Tolosa Hunt Syndrome: MRI Findings.

Tolosa-Hunt syndrome (THS) is an idiopathic inflammatory condition involving the cavernous sinus and orbital apex with an incidence of 1 case per million per year. We report on a case of a 70-year-old male with atypical MRI findings, vision loss, and painless ophthalmoplegia.  Ophthalmic evaluation revealed his best-corrected visual acuity was 20/40 in the right eye and counting fingers at a 0.5-foot distance in the left eye. External examination of the left eye revealed limited ocular movement, proptosis, and a positive relative afferent pupillary defect. Complete blood count, inflammatory markers, and full biochemistry tests, including thyroid and liver function tests, were within the normal range. A magnetic resonance imaging of the orbits with and without contrast demonstrated a homogenously enhancing lesion at the posterior intraconal compartment of the left orbit, extending to the orbital apex with the involvement of the adjacent extraocular muscles. The patient was started on intravenous methylprednisolone 60 mg daily and later discharged on prednisone 5 mg daily with partial symptom improvement on follow-up. Resection and biopsy revealed a soft tissue lesion with mixed inflammatory infiltrate. The clinical, pathological, and imaging findings favored the diagnosis of THS.

Establishment of the upstream processing for renewable production of hydrogen using vermicomposting-tea and molasses as substrate.

This study aimed to establish the optimal operational conditions for hydrogen production using vermicomposting-tea and sugarcane molasses as substrate. The experiments were carried out by triplicate in 110 ml serological bottles, a Box-Behnken design of experiments was performed in anaerobic dark conditions. The maximal hydrogen production (HP), hydrogen production rate (HPR), and hydrogen yield (HY) attained were 1021.0 mlL-1, 5.32 mlL-1h-1, and 60.3 mlLH2-1/gTCC, respectively. The statistical model showed that the optimal operational conditions for pH, molasses concentration, and temperature were 6.5; 30 % (v/v) and 25 °C. The bioreactor run showed 17.202 L of hydrogen, 0.58 Lh-1, and 77.2 mlH2gTCC-1 For HP, HPR, and HY. Chemometric analysis for the volatile fatty acids obtained at the fermentation showed that only two principal components are required to explain 90 % of the variance. The representative pathways for hydrogen production were acetic and butyric acids. This study established the operational conditions for the upstream processing amenable to pilot and industrial-scale operations. Our results add value to molasses within the circular economy for hydrogen production using a novel consortium from vermicompost.

Neurocisticercosis: lesión única cerebral con serología negativa y confirmación post exéresis. Reporte de caso. / Neurocysticercosis: single brain lesion with negative serology and post exeresis confirmation. Case report

Los diagnósticos diferenciales de una lesión única intraparenquimatosa cerebral con borde en anillo son múltiples, desde un proceso infeccioso parasitario hasta una neoplasia primaria del sistema nervioso, por lo que su manejo puede ser controversial y debe tenerse en cuenta la prevalencia epidemiológica según la situación demográfica donde se presente. De esta manera, presentamos el caso de una paciente adulta joven que ingresó al servicio de neurocirugía con sintomatología focal sensitiva asociado a cefalea intermitente, con una TC de encéfalo que reveló una lesión subcortical localizada en la parte superior del giro postcentral izquierdo con edema perilesional importante y realce periférico tras contraste. Se realizaron pruebas de serología en suero y LCR para neuroparásitos, las cuales se reportaron negativas. Se procedió a realizar exéresis completa de la lesión con uso de ecografía intraoperatoria para minimizar tiempo quirúrgico y área de lesión cortical, la cual se envió a estudio de histopatología y reportó el diagnóstico de neurocisticercosis en estadio nodular granulomatoso. Se realiza el presente reporte de caso con una búsqueda exhaustiva en la literatura sobre la sensibilidad y utilidad de las pruebas de serología parasitaria para la confirmación diagnóstica de la neurocisticercosis y para evitar intervenciones neuroquirúrgicas invasivas

The differential diagnoses of single, ring-enhancing brain lesions are multiple, from a parasitic infection to a primary tumor of the central nervous system, therefore, the management of these lesions can be controversial, and the epidemiological prevalence must be taken into account according the demographic situation of the patient. We present the case of a young adult female who was admitted to the neurosurgery service, debuting sensory focal symptoms associated with headache. Brain CT and MRI revealed a subcortical cyst-like lesion in the left superior postcentral gyrus, with large perilesional edema and peripheral enhancement following contrast administration. Serological test for CNS parasites in serum and CSF were negative. Consequently, we realized a complete removal of the cyst with intraoperative ultrasound to optimize the surgical time and the cortical surgical area. The histopathological examination revealed a degenerating cysticercus. For this reason, a bibliographic research was carried out to identify the sensitivity of serological tests for the diagnostic confirmation of neurocysticercosis and thus avoid invasive neurosurgical interventions

Respiratory muscle impairment evaluated with mep/mip ratio in children and adolescents with chronic respiratory disease / Fraqueza muscular respiratória avaliada por meio da relação pemax/pimax em crianças com doença respiratória crônica

