Decerebration induced by surgical transection of cerebral ganglion of crayfish

Background: Since the neural structures of the crayfish brain closely resemble their equivalent in the mammals. This can be suggested by observing the similarity that exists in the brain divided by the surgical transection of the crayfish brain in which the protocerebrum remains attached to the first two cranial nerves, findings also described by Frederic Bremer in 1935 in cats with cerebral transection.Methods: Total 11 Adult male crayfish were trained to respond with defense reflex, the animals were placed in water at 0°C, remained without any movement, and subsequently through a small incision of 3 mm in diameter in the medial antero region and dorsal cephalothorax region, a surgical section of the cerebral ganglion was performed. Immediately after surgery, metal microelectrodes were implanted to collect the activity of the photoreceptors and visual fibers.Results: Once the defense reflex begins to recover in previously decerebrated crayfish, it means that it shows signs of reconnection. The isolated protocerebrum with the deutocerebrum olfactory lobe remain alive for several days and the neuronal connections were reestablished, as measured throughout the bilateral defense activity. The defense reflex was observed in all animals and then recovered after surgery.Conclusions: The crayfish is an excellent model to work the visual activity, all coding of visual information was suppressed in de-cerebrated crayfish. The recovery of the neural disconnection is observed from 40 days, where the defence reflex appears again before visual stimuli.

Thoracic limb salvage by fibular free flap

The treatment of most fractures of the ulna and radius is usually performed by anatomical reduction and internal fixation, when damage is extensive and local soft tissue cannot provide a complete wound coverage, locoregional flaps present a suitable reconstructive benefit. A 35-year-old male patient suffered an exposed diaphysio-metaphyseal fracture with multi-fragmented distal radius. The patient was evaluated during a 10-day period at the National Institute of Rehabilitation, where the osteosynthesis material and a severe infectious process with necrosis were identified. Necrosectomy of the posterior compartment and removal of the osteosynthesis material was performed, a skin defect of approximately 22x16 cm was observed with a bone gap of 6 cm of radius and ulna. a fibula-free flap is placed to correct the skin defect and an external fixative used for bone alignment. The fibular free flap presents an excellent therapeutic alternative in the resolution of bone gaps with extensive skin defect. Whenever a trained microsurgery team is available, current scales of limb injury should be considered but not utilized for therapeutic approach, always trying to shift amputation as the first option, to the very last one of them.

Use of advanced flap and microsurgery techniques in the resolution of mediastinitis as a complication of cardiac surgery

In the majority of cases, mediastinitis is a potential complication in any cardiac surgical procedure. The objective of this case report is to accurately describe how the combination of microsurgery and soft tissue flaps can be an effective therapeutic alternative in the treatment of mediastinitis as a complication of cardiac valve replacement. Female 63-year-old patient with a background of obesity, hypertension and extense cardiac interventions, she was programmed for necrosectomy with left pectoralis flap technique. Mediastinitis, although a rare complication of the sternotomy performed in cardiac surgery, occurring in 1-2%, carries a high mortality rate.  Early diagnosis of mediastinitis after cardiac surgery requires high clinical suspicion, initially making the diagnosis may be difficult, risk factors should be considered. An early surgical approach can reduce the morbidity and mortality of this condition. The pectoralis flap should be considered as a safe therapeutic option.

Pelvic limb reconstruction failed by propeller flap resolved with microsurgery

Reconstruction of lower limb defects is a constant challenge for surgeons, the etiology of the defect can be very variable from diabetic ulcers, traffic accidents, fall from height, oncological resections and many others. Free flaps have always been an important option because it has great results in complex reconstructions in lower limbs, it is a microvascular technique, so it has a higher level of complexity. This technique is usually reserved for extensive perilesional wide defects. On the other hand, the propeller flap, which is considered less invasive and easier as it does not involve microvascular surgery. An 18-year-old patient who had a fracture of the right tibial pylon due to a 7-meter drop, who after orthopedic treatment had a defect with exposure of ostesynthesis material of 3 cm in circumference in the medial malleolus. This defect was first managed with a propeller flap complicated with necrosis at 48 hours which was treated with sub atmospheric pressure system for 5 days and later with an ultra-thin anterolateral flap of the pelvic limb. Complete pedicled propeller flap failure is very rare but, because necrosis develops distally, even partial necrosis can expose bone, tendons, or other tissue. Some surgeons consider that propeller flap placement is risky in this location, especially the distal third of the lower leg a prefer to use free flaps. Whenever any pelvic member reconstruction plan fails in the distal third, the best and safest is the use of microsurgery even with the failure of a previous micro vascular flap.

