetivo: Evaluar la efi cacia de la aplicación de un apósito adhesivo facial para el control de la infl amación postquirúrgica de la odontectomía del tercer molar. Material y métodos: Se realizó un ensayo clínico controlado de fase I multicéntrico. Se conformó un grupo de estudio experimental y de control con 10 participantes en cada uno, de ambos sexos, de 18-30 años de edad, sanos y que presentaron un tercer molar inferior izquierdo retenido vertical o mesioangular, clase I o II, posición A o B (Pell y Gregory). Se efectuaron las odontectomías bajo anestesia local y sólo en el grupo experimental se utilizó un apósito adhesivo transparente marca Tegaderm® de 3M, el cual se colocó sobre la mejilla de los pacientes durante 48 horas. La evaluación de la infl amación se realizó con el método de Laskin modifi cado previo al procedimiento, a las 48 horas y en el quinto día postoperatorio. Resultados: El promedio de la longitud de la línea 1 a las 48 horas y al quinto día postoperatorio en el grupo experimental fue menor que en el grupo control siendo las diferencias estadísticamente signifi cativas. En el resto de las líneas, la longitud promedio también fue menor en el grupo experimental; sin embargo, no se encontraron diferencias estadísticamente signifi cativas. Conclusión: Este ensayo clínico no es concluyente respecto a la efi cacia del apósito adherible facial para reducir la infl amación postquirúrgica de la odontectomía del tercer molar (AU)

Introduction: The third molar odontectomy produces a metabolic response to surgical trauma characterized by an important infl ammation of the area, so that, for its control, it has diff erent therapeutic options as the pharmacotherapy, cryotherapy and laser therapy, as well as other alternatives such as compression of the region, whose proposal presented in this work is using a facial adhesive dressing. Objective: Evaluate the eff ectiveness of the implementation of a facial adhesive dressing for the control of postsurgical infl ammation of the third molar odontectomy. Material and methods: It has been made a controlled clinical trial of phase I multicentric. It formed a group of experimental and control study with 10 participants in each one, of both sexes, 18- 30 years of age, healthy and that presented a lower left third molar retained vertical or mesioangular, class I or II, position A or B (Pell and Gregory). Odontectomy were performed under local anesthesia and only in the experimental group used a transparent fi lm dressing Tegaderm® by 3M which was placed on the cheek of the patients for 48 hours. The evaluation of the infl ammation was performed with the method of Laskin modifi ed prior to the procedure, at 48 hours and on the 5th postoperative day. Results: The average of the length of the line 1 to 48 hours and at the 5th postoperative day was lower in the experimental group than in the control group, the diff erences being statistically signifi cant. In the rest of the lines, the average length was also lower in the experimental group, however, there were no statistically signifi cant diff erences. Conclusion: This trial is not conclusive as to the eff ectiveness of the dressing stick coating facial to reduce the postsurgical infl ammation of the third molar odontectomy (AU)

Microforma de fisura labial superior incompleta unilateral: reporte de un caso / Microform of unilateral incomplete upper cleft lip: report of a case

La microforma de fisura labial es una expresión de la fisura labial superior incompleta que se caracteriza por un surco o depresión cutáneomuscular a lo largo del margen del filtrum, asimetría o discontinuidad del margen mucocutáneo a nivel del pico del arco de Cupido, discontinuidad de la porción superior del músculo orbicular de la boca y deformidad menor del ala nasal. Es una condición que por su aparente poca gravedad y aparente fácil reparación, así como por su inusual presentación clínica, los reportes literarios sobre ella son escasos. Se presenta una revisión bibliográfica al respecto y se comunica un caso clínico como aporte a la literatura (AU)

The microform cleft lip is an expression of incomplete superior cleft lip is characterized by a groove or depression cutaneous and muscular along the margins of the philtrum, asymmetry or discontinuity mucocutaneous margin at the peak of Cupid's bow, discontinuity in the upper portion of the orbicularis oris muscle and minor deformity of the nasal ala. It is a condition for its apparent low gravity and apparent easy to repair as well as for its unusual clinical presentation, literature reports are scarce. We present a literature review and communicate about a case as a contribution to literature (AU)