ABSTRACT Objective: To evaluate the strength of respiratory muscles and to compare maximum inspiratory (MIP) and expiratory (MEP) pressure and MEP/MIP ratio between patients with chronic respiratory diseases and healthy individuals. Methods: Case-control study. Individuals with neuromuscular disease and post-infectious bronchiolitis obliterans were considered. In addition, they were also matched according to anthropometric and demographic characteristics with healthy children and adolescents. MIP, MEP in the three groups, and pulmonary function only in patients with chronic respiratory diseases were recorded. Results: A total of 52 subjects with CRD (25 with neuromuscular disease, and 27 with post-infectious bronchiolitis obliterans) and 85 healthy individuals were included, with an average age of 11.3±2.1 years. Patients with neuromuscular disease and post-infectious bronchiolitis obliterans presented lower MIP and MEP when compared with healthy individuals, although MEP/MIP ratio was lower in patients with neuromuscular disease (0.87±0.3) and higher in patients with post-infectious bronchiolitis obliterans (1.1±0.3) compared to the healthy group (0.97±0.2). Only in patients with neuromuscular disease a negative correlation was observed between MEP/MIP ratio and age (r=-0.50; p=0.01). Conclusions: Differences in the pattern of muscular weakness between patients with chronic respiratory diseases were observed. In patients with neuromuscular disease, a decrease in the MEP/MIP ratio depending on MIP was verified; and in those patients with post-infectious bronchiolitis obliterans, an increase in the MEP/MIP ratio depending on MIP was also observed.

RESUMO Objetivo: Avaliar a força dos músculos respiratórios e comparar a relação entre a pressão expiratória máxima (PEmáx) e a pressão inspiratória máxima (PImáx) em pacientes com doença respiratória crônica (DRC) e crianças saudáveis. Métodos: Estudo caso-controle. Foram selecionados indivíduos com doença neuromuscular e bronquiolite obliterante pós-infecciosa. Ademais, os grupos foram pareados com crianças e adolescentes saudáveis, considerando características antropométricas e demográficas. Foram registradas a PImáx e a PEmáx nos três grupos e a função pulmonar apenas em pacientes com doença respiratória crônica. Resultados: Foram incluídos 52 indivíduos com DRC (25 com doença neuromuscular e 27 com bronquiolite obliterante pós-infecciosa) e 85 indivíduos saudáveis, com idade média de 11,3±2,1 anos. Pacientes com doença neuromuscular e bronquiolite obliterante pós-infecciosa apresentaram menor PImáx e PEmáx em comparação aos indivíduos saudáveis, embora a relação PEmáx/PImáx tenha sido menor nos pacientes com doença neuromuscular (0,87±0,3) e maior nos pacientes com bronquiolite obliterante pós-infecciosa (1,1±0,3) em comparação ao grupo saudável (0,97±0,2). Somente em pacientes com doença neuromuscular foi observada uma correlação negativa entre a razão PEmáx/PImáx e a idade (r=-0,50; p=0,01). Conclusões: Foram observadas diferenças no padrão de fraqueza muscular em pacientes com doença respiratória crônica. Nos pacientes com doença neuromuscular, verificou-se diminuição na relação PEmáx/PImáx dependendo da PImáx; em pacientes com bronquiolite obliterante pós-infecciosa, foi observado aumento na relação dependendo da PImáx.

Programa de rehabilitación respiratoria infantil en un hospital público de Chile / Pediatric pulmonary rehabilitation program at a Chilean public hospital

Introducción. La rehabilitación respiratoria infantil es relevante en el manejo de enfermedades respiratorias crónicas. En Chile, se desarrolla solo en algunos hospitales.Objetivo. Describir los resultados de un programa de rehabilitación respiratoria infantil tras 3 meses de rehabilitación.Metodología. Estudio retrospectivo de los pacientes con enfermedad pulmonar crónica, enfermedad neuromuscular y otras patologías crónicas admitidos desde junio de 2011 a junio de 2017. Se realizó evaluación física general, evaluación de musculatura respiratoria y espirometría. Se planificó entrenamiento físico general y entrenamiento muscular respiratorio, con protocolos institucional, mixto y domiciliario.Resultados. Ingresaron al programa 156 pacientes (11,45 ± 3,55 años), 68 con enfermedad pulmonar crónica (11,56 ± 4,6 años, el 43,5 %), 45 con enfermedad neuromuscular (11,4 ± 3,7 años, el 28,8 %) y 43 con patologías crónicas diversas (11,31 ± 3,9 años). Del total, se entrenaron 102 (el 65,4 %); dirigido (n = 27), mixto (n = 23) y domiciliario (n = 50) con adherencia del 69 %, del 87,5 % y del 70 %, respectivamente. Aumentó el 19,3 % la presión inspiratoria máxima (p = 0,001), el 14,5 % la presión espiratoria máxima (p = 0,001), el 12,9 % la capacidad vital forzada (p = 0,001), el 11,6 % el volumen espiratorio forzado al primer segundo (p = 0,004) y 17,6 metros en el test de marcha de 6 minutos (p = 0,036) tras 3 meses de rehabilitación.Conclusiones. El protocolo de intervención incrementó el estatus funcional cardiorrespiratorio. La adherencia fue superior al 65 %.

Introduction. Pediatric pulmonary rehabilitation is relevant in the management of chronic respiratory diseases. In Chile, it is provided only at certain hospitals.Objective. To describe the outcomes of a pediatric pulmonary rehabilitation program after 3 months of rehabilitation.Methodology. Retrospective study of patients with chronic lung disease, neuromuscular disease, and other chronic conditions admitted to the program between June 2011 and June 2017. Assessments included general physical and respiratory muscle examination, and spirometry. General physical training and respiratory muscle training were planned according to facility-based, mixed and home protocols. Results. A total of 156 patients (11.45 ± 3.55 years old) were included, 68 had chronic lung disease (11.56 ± 4.6 years old, 43.5 %); 45, neuromuscular disease (11.4 ± 3.7 years old, 28.8 %); and 43, various chronic conditions (11.31 ± 3.9 years old). Out of all patients, 102 (65.4 %) followed training protocols; targeted (n = 27), mixed (n = 23), and home (n = 50); compliance was 69 %, 87.5 %, and 70 %, respectively. Peak inspiratory pressure increased by 19.3 % (p = 0.001); peak expiratory pressure,14.5 % (p = 0.001); forced vital capacity, 12.9 % (p = 0.001); forced expiratory volume in 1 second, 1.6 % (p = 0.004); and the six-minute walk test, 17.6 meters (p = 0.036) after 3 months of rehabilitation.Conclusions. The intervention protocol improved cardiorespiratory functional capacity. Compliance was over 65 %.