Heparin-induced bleeding treatment in microsurgery

Microsurgery is associated with prolonged surgical times with an increased risk of deep vein thrombosis, pulmonary embolism and myocardial infarction. The use of antithrombotic means is a commonly employed tactic to prevent vascular thrombosis after microvascular free flap surgery. Flap loss is a devastating complication of microsurgical procedures that leads to detrimental outcomes. A 32-year-old male patient has a ruptured calcaneal tendon. He underwent 5 surgical cleanings with multiple failed sequential attempts at wound closure. Traumatology department in its microsurgery division where it is proposed to perform neo-tendon with graft of palmaris longus of the right thoracic extemity and radial antebrachial microvascular flap. The neo tendon was performed in addition to the micro surgical coverage with the radial antebrachial flap.When having vascular control with micro-clamps, 6000 U of unfractionated heparin was initiated, approximately 20 minutes after the end of the microvascular anastomosis, there was incoercible bleeding, which is initially treated with spray fibrin. Continued bleeding after 3 hours, so it was decided to reverse the effect of heparin with transfusion of fresh frozen plasma, 10 mg of vitamin K and fibrinogen. The effect of heparin was reversed without having thrombotic complications of microvascular anastomoses. The flap was not reexplored since they showed no signs of vascular compromise. If anticoagulants have been used and an incoercible hemorrhage is found, the effect of heparin must be reversed. In the transfer of tissues with microsurgery, the recommended and safe anticoagulation are prophylactic doses and not therapeutic doses.

Reverse-flow anterolateral thigh flap for knee soft-tissue reconstruction: case report

The reconstruction of the injured tissue around the knee is a complex procedure for the plastic and orthopaedic surgeon. The objective is to provide an acceptable function and aesthetic result. Successful wound management includes meticulous debridement, planning and proper execution of the surgical procedure. An 11-year-old male patient with a right patellar fracture using an anterolateral thigh flap with reverse flow to cover the skin defect. For such purposes, the reverse flow anterolateral flap is an effective, trustworthy and well-documented option. The correct obtaining and implantation of the flap reduces the morbidity of the donor site, offers options in size and design, an adequate length of the pedicle and the possible combination with the fascia lata in case it is required. The versatility of the reverse flow anterolateral flap makes it a possible therapeutic alternative in reconstructive surgery since it is aesthetic and functional for the reconstruction of tissue near the knee joint.

Microsurgery in complex trauma of pelvic limb in a pediatric patient: case report

Complex trauma is defined as the condition secondary to the exchange of kinetic energy of two or more tissues in one limb. This entity is a surgical emergency that can have many sequelae and can even result in limb loss. An 11-year-old female patient presents complex pelvic limb trauma secondary to contuse injury caused by a helicopter’s rotor blades.  Pelvic limb reconstruction was performed with iliac crest bone graft, the fracture was stabilized with an external fixator and the skin defect was covered with an anterolateral microvascular thigh flap (ALT). There was an adequate integration of the bone graft with adequate skin coverage thanks to the ALT thigh flap. The patient presented discreet limb shortening as consequence.  Currently, microsurgery is the only medical option that meets the objectives of limb reconstruction. Microsurgical techniques can be used in pediatric and adult patients. The success of any recovery from complex trauma is vigorous surgical cleaning, avoiding sequential and/or multiple washes.