Morfología radicular de los terceros molares / Root canal morphology of third molars

Introducción: la morfología radicular es una característica del tercermolar que puede incrementar el grado de difi cultad de la odontectomía,lo que hace necesario indagar sobre sus aspectos anatómicos más frecuentes. Objetivo: Conocer la morfología radicular de los terceros molares. Material y métodos: Se valoraron 155 tomografías computarizadas cone-beam (TCCB) de pacientes ≥ 16 años de edad, de ambos sexos, con al menos un tercer molar retenido o erupcionado con desarrollo radicular completo. Las características estudiadas fueron el número, longitud, diámetro y forma de las raíces. Resultados: Los terceros molares superiores presentaron con mayor frecuencia raíces fusionadas (57.9 por ciento) en forma cónica sobre su eje (27.2 por ciento). Los casos con raíces separadas mostraron más comúnmente una curvatura hacia distal en el tercio medio de la raíz vestíbulo-mesial (35 por ciento), mientras que la forma predominante de la raíz vestíbulo-distal fue la recta sobre su eje longitudinal (28.8 por ciento). Las formas más frecuentes de la raíz palatina fueron la recta sobre su eje longitudinal y la recta palatinizada conigual número de casos (18.7 por ciento), siendo ésta la que tuvo mayor longitud (11.7 ± 1.7 mm) y diámetro en sus diferentes tercios (cervical 4.8 ± 0.9 mm, medio 4 ± 1.1 mm y apical 2.8 ± 0.9 mm). Los terceros molaresinferiores presentaron mayormente dos raíces (75.9 por ciento) convergentes yseparadas por un septum óseo (38.1 por ciento), siendo la raíz vestíbulo-distal la que presentó mayor diámetro en sus diferentes tercios (4.1 ± 1 mm,3.4 ± 0.7 mm y 2.3 ± 0.6 mm, respectivamente). Conclusiones:Las características de las raíces de los terceros molares observadas en la TCCB se acercan a las descripciones anatómicas. Se observaron, además, múltiples variaciones en su forma, tanto en las fusionadas como en las separadas. Este aspecto morfológico debe ser tomado en cuenta para prever el grado de dificultad de la odontectomía del tercer molar.

Introduction: The root morphology of third molars is something thatcan make extraction more diffi cult, which is why research is needed intothe most common anatomical aspects of this characteristic. Objective:To understand the root morphology of the third molar. Material andmethod: 155 cone-beam computed tomography (CBCT) images ofpatients aged ≥ 16 years of both sexes with at least one retained orerupted third molar with complete root development were examined.The features assessed were: number, length, diameter, and shape ofthe roots. Results: The upper third molar was found to have a greaterfrequency of fused (57.9%) and cone-shaped roots (27.2%). Cases ofseparate roots most commonly displayed distal curvature towards themiddle third of the mesiobuccal root (35%), while the distobuccal rootwas more typically straight along its longitudinal axis (28.8%). Thepalatal root was most commonly either straight along its longitudinalaxis or its palatal side (18.7% in both cases), the latter being longer(11.7 ± 1.7 mm) and having a greater diameter in each of its threesections (cervical 4.8 ± 0.9 mm, middle 4 ± 1.1 mm, and apical 2.8 ±0.9 mm). The presence of two converging roots (75.9%) and two rootsseparated by an interdental septum (38.1%) was more common in lowerthird molars, with the distobuccal root having the greatest diameterin each of its three sections (cervical, 4.1 ± 1 mm, middle, 3.4 ± 0.7mm, and apical 2.3 ± 0.6 mm). Fused roots were longer (11.6 ± 1.8mm) and most commonly cone-shaped with distal tapering (27.7%).Conclusions: The characteristics observed in the CBCT images of theroots of the third molars were similar to those described in anatomicalliterature. Furthermore, multiple variations were found in their shape, inboth the fused and the separate root canals. This morphological aspectshould be taken into consideration in order to determine the degree ofdiffi culty of a third molar extraction.