Molecular Profiling and Functional Analysis of Macrophage-Derived Tumor Extracellular Vesicles.

Extracellular vesicles (EVs), including exosomes, modulate multiple aspects of cancer biology. Tumor-associated macrophages (TAMs) secrete EVs, but their molecular features and functions are poorly characterized. Here, we report methodology for the enrichment, quantification, and proteomic and lipidomic analysis of EVs released from mouse TAMs (TAM-EVs). Compared to source TAMs, TAM-EVs present molecular profiles associated with a Th1/M1 polarization signature, enhanced inflammation and immune response, and a more favorable patient prognosis. Accordingly, enriched TAM-EV preparations promote T cell proliferation and activation ex vivo. TAM-EVs also contain bioactive lipids and biosynthetic enzymes, which may alter pro-inflammatory signaling in the cancer cells. Thus, whereas TAMs are largely immunosuppressive, their EVs may have the potential to stimulate, rather than limit, anti-tumor immunity.

Poligrafía pediátrica: experiencia de 6 años / Pediatric polygraphy: a 6-year experience

INTRODUCCIÓN: El diagnóstico precoz de los Trastornos Respiratorios del Sueño (TRS) puede permitir una intervención oportuna. La poligrafía (PG) es una alternativa confiable y accesible en la actualidad. OBJETIVO: Describir y analizar PG de niños > 1 año con sospecha de TRS. PACIENTES Y MÉTODO: Se incluyeron PG de niños y adolescentes > 1 año de edad con sospecha de TRS, desde diciembre de 2011 hasta agosto de 2017 provenientes de la ciudad de Concepcion, Chile. Se recopilaron datos demo gráficos, clínicos y variables poligráficas. Estadística descriptiva, expresando resultados en mediana y rango. Se determinó asociación entre índice de apnea hipopnea (IAH) y saturación mediante Rho de Spearman; considerando significancia p < 0,05. RESULTADOS: Se analizaron 190 estudios. Edad 7,9 años (1,0-20,6), varones 61%. Diagnósticos: enfermedades neuromusculares (ENM) (24,2%), daño pulmonar crónico (21,1%), obstrucción de vía aérea superior (OVAS) (19,5%), daño neurológico (11%), síndrome de Down (8,9%) malformaciones VAS (7,4%), hipoventilación central (3,7%), obesidad (2,6%) y otros (1,6%). El 55,3% de las PG resultaron alteradas; síndrome de apnea hipopnea obstructiva del sueño (SAHOS) leve en 53,3%, moderado 30,5% y severo 16,2%. No se observaron diferencias significativas en IAH entre grupos de patologías (p = 0,032), destacando un mayor IAH en Obesidad 9,0 (0,41-51) y ENM 23,9 (0,4-36,6). Se constató asociación entre IAH y parámetros de saturación; saturación promedio (rho = -0,425; p = 0,001); mínima (rho = -0,654; p = 0,001); y saturación bajo 90% (rho = 0,323; p = 0,001) en la totalidad de la muestra. DISCUSIÓN: Existió un alto porcentaje de SAHOS en pacientes pediátricos de riesgo, en especial en aquellos con ENM y obesidad. La PG es una herramienta accesible e implementable en un hospital público; situación potencialmente extrapolable a otros centros asistenciales.

INTRODUCTION: The early diagnosis of Sleep Disordered Breathing (SDB) may allow proper intervention. Currently, polygraphy (PG) is a reliable and accessible alternative. OBJECTIVE: To describe and analyze the PG of children > 1 year old with suspicion of SDB. PATIENTS AND METHOD: PG of children > 1 year old and adolescents from Concepcion, Chile, with suspected SDB were included, from December 2011 to August 2017. Demographic, clinical and polygraphic variables were collected. It was used descriptive sta tistics, expressing results in median and range. The association between apnea-hypopnea index (AHI) and oxygen saturation was determined by Spearman's Rho, considering significance of p < 0.05. RESULTS: 190 studies were analyzed. Age 7.9 years old (1.0-20.6), 61% males. Diagnosis: neuromuscular disease (NMD) (24.2%), chronic lung damage (21.1%), upper airway obstruction (UAO) (19.5%), neurological damage (11%), Down syndrome (8.9%), upper airway malformations (7.4%), central hypoventilation (3.7%), obesity (2.6%), and others (1.6%). 55.3% were altered PG, with 53.3% of mild Obstructive Sleep Apnea Hypopnea Syndrome (OSAHS), 30.5% moderate, and 16.2% severe. There were no significant differences in AHI between groups of pathologies (p = 0.032), highlighting a higher AHI in obese patients 9 (0.41-51), and those with NMD 23.9 (0.4-36.6). It was found asso ciation between AHI and oxygen saturation parameters: mean saturation (rho = -0.425; p = 0.001), minimum (rho = -0.654; p = 0.001), and oxygen saturation below 90% (rho = 0.323; p = 0.001) in the whole sample. DISCUSSION: There was a high percentage of OSAHS in at-risk pediatric patients, especially in those with NMD and obesity. PG is an accessible and implementable tool in a public hospital, a situation that can potentially be extrapolated to other healthcare centers.