Angiosome study of the first digital feet space, for reconstruction of the digital tip

Background: The concept of angiosome explains the anatomical variations that exist between the vessels of different regions of the body and helps to understand the contributions of arterial blood supply to the skin and adjacent structures, dividing the human body into three-dimensional vascular blocks.Methods: This was an observational and descriptive study. In both lower extremities of 5 corpses with adequate tissue preservation in the operating room attached to the teaching area of the National Institute of Forensic Sciences in Mexico City. Angiosome study of the medial neurocutaneous flap of the second toe of both feet was performed.Results: The average, in centimeters, of the surface of the flaps was 1.57 cm x 2.47 cm, the average diameter of the inter-metatarsal digital artery was 1.1 millimeters and the average diameter of the veins draining the angiosome was 1.4 millimeters. The most constant anatomy was that of the nerve, which was present in all cases, with the digital nerve forming the neurosome of the flap.Conclusions: To obtain optimal results in microsurgery transfers, it is necessary to have a technique that is quick for harvesting the flap and with adequate systematization so as not to injure the neurovascular bundle, this is achieved through complete anatomical knowledge, without forgetting the main variants.

Odontomas: reporte y serie de casos clínicos. Facultad de Odontología, Universidad de Cartagena 2010-2015 / Odontomas: report and clinical case series. School of Dentistry, University of Cartagena, 2010-2015

RESUMEN: Los odontomas son los tumores benignos más prevalentes en la cavidad oral, los cuales, por lo general, son diagnosticados mediante exámenes radiográficos de rutina. En la Facultad de Odontología de la Universidad de Cartagena se realizaron un total de 1,261 cirugías orales entre los años 2010 y 2015, donde se presentaron 12 casos con diagnóstico de odontomas, los cuales fueron identificados al inspeccionar sus respectivas historias clínicas. En algunos casos, los odontomas acompañados de otras características se asocian a síndromes, tales como el síndrome de Gardner, este reporte menciona un caso con ciertas características, como la posible presencia de poliposis colorrectal, órganos dentales supernumerarios y excrecencias óseas presentes en un niño de 12 años de edad, por lo cual se realizaron estudios para determinar la asociación a mencionado síndrome. La localización de los odontomas es una característica particular de ellos, que se encuentra alterada en el caso anteriormente resaltado.

ABSTRACT: Odontomas are the most prevalent benign tumors in the mouth, they are normally diagnosed after routine X-ray examinations. Between 2010-2015, a total of 1,261 oral surgical interventions were practiced at the School of Dentistry, University of Cartagena. In them, 12 cases of odontoma were identified after reviewing respective clinical histories. In some cases, when odontomas are accompanied by other characteristics, they can be associated to syndromes, such as Gardner's syndrome. The present report informs of a case with certain characteristics such as possible presence of colorectal polyposis, supernumerary teeth and bone excrescences present in a 12 year old male, therefore, studies were undertaken to determine association to the aforementioned syndrome. Location of odontomas was an inherent characteristic and found to be altered in the previously mentioned case.

Tuberculosis cutánea / Cutaneous tuberculosis

La tuberculosis cutánea (TC) es una afección infrecuente dentro de la tuberculosis extrapulmonar, siendo su clínica variada e inespecífica. Se presenta el caso de TC: Mujer de 48 años sin antecedentes mórbidos que consultó por lesión cutánea en pabellón auricular y piel circundante, de dos años de evolución, pruriginosa, con aumento de tamaño progresivo y supuración serosa ocasional, al examen se constató placa eritematosa anaranjada, de consistencia blanda. Reacción en Cadena de Polimerasa de biopsia evidenció infección por Mycobacterium tuberculosis, logrando remisión de la lesión con tratamiento antituberculoso establecido en las normas sanitarias de Chile. La TC es una entidad de difícil diagnóstico, incluso contando con cultivos. A causa del aumento de casos de tuberculosis por el incremento de factores inmunosupresores, y a su potencial agresividad sistémica, se recomienda un alto nivel de sospecha.

Cutaneous tuberculosis (CT) is an infrequent condition of extrapulmonary tuberculosis, with a varied and non-specific clinical morphologies. A case of CT is presented: 48-yearold woman with no morbid history, who consulted for a skin lesion in the auricular pavilion and surrounding area, of two years of evolution, pruritic, with increasing progressive size and occasional serous secreation. On physical examination, orange erythematous plaque with soft consistency was found. Polymerase Chain Reaction from biopsy, showed infection by Mycobacterium tuberculosis, achieving remission of the lesion with antituberculosis treatment established in Chilean sanitary regulations. CT is an entity difficult to diagnose even with the use of culture. A high level of suspicion is recommended because of the increase of cases of tuberculosis due to immunosuppressive factors and their potential systemic aggressiveness.