Estudio bioquímico del veneno de la anémona de mar Phymactis papillosa (Actiniidae)

En este trabajo se ha estudiado bioquímicamente el veneno de Phymactis papillosa, colectadas en la bahía de Ancón. El veneno fue obtenido mediante shock hipotónico y luego se liofilizó. El análisis electroforético del veneno soluble mostró la presencia de 5 bandas proteicas con pesos moleculares entre 5 y 25.1 kDa. El veneno soluble fue fraccionado por cromatografía de filtración en una columna de Sephadex G-50, obteniéndose cuatro picos de proteína (I, II, III y IV). Tanto en el veneno soluble como en las fracciones colectadas se midió actividad de proteasa, fosfolipasa, hialuronidasa, fosfatasa ácida y fosfatasa alcalina; así como, actividad hemolítica y neurotóxica. Se encontró actividad proteolítica sobre caseína, en el veneno soluble y en los picos I y III. No se detectó actividad de fosfolipasa, hialuronidasa, fosfatasa ácida y fosfatasa alcalina. La actividad hemolítica, ensayada sobre eritrocitos humanos, se encontró en el veneno soluble y en el pico II. Finalmente, tanto el veneno soluble como el pico III mostraron ser neurotóxicos al ser inyectados en ratones albinos vía intraperitoneal. Se concluye que el veneno soluble de P. papillosa tiene actividad proteolítica, hemolítica y neurotóxica

In this work, the poison of Phymactis papillosa collected in Ancón bay has been studied biochemically. The venom was obtained by hypotonic shock and then lyophilized. Electrophoretic analysis of the soluble poison showed the presence of 5 protein bands with molecular weights between 5 and 25.1 kDa. The soluble venom was fractionated by filtration chromatography on a Sephadex G-50 column, yielding four protein peaks (I, II, III and IV). In the soluble venom and collected fractions was measured protease activity, phospholipase, hyaluronidase, acid phosphatase and alkaline phosphatase; as well as hemolytic and neurotoxic activity. Proteolytic activity on casein was found in the soluble venom and peaks I and III. Was not detected phospholipase activity, hyaluronidase, acid phosphatase and alkaline phosphatase. Hemolytic activity on human red cells tested, was found in the soluble venom and peak II. Finally, the soluble venom as the peak III showed be neurotoxic when injected into white mice intraperitoneally. It is concluded that the soluble venom of P. papillosa has proteolytic, hemolytic and neurotoxic activity

Allelic transcripts dosage effect in morphologically normal ovarian cells from heterozygous carriers of a BRCA1/2 French Canadian founder mutation.

We hypothesized that the transcriptome of primary cultures of morphologically normal ovarian surface epithelial cells could be altered by the presence of a heterozygous BRCA1 or BRCA2 mutation. We aimed to discover early events associated with ovarian carcinogenesis, which could represent putative targets for preventive strategies of this silent killer tumor. We identified the first molecular signature associated with French Canadian BRCA1 or BRCA2 founder mutations in morphologically normal ovarian epithelial cells. We discovered that wild-type and mutated BRCA2 allelic transcripts were expressed not only in morphologically normal but also in tumor cells from BRCA2-8765delAG carriers. Further analysis of morphologically normal ovarian and tumor cells from BRCA1-4446C>T carriers lead to the same observation. Our data support the idea that one single hit in BRCA1 or BRCA2 is sufficient to alter the transcriptome of phenotypically normal ovarian epithelial cells. The highest level of BRCA2-mutated allele transcript expression was measured in cells originating from the most aggressive ovarian tumor. The penetrance of the mutation and the aggressiveness of the related tumor could depend on a dosage effect of the mutated allele transcript.

[Isaac and Jose Horwitz in Chilean psychiatry]. / Isaac y José Horwitz en la psiquiatría chilena.

During the XXth century, neuropsychiatrists Isaac and José Horwitz worked in the Asylum, the current Psychiatric Institute Dr José Horwitz. While Isaac dedicated part of his time to teach in Medical and Nursing Schools, his brother José preferred clinical work on mental health. Both chaired consecutively the Service A of the old Hospital and José occupied in his last year the Director's position. After a scholarship in Mental Health in Baltimore, José developed, in conjunction with other outstanding colleagues, the first investigations on psychiatric morbidity in Chile, promoted the use of work therapy for individuals with chronic mental diseases, and helped to improve and plan projects for the prevention and treatment of alcoholism.