Caracteres estructurales y ultraestructurales de la gametogénesis de Chara hydropitys (Charophyceae) / Structural and ultrastructural characters of the gametogenesis of Chara hydropitys (Charophyceae)

Resumen Los oosporangios y anteridios de Charophyceae son los órganos de reproducción sexual femeninos y masculinos respectivamente. Estas estructuras se caracterizan por su complejidad morfológica y utilidad en taxonomía y sistemática. En el presente trabajo se describen los detalles estructurales y ultraestructurales de la gametogénesis en Chara hydropitys. El material fértil del alga se recolectó en una quebrada tributaria del Río Meléndez en la ciudad de Cali, Colombia (3º21´23´´N - 76º32´5.2´´W). Los especímenes fueron fijados y procesados de acuerdo a los protocolos estándar para la inclusión en resina y obtención de secciones finas que se colorearon con toluidina O (0.3-0.7 μm) para su observación en microscopía fotónica y secciones ultrafinas (60-90 nm) para microscopía electrónica de transmisión (MET). Además, se procesaron muestras para microscopio electrónico de barrido (MEB). Los oosporangios están recubiertos por las células espirales que forman de 10-12 circunvoluciones y terminan en cinco células coronulares. La pared de los oosporangios inmaduros está formada por dos capas que corresponden a la pared de las células espirales y de la oosfera. Al madurar la pared del oosporangio tiene seis capas adicionales, tres de las cuales son aportadas por la oospora y las tres restantes por las células espirales. La oosfera aumenta progresivamente de tamaño a medida que las células espirales crecen y se dividen. En el citoplasma de la oosfera inmadura no se aprecian inclusiones citoplasmáticas conspicuas, pero con la maduración el número de gránulos de almidón aumenta llegando a ocupar la mayor parte del volumen celular. En las células espirales del oosporangio maduro se observan numerosos cloroplastos con prominentes depósitos de almidón entre las lamelas tilacoidales y una vacuola que ocupa casi toda la célula. En las observaciones con MEB se aprecia que la pared externa de la oospora, sobre la zona de la fosa presenta microornamentaciones de tipo verrucado. En los anteridios maduros las células del escudo están fuertemente pigmentadas de color naranja por la presencia de numerosos plastoglóbulos entre las lamelas tilacoidales. De las células del capítulo secundario se desarrollan los filamentos espermatógenos que por divisiones mitóticas unidireccionales y sincrónicas forman los espermatocitos. A partir de estas células haploides por espermiogénesis se desarrollarán los anterozoides biflagelados. Los eventos subcelulares relacionados con estos procesos de división y diferenciación celular incluyen inicialmente cambios en la condensación de la cromatina, pérdida del nucléolo y mayor actividad de los dictiosomas. Posteriormente, el citoplasma se retrae y los orgánulos se alinean a lo largo del núcleo condensado y del aparato flagelar. Los anterozoides maduros emergen a través de un poro lateral de la pared de los espermatocitos. Todos los eventos descritos indican que los procesos de gametogénesis y los detalles estructurales de los gametos son por lo general características ampliamente conservadas en este grupo de algas.

Abstract InCharophyceae, the oosporangia and antheridia are the respective female and male structures of sexual reproduction. These organs are characterized by their morphological complexity and usefulness in taxonomy and systematics. Here we described the structural and ultraestructural details of Chara hydropitys gametogenesis. The fertile material from the algae was collected in a tributary stream of the Río Meléndez in Cali, Colombia (3º21´23´´N - 76º32´5.2´´W) in March 2011. The specimens were fixed and processed following the standard protocols for inclusion in resin. Thin sections (0.3-0.5 μm) were stained with toluidine O, and were observed by photonic microscopy, and additional ultrathin sections (60-90 nm) were observed by transmission electron microscopy (TEM); other samples were processed and observed by scanning electron microscopy (SEM). We found that the oosporangia are covered with spiral cells, forming 10-12 convolutions and ends in five coronula cells. The immature oosporangia wall is formed by two layers that correspond to the wall of the spiral cells and to the oosphere. In mature stages, the oosporangia wall is composed by six additional layers, three of them are provided by the oosphere and the other three are provided by the spiral cells. Oosphere size increases progressively while the spiral cells grow and divide. The cytoplasm of the immature oosphere does not exhibit conspicuous cytoplasmic inclusions, nevertheless, with the maturation, the number of starch granules increases, occupying most of the cell volume. In the spiral cells of the mature oosporangia we observed large number of chloroplast with starch accumulations, between thylakoid lamellae and a vacuole that occupies almost the entire cell. By using SEM it was possible to appreciate, that the external wall of the oospore, more accurately, on the fossa area, shows verrucose micro-ornamentations with verrucae elevations. In mature antheridia, shield cells are strongly pigmented orange due to the presence of a large number of plastoglobules between thylakoid lamellae. The spermatogenous filaments are developed from cells of the secondary capitulum; those, by unidirectional and sincronic mitotic divisions develop the spermatocytes. The biflagellate antherozoids are developed from the haploid cells by spermiogenesis. The subcellular events related with these division and differentiation processes, include first, chromatin condensation, loss of nucleoli and more activity in dictyosomes. Subsequently, retracts the cytoplasm and the organelles are aligned along the condensed nucleus and flagellar apparatus. Mature antherozoids emerge through a side wall pore of the spermatocytes. All the described events showed that the gametogenesis processes and the gametes structural details in general, are widely conserved in this algae group.