Pustulosis aguda erosiva del cuero cabelludo / Erosive pustular dermatosis of the scalp

La Pustulosis Erosiva del cuero cabelludo fue descrita por primera vez por Pye, Peachy y Burton en 1979, en mujeres mayores¹. De etiología y patogenia no del todo clara, se relaciona con exposición a trauma local. Se presenta como lesiones erosivas, costrosas y pustulosas de carácter estéril. Su cuadro histológico no es específico, por lo que el diagnóstico es de exclusión. Se han reportado múltiples tratamientos, pero los que han demostrado mejor resultado se basan en el uso de corticoides tópicos de alta potencia y retinoides orales. Presentamos un caso de pustulosis erosiva del cuero cabelludo en un paciente varón y una revisión de los principales aspectos clínicos e histopatológicos de esta enfermedad.

In 1979 Pye, Peachy and Burton described the Erosive Pustular Dermatosis of the scalp in elder women. The etiology and pathogenesis is still unknown; nonetheless, it is most commonly associated with the exposure to local trauma. The disease is manifested as sterile erosive, crusty and pustular lesions on the scalp. Its histological profile is unspecific; therefore, it is a diagnosis of exclusion. Multiple treatments have been reported, high-potency topical corticosteroids and oral retinoids have shown favorable response. Herein we present a case of an erosive pustular dermatosis of the scalp on a male patient and a review of the clinical and histological characteristics of this disease.

Efecto de la Leishmania mexicana, RANTES y TNF alfa en el fenotipo y propiedades migratorias in vitro de células dendríticas esplénicas de ratones BALB/c neonatos y adultos / Dendritic cells of BALB/c mice: phenotypic characteristics and migratory properties

Las células dendríticas (CDs) son esenciales en el desarrollo y regulación la respuesta inmunitaria (RI). Existen controversias en cuanto al potencial de inducción de la RI por las CDs en el período neonatal. Se ha propuesto que la RI específica de un neonato depende de la relación cuantitativa CD/linfocito T, y del momento, etapa neonatal o adulta, del encuentro con el antígeno, lo que parece influir sobre las propiedades fenotípicas y biológicas de las CDs, modificando su comportamiento. Por tal motivo, nos planteamos evaluar el efecto de un antígeno, Leishmania mexicana (L. mexicana) y de las citoquinas TNFa y RANTES sobre las características fenotípicas y propiedades migratorias, in vitro, de las CDs esplénicas provenientes de ratones BALB/c neonatos y adultos, usando citometría de flujo y la cámara de Boyden. Las CDs de ratones neonatos y adultos, en condiciones basales, expresan de manera similar, las moléculas CD40, CD86, CMHII y CD54. Este mismo fenómeno se observó al incubar dichas células con el Ag (L. mexicana) a excepción de la molécula CD40 cuya intensidad de expresión se elevó significativamente (P<0,05) en ambos grupos de estudio. El índice de migración de las CDs en presencia de medio de cultivo condicionado de L. mexicana, RANTES y TNFa fue mayor en adultos que en neonatos. Estos resultados muestran que las CDs neonatales son fenotípicamente similares a las adultas. Ante los mismos estímulos se comportan de manera diferente, sugiriendo la existencia de otros factores, que pudieran explicar la mayor susceptibilidad a infecciones en la etapa neonatal.

Dendritic cells (DCs) are essential in the development and regulation of the immune response (IR). The inherent potential of DCs to induce a specific immune response in the neonatal period is controversial. It has been suggested that the specific IR in neonates depends on the quantitative relation of DC/T lymphocytes, as well as on the neonatal or adult age at which the interaction antigen/DC/T lymphocytes occurs. This suggests that this contact has an influence on the phenotypic and/or biological properties of DCs, which modifies its behavior. Therefore, the effects of Leishmania mexicana (L. mexicana) and of TNFa and RANTES cytokines on immunophenotypical characteristics were evaluated on spleen DCs, from neonate and adult BALB/c mice, by using flow cytometry and in vitro migratory properties with a Boyden Chamber. In basal conditions, neonate and adult DCs express the same molecules (CD40, CD86, MHCII and CD54). When the DCs interact with the antigen L. mexicana, the expression of these molecules are similar in adults and in neonates, with the exception of CD40 whose intensity of expression was raised (P<0,05) in both groups. The rate of migration of the DCs in a culture medium conditioned of L. mexicana, RANTES and TNFa was higher in adults than in newborn mice. These observations suggest that neonatal and adult mice DCs have similar phenotypic characteristics. Under the effect of the same stimulus they respond differently; suggesting that other factors are involved in the higher susceptibility that newborns have to infections.