[Arturo Vivado Orsini and the renewal of psychiatric treatments]. / Arturo Vivado Orsini y la renovación de los tratamientos psiquiátricos.

During the first half of the twentieth century, new psychiatric treatments were discovered, such as malario therapy, insulin therapy, electroshock, penicillin therapy, and the anti-alcoholic aversive therapy. These treatments gave a new hope to mental patients, even in our country. It was precisely while Dr. Arturo Vivado, Full Professor of Psychiatry at the University of Chile, worked and taught, that these treatments were progressively applied in Chile. After an effortful career, Dr. Vivado was appointed Director of the Psychiatric Asylum in Santiago, in 1945. He was a skillful clinician and pragmatic with his psychological belief, equanimus and affectionate with people. His most important contributions to the specialty are described in this review.

Video-assisted versus open anterior lumbar spine fusion surgery: a comparison of four techniques and complications in 135 patients.

STUDY DESIGN: A retrospective review involved 135 patients undergoing anterior interbody fusion using four different approaches: transperitoneal video-assisted surgery with insufflation, retroperitoneal endoscopic video-assisted surgery, minilaparotomy retroperitoneal surgery, and traditional oblique muscle-splinting retroperitoneal surgery. OBJECTIVE: To describe and compare the operative procedure and perioperative complications of four different interbody fusion techniques. SUMMARY OF BACKGROUND DATA: Although anterior lumbar interbody fusion surgery has a long history, several new and innovative approaches have been introduced recently. In contrast to the traditional oblique muscle-splitting retroperitoneal flank incision, the following have been used: a "minilaparotomy" open extraperitoneal approach through a small midline incision, a transperitoneal video-assisted insufflation technique, and a video-assisted gasless retroperitoneal endoscopic technique. METHODS: A retrospective review was performed using the hospital records, operating room records, and clinic charts of 135 consecutive patients (50 men and 85 women) who underwent surgery between December 1993 and February 1998. Cases were included if either bone grafts alone or cylindrical cages with bone graft inside were used. Cases with anterior instrumentation using plates or rods were excluded. Diagnoses included degenerative disc disease, spondylolisthesis, or pseudarthrosis of a previous lumbosacral fusion. Patients with tumors or infection were excluded. The patients all were adults ranging in age from 17 to 83 years. Among the 135 patients, 12 had undergone previous anterior spine fusion surgery and 64 had undergone prior abdominal surgery. RESULTS: The onset of new radicular pain or numbness, not experienced by the patient before surgery, occurred in six patients (18%; all with transperitoneal video-assisted surgery using insufflation). Vascular problems occurred in five patients (3.7% overall): two in the transperitoneal video-assisted group (5.9% of the group) and three in the minilaparotomy group (8.7% of the group). Retrograde ejaculation occurred in 4 of the 50 male patients (8% of the group): three in the transperitoneal video-assisted group (25% of the group) and one in the minilaparotomy group (2% of the group). Two patients had ureteral injuries (1.5% overall): one each in the retroperitoneal endoscopic and minilaparotomy groups. Conversion to open procedures was performed in seven patients (11% of the video-assisted procedures). The reasons for conversion included two major vessel lacerations and five peritoneal tears in the retroperitoneal video-assisted group. CONCLUSIONS: A comparative analysis of four techniques for approaching the lower lumbar spine to perform arthrodesis in 135 patients showed an incidence of complications consistent with the literature for video-assisted techniques, but higher than for open techniques. For these and other reasons, the video-assisted approaches have been abandoned by the surgeons of this report.

Dr. Oscar Fontecilla Espinoza (1882-1937)

RESUMEN Oscar Fontecilla alcanzó el cargo de Profesor Titular cuando la Psiquiatría fue reconocida por la Facultad de Medicina como especialidad independiente. Orador talentoso, polemista notable, dotado de cualidades morales e intelectuales superiores, participó en la vida política desechando cargos de representación pública. Reconocido en el medio académico aportó con diversas iniciativas al desarrollo de la especialidad, alcanzando un prestigio que atravesó las fronteras. En plena edad creativa fue desgraciadamente asesinado por un paciente.