Occurrence of Pepper Mild Mottle Virus (PMMoV) in Groundwater from a Karst Aquifer System in the Yucatan Peninsula, Mexico.

The Yucatan Peninsula of Mexico hosts a karst aquifer system that is the only source of freshwater for the area; however, it is vulnerable to human-mediated contamination. Pepper mild mottle virus (PMMoV) is one of the most abundant RNA viruses associated with human feces, making it a viable indicator for tracking fecal pollution in aquatic environments, including groundwater. In this study, groundwater samples collected from a karst aquifer from fresh and brackish water locations were analyzed for fecal indicator bacteria, somatic and male F+ specific coliphages, and PMMoV during the rainy and dry seasons. Total coliform bacteria were detected at all sites, whereas Escherichia coli were found at relatively low levels <40 MPN/100 ml. The highest average concentrations of somatic and male F+ specific coliphages were 920 and 330 plaque forming units per 100 ml, respectively, detected in freshwater during the rainy season. PMMoV RNA was detected in 85% of the samples with gene sequences sharing 99-100% of nucleotide identity with PMMoV sequences available in GenBank. Quantification of PMMoV genome copies (GC) by quantitative real-time PCR indicated concentrations ranging from 1.7 × 101 to 1.0 × 104 GC/L, with the highest number of GC detected during the rainy season. No significant correlation was observed between PMMoV occurrence by season or water type (p > 0.05). Physicochemical and indicator bacteria were not correlated with PMMoV concentrations. The abundance and prevalence of PMMoV in the karst aquifer may reflect its environmental persistence and its potential as a fecal indicator in this karst aquifer system.

Esporogénesis y esporas de Equisetum bogotense (Equisetaceae) de las áreas montañosas de Colombia / Sporogenesis and spores of Equisetum bogotense (Equisetaceae) from mountain areas of Colombia

Studies on some reproductive traits in Equisetum species are scarce and valuable to understand species distribution. Therefore, a detailed study of the sporogenesis process and spore development in E. bogotense is presented, with an analysis of the main events during meiosis, maturation of spores, spore wall ultrastructure, orbicules and elaters. Specimens were collected from 500 to 4 500m in Cauca, Colombia. Strobili at different maturation stages were fixed, dehydrated, embedded in resin, and ultra-microtome obtained sections were stained with Toluidine blue. Observations were made with optical microscopy with differential interference contrast illumination technique (DIC), transmission and scanning electron microscopy (TEM and SEM). Ultrathin sections (70-80μm) for TEM observations were stained with uranyl acetate and lead citrate; while samples for SEM observations, were fixed, dehydrated in 2.2-dimethoxypropane and dried at critical point as in standard methods. Strobili have numerous mature sporangiophores, each one with a peltate structure, the scutellum, bearing five-six sessile sporangia attached to the axis of strobilus by the manubrium. Immature sporocytes (spore mother cells) are tightly packed within the young sporangia. The sporocytes quickly undergo meiosis, by passing the stage of archesporium and give origin to tetrads of spores. The tapetum loses histological integrity during early stages of sporogenesis, intrudes as a plasmodial mass into the cavity of the sporangium, partially surrounding premeiotic sporocytes, and then, tetrads and adult spores. The tapetum disintegrates towards the end of the sporogenesis, leaving spores free within the sporangial cavity. Spores present several cytological changes that allow them to achieve greater size and increase the number of plastids, before reaching the adult stage. Sporoderm includes three layers external to the cytoplasmic membrane of the spore cell, and they are pseudoendospore, exospore and perispore. Viewed with SEM, the exospore is smooth to rugulate, with micro perforations, while the perispore is muriform, rugate, with narrow, delicate, discontinuous, randomly distributed folds delimiting incomplete, irregular areolae, externally covered by of different size, densely distributed orbicules. These orbicules are also found all over the external face and margins of the elaters, while the internal face is smooth and lack orbicules. Viewed with TEM, the exospore is a thick layer of fine granular material, while perispore is a thinner layer of dense, separate orbicules. The elaters are composed by two layers of fibrillar material: an inner layer with longitudinally oriented fibrils and an outer, thicker and less dense layer with fibrils transversely fibrils and abundant, external orbicules. It is suggested that the processes of ontogeny and characters of the sporoderm are relatively constant in Equisetum; however, sporogenesis in E. bogotense is synchronous and this condition has been observed so far only in E. giganteum, a tropical genus also found in Colombia.

Los estudios sobre aspectos reproductivos son escasos en Equisetum. Por eso, hemos realizado un análisis detallado del proceso de esporogénesis, desarrollo de las esporas, ultraestructura de procesos que tienen lugar durante la meiosis, formación de la pared esporal, orbículas y eláteres de E. bogotense, en especímenes procedentes del Cauca, Colombia. Los estudios se efectuaron mediante microscopía fotónica, electrónica de transmisión (TEM) y de barrido (SEM). Los estróbilos llevan numerosos esporangióforos maduros, cada uno con un escutelo peltado, unido al eje del estróbilo por el manubrio y portador de 5-6 esporangios sésiles. Los esporocitos experimentan meiosis dando origen a tétradas de esporas. El tapete pierde la integridad histológica en las primeras etapas de esporogénesis y rodea los esporocitos premeióticos, posteriormente a las tétradas y finalmente las esporas inmaduras, que experimentan cambios citológicos y de tamaño antes de alcanzar la etapa adulta. El esporodermo de las esporas adultas de E. bogotense consiste de seudoendosporio, exosporio y perisporio. Vistos con MEB, el exosporio de las esporas adultas es liso a rugulado con microperforaciones y el perisporio es muriforme, rugado, con pliegues delicados, estrechos, discontinuos, que se distribuyen al azar y delimitan aréolas incompletas. Externamente el perisporio está cubierto por orbículas, que se forman también en la cara externa y los márgenes de los eláteres. Vistos con TEM, el exosporio es una capa de material granular fino y el perisporio, una capa mucho más delgada con orbículas discretas. Los eláteres están formados por dos capas de naturaleza fibrilar, orientadas longitudinalmente y transversalmente. La esporogénesis en E. bogotense es sincrónica, similar a la de E. giganteum, otra especie de distribución tropical que también crece en Colombia.

Synthesis of stereotetrads by regioselective cleavage of diastereomeric MEM-protected 2-methyl-3,4-epoxy alcohols with diethylpropynyl aluminum.

The regioselectivity of the epoxide ring opening of 2-methyl-3,4-epoxy alcohols with diethylpropynylalane has been studied as a function of the C1 alcohol protecting group. An efficient selective method was developed using MEM as the protecting group. The reaction proceeded in a highly regioselective manner providing the useful 1,3-diol motif. The undesired 1,4-diol product produced by some free alcohol diastereomers was not observed. This highly stereoselective method provides access to termini-differentiated stereotetrads, which are essential building bocks for polypropionate synthesis.

Ontogenia de los estróbilos, desarrollo de los esporangios y esporogénesis de Equisetum giganteum (Equisetaceae) en los Andes de Colombia

Ontogeny of strobili, sporangia development and sporogenesis in Equisetum giganteum (Equisetaceae) from the Colombian Andes. Studies on the ontogeny of the strobilus, sporangium and reproductive biology of this group of ferns are scarce. Here we describe the ontogeny of the strobilus and sporangia, and the process of sporogenesis using specimens of E. giganteum from Colombia collected along the Rio Frio, Distrito de Sevilla, Piedecuesta, Santander, at 2 200m altitude. The strobili in different stages of development were fixed, dehydrated, embedded in paraffin, sectioned using a rotatory microtome and stained with the safranin O and fast green technique. Observations were made using differential interference contrast microscopy (DIC) or Nomarski microscopy, an optical microscopy illumination technique that enhances the contrast in unstained, transparent. Strobili arise and begin to develop in the apical meristems of the main axis and lateral branches, with no significant differences in the ontogeny of strobili of one or other axis. Successive processes of cell division and differentiation lead to the growth of the strobilus and the formation of sporangiophores. These are formed by the scutellum, the manubrium or pedicel-like, basal part of the sporangiophore, and initial cells of sporangium, which differentiate to form the sporangium wall, the sporocytes and the tapetum. There is not formation of a characteristic arquesporium, as sporocytes quickly undergo meiosis originating tetrads of spores. The tapetum retains its histological integrity, but subsequently the cell walls break down and form a plasmodium that invades the sporangial cavity, partially surrounding the tetrads, and then the spores. Towards the end of the sporogenesis the tapetum disintegrates leaving spores with elaters free within the sporangial cavity. Two layers finally form the sporangium wall: the sporangium wall itself, with thickened, lignified cell walls and an underlying pyknotic layer. The mature spores are chlorofilous, morphologically similar and have exospore, a thin perispore and two elaters. This study of the ontogeny of the spore-producing structures and spores is the first contribution of this type for a tropical species of the genus. Fluorescence microscopy indicates that elaters and the wall of the sporangium are autofluorescent, while other structures induced fluorescence emitted by the fluorescent dye safranin O. The results were also discussed in relation to what is known so far for other species of Equisetum, suggesting that ontogenetic processes and structure of characters sporoderm are relatively constant in Equisetum, which implies important diagnostic value in the taxonomy of the group. Rev. Biol. Trop. 59 (4): 1845-1858. Epub 2011 December 01.

Estudios sobre la ontogenia del estróbilo, los esporangios y la biología reproductiva de Equisetum son escasos, por lo tanto, para la especie E. giganteum, se estudiaron estos aspectos en especímenes recolectados a orillas del Río Frío, Santander, Colombia (2 200m). Los estróbilos en diferentes etapas de maduración fueron fijados, deshidratados, embebidos en parafina, seccionados en micrótomo rotatorio y teñidos con safranina O-fast green. Las observaciones se efectuaron mediante un microscopio óptico de alta resolución con contraste diferencial de interferencia (DIC) y microscopio de fluorescencia. Los estróbilos se inician a partir del meristemo apical, tanto en el eje principal como en los laterales, sin diferencias en el proceso de ontogenia y esporogénesis entre estróbilos de diferentes ejes. Sucesivas mitosis y diferenciación celular conducen al crecimiento del estróbilo, y a la formación de los esporangióforos peltados, formados por el manubrio, o porción basal con aspecto de pedicelo, el escutelo, o porción apical aplanada y las iniciales del esporangio, los cuales se diferenciarán para formar la pared del esporangio, los esporocitos y el tapete. No se forma arquesporio y los esporocitos experimentan meiosis para formar tétradas de esporas. El tapete mantiene la integridad histológica hasta la formación de las tétradas y en esa etapa forma un plasmodio que invade la cavidad esporangial la cual rodea parcialmente las tétradas y luego las esporas, y aparecen las cámaras plasmodiales, un término propuesto aquí para las formaciones designadas en inglés "tapetal gaps". La pared del esporangio queda reducida a dos capas celulares: una externa con engrosamientos lignificados en todas las paredes celulares y una interna picnótica. Al finalizar la esporogénesis, el tapete degenera, y las esporas, con exosporio, perisporio delgado, casi membranáceo y eláteres quedan libres en la cavidad esporangial. El esporodermo, los núcleos y nucléolos presentan fluorescencia roja, inducida por coloración con safranina O, mientras que los eláteres y las células de la pared del esporangio presentan autofluorescencia amarillo-naranja.

Hemofiltración veno venosa en pacientes críticos: [revisión] / Venous venous hemofiltration in critical patients: [review]

El fracaso renal agudo en el paciente crítico generalmente cursa en el contexto de disfunción de varios órganos y sistemas. Las técnicas continuas de sustitución renal, como la hemofiltración veno-venosa, son una clara opción para pacientes con inestabilidad hemodinámica por su buena tolerabilidad. Mediante un estudio observaciones retrospectivo, revisamos los resultados de los tratamientos con terapia renal sustitutiva con hemofiltración veno-venosa continua en un periodo de 24 meses, con el objetivo de conocer el porcentaje de pacientes que superaron el episodio agudo. Se analiza la causa de ingreso y la puntuación Apache II como sistema para cuantificar la gravedad del enfermo. Los resultados obtenidos muestran una mortalidad de alrededor del 69%. Los pacientes con shock séptico de origen abdominal presentan menor mortalidad comparado con otras causas y puntuación Apache II similar. Los pacientes con shock cardiogénico, a pesar de tener una puntuación más baja, presentan una mayor mortalidad.

Stereoselective VO(acac)(2) Catalyzed Epoxidation of Acyclic Homoallylic Diols. Complementary Preparation of C2-syn-3,4-Epoxy Alcohols.

A substrate-controlled stereoselective epoxidation of free and monoprotected homoallylic diols was developed. This second-generation approach is based on the incorporation of a primary hydroxy directing group at the C2 methyl carbon, which changes the nature of the vanadium ester intermediate providing a new diastereoselectivity manifold for the preparation of 3,4-epoxy alcohols. This modification favored the formation of the challenging C2-syn epoxy alcohol product not previously available using the standard homoallylic alcohol substrates. These new epoxy alcohol diastereomers expand the scope and generality for the utilization of 3,4-epoxy alcohols as precursors for stereoselective polypropionate synthesis.

Frequency of Fabry disease in male and female haemodialysis patients in Spain.

BACKGROUND: Fabry disease (FD), an X-linked lysosomal storage disorder, is caused by a reduced activity of the lysosomal enzyme alpha-galactosidase A. The disorder ultimately leads to organ damage (including renal failure) in males and females. However, heterozygous females usually present a milder phenotype with a later onset and a slower progression. METHODS: A combined enzymatic and genetic strategy was used, measuring the activity of alpha-galactosidase A and genotyping the alpha-galactosidase A gene (GLA) in dried blood samples (DBS) of 911 patients undergoing haemodialysis in centers across Spain. RESULTS: GLA alterations were found in seven unrelated patients (4 males and 3 females). Two novel mutations (p.Gly346AlafsX347 and p.Val199GlyfsX203) were identified as well as a previously described mutation, R118C. The R118C mutation was present in 60% of unrelated patients with GLA causal mutations. The D313Y alteration, considered by some authors as a pseudo-deficiency allele, was also found in two out of seven patients. CONCLUSIONS: Excluding the controversial D313Y alteration, FD presents a frequency of one in 182 individuals (0.55%) within this population of males and females undergoing haemodialysis. Moreover, our findings suggest that a number of patients with unexplained and atypical symptoms of renal disease may have FD. Screening programmes for FD in populations of individuals presenting severe kidney dysfunction, cardiac alterations or cerebrovascular disease may lead to the diagnosis of FD in those patients, the study of their families and eventually the implementation of a specific therapy.

Impacto del índice de masa corporal en la nefrectomía radical laparoscópica por cáncer de riñón / Impact of body mass index in laparoscopic radical nephrectomy for renal cell carcinoma

Introducción: La obesidad es causa de aumento de complicaciones intra y post operatorias en pacientes sometidos a cirugía convencional. La Nefrectomía Radical Laparoscópica (NRL) es hoy la técnica de elección para el tratamiento del carcinoma de células renales. Nuestro objetivo es evaluar el impacto de la obesidad representado por el Índice de Masa Corporal (IMC) en pacientes sometidos a NRL por cáncer renal. Material y Método: Estudio prospectivo aleatorio de 82 NRL consecutivas, en pacientes con sospecha de cáncer renal, realizadas entre julio del 2001 y agosto del 2005. Los pacientes fueron analizados en 3 grupos según su IMC: Grupo 1: No obesos (IMC menor a 30), Grupo 2: obesos (IMC entre 30 y 35), y Grupo 3: obesos mórbidos (IMC mayor a 35). Correspondieron a 60 hombres y 20 mujeres, con una edad promedio de 60,59 años. Se realizaron 17 NRL mano asistidas y 65 NRL puras. Resultados: El grupo 1 (No obesos) se compone de 55 (67,07 por ciento) pacientes, el grupo 2 (Obesos) de 17 (20,73 por ciento) pacientes, y el grupo 3 (Obesos Mórbidos) de 10 (12,19 por ciento) pacientes. El tiempo operatorio promedio fue de 131,63 minutos, 138,88 minutos, y 141 minutos respectivamente no habiendo diferencias estadísticamente significativas. En cuanto al sangrado promedio, los valores fueron 139,09ml. para el grupo 1, 254 ml. para el grupo 2 y a 137 ml. para el grupo 3; sin diferencias estadísticamente significativas. En 78 pacientes el diagnóstico histológico fue de Hipernefroma, en 4 pacientes no se encontró neoplasia. Todos se encuentran sin progresión de la enfermedad con un seguimiento promedio de 18 meses. Conclusión: No existen diferencias significativas entre pacientes no obesos, obesos y obesos mórbidos con esta técnica. Nuestro estudio demuestra que la NRL es el abordaje de elección en pacientes obesos con cáncer renal.

Introduction: Obesity caused an increased of intra-and post-operative complications in patients undergoing conventional surgery. Laparoscopic radical nephrectomy (LRN) is currently the technique of choice for the treatment of renal cell carcinoma. Our goal is to evaluate the impact of obesity represented by body mass index (BMI) in patients undergoing LRN for renal cancer. Material and Methods: Prospective randomized study of 82 consecutives LRN in patients with suspected renal masses, conducted between July 2001 and August 2005. Patients were analyzed in 3 groups according to their BMI: Group 1: Non-obese (BMI less than 30), Group 2: obese (BMI between 30 and 35) and Group 3: morbidly obese (BMI greater than 35). There was 60 males and 20 females with a mean age of 60.59 years. We make 17 hand assisted LRN and 65 pure LRN. Results: Group 1 (not obese) is composed of 55 (67.07 percent) patients in group 2 (obese) 17 (20.73 percent)patients, and group 3 (morbidly obese) 10 (12, 19 percent) patients. Medium operative time was 131.63 minutes, 138.88 minutes and 141 minutes respectively, no statistically significant differences. As the average bleeding, the values were 139.09 ml. for group 1, 254 ml. for group 2 and 137 ml. For group 3, no statistically significant difference. In 78 patients the histological diagnosis was Hypernephroma and in 4 patients no tumor was found. All patients are free of disease progression with an average of 18 months. Conclusion: No significant differences exist between non-obese patients, obese and morbidly obese with this technique. Our study shows that LRN is the approach of choice in obese patients with kidney cancer.

Aneurisma ventricular calcificado en un paciente con cardiopatía isquémica y antecedente de trauma cerrado de tórax / Patient with ischemic heart disease and a calcified ventricular aneurysm with of blunt thoracic trauma

Se presenta el caso de un paciente con cardiopatía isquémica y aneurisma ventricular calcificado con insuficiencia cardíaca, angor de esfuerzo y fenómeno embólico cerebral previo, con el antecedente de trauma cerrado de tórax 24 años antes.

Síndrome de Marfán / Marfans syndrome

Se presenta el caso de una familia con síndrome de Marfán diagnosticada a través de uno de sus miembros quien ingresó a las sala de urgencias por episodio de insuficiencia cardíaca.

Angina de pecho con arterias angiográficamente normales. Características epidemiológicas y clínicas / Angina pectoris with normal angiographic arteria. Characteristic epidemiologic and clinics

Introducción: Las lesiones obstructivas por arterioesclerosis coronaria genera diversos síndromes coronarios. Sin embargo, un subgrupo de pacientes con angina de pecho y alteraciones electrocardiográficas no presenta dichas lesiones, en el que se incluyen el vasoespasmo coronario, la angina microvascular, los puentes musculares y otras condiciones. En este estudio se evaluaron las principales características clínicas y electrocardiográficas de este grupo de pacientes. Material y métodos: Se incluyeron pacientes con cualquier sindrome coronario y angiografía coronaria sin lesiones obstructivas. Se consignaron los factores de riesgo cardiovascular, los síntomas de presentación, alteraciones electrocardiográficas y ecoradiográficas y los fármacos utilizados. Resultados: Se reclutaron 26 casos, 13 hombres y 13 mujeres con edad promedio de 56.6 años (rango 16-78). Se presentó angina microvascular en 16 casos, vasoespasmo coronario en 8, uno con un puente coronario y uno con flujo lento. Como síntomas se observó disnea en 18 pacientes, angor tímpico en 19 anormal en 18 pacietes, y el de esfuerzo de 13 casos. De 19 ecocardiogramas, 9 fueron anormales. Los fármacos más utilizados fueron los betabloqueadores de los canales del calcio y los nitratos. Conclusiones: Los pacientes con síndromes coronarios y angiografía coronaria sin lesiones obstructivas presentan frecuentemente factores de riesgo coronario, no hay diferencia de género y los exámenes auxiliares son anormales lo que motiva la realización de la angiografía. Palabras clave: Angina de pecho, coronarias angiográficamente normales.

Analisis crítico retrospectivo de la uretrotomía interna endoscópica / Retrospective critical analysis of internal endoscopic urethrotomy

Se presenta un análisis retrospectivo de los resultados alcanzados en 136 uretrotomías internas endoscópicas practicadas en 95 pacientes portadores de estrecheces uretales en su mayoría inflamatorias (39%) y traumáticas (26%) localizadas de preferencia a nivel de la uretra bulbar (60%) y membranosa (30%). El 2,2% de las intervenciones fracasaron. Se registró un 17,6% de complicaciones siendo las más frecuentes la creación de falsa vía y la uretrorragia. Las recidivas ocurrieron en el 43,2% de los pacientes. De ellas el 46% se presentó antes del año y el 54% entre 1 y 4 años después de la uretrotomía inicial. En resumen, y desde un ponto de vista global, se considera que la uretrotomía endoscópica fue exitosa en el 56,8% de la casuística. Este porcentaje relativamente bajo induce a pensar en la necesidad de modificar la técnica del procedimientro o de complementarlo con dilataciones y calibraciones periódicas