Un estudio, basado en la comunidad, de las condiciones de salud ocupacional en seis actividades industriales / A community-based survey of occupational health conditions in six industrial activities

Objetivos del estudio: Este estudio basado en la comunidad, examinó las condiciones de salud ocupacional y seguridad en seis industrias mexicanas y comparó los resultados obtenidos con informes de salud ocupacional del gobierno. Diseño: Entrevistas personales estructuradas para recopilar información acerca de las condiciones de trabajo, lesiones y enfermedades de los trabajadores de 32 fábricas centinelas en cuatro ciudades industriales en México. De estas fábricas se tomó una muestra dirigida de 3.651 trabajadores actualmente empleados. Principales resultados: Los daños a la salud reportados con mayor frecuencia fueron lesiones ocupacionales y enfermedades pulmonares. La frecuencia de lesiones graves y mortales y de casi todas las otras enfermedades, fueron mayores en las industrias más grandes del cemento, automotriz y vidrio. Los trabajadores en las industrias de tamaño medio y pequeño de alimentos, calzado y textil reportaron menor frecuencia de equipo de seguridad y capacitación en seguridad. Conclusiones: La prevalencia de lesiones y enfermedades entre los trabajadores e industrias estudiadas fue más alta que aquellos datos reportados por organismos oficiales. Una opción factible en términos de recursos invertidos y calidad de la información reunida es la implementación de estudios periódicos de prevalencia de enfermedades ocupacionales y lesiones en la comunidad. Este tipo de estudio permite evaluar la eficacia de las políticas y programas oficiales de salud para el mejoramiento de las condiciones de salud y seguridad ocupacional, y para detectar cambios en la salud asociados con los impactos en la economía global.

Implantación de marcapasos definitivos en programa de cirugía ambulatoria / Ambulatory pacemaker surgery

Desde 1958 se conoce lo que llamamos estimulación cardíaca crónica, inicialmente ésta se consideraba un procedimiento quirúrgico complejo para el cirujano cardiovascular y exigía hospitalización por varios días. Con el desarrollo de nuevas técnicas y de materiales, así como el surgimiento de la cirugía ambulatoria y su aplicación en la implantación de marcapasos, se abatió la estancia hospitalaria y consecuentemente los costos de este procedimiento. Desde 1986 Zegelman describe una serie de 583 casos en los cuales se colocó en forma ambulatoria un marcapaso definitivo, sin reportarse mortalidad. El objetivo del presente estudio fue valorar la eficacia y seguridad de la colocación de marcapasos definitivos en el Programa de Cirugía Ambulatoria. Se incluyeron 177 pacientes en estancia corta y 95 en estancia tradicional; la estancia hospitalaria fue 15.7±15.1 horas para el primer grupo y 238 ±188 horas para el segundo y se presentaron complicaciones en el 2.2% de los 272 pacientes. Las complicaciones fueron similares en ambos grupos y se resolvieron favorablemente, además no hubo mortalidad. Concluimos que la colocación de marcapasos definitivos en Programa de Cirugía Ambulatoria representa una opción segura para el paciente y con menor costo para la institución. Que el éxito de este programa depende del número de implantes de un centro hospitalario y de la experiencia del operador.

The chronic cardiac stimulation is know since 1958, pacemaker implant was considered a difficult procedure that was performed through cardiovascular surgery and the patient required several in hospital days. On the grounds of new surgical techniques and development of new materials for pacemakers, as well as the rise of Ambulatory Surgery and its application in pacemaker implants, the hospital stay and consequently, costs have decreased significantly. In 1986, Zegelman reported 583 patients subjected to ambulatory pacemaker surgery without mortality. The purpose of this report it to evaluate the efficacy and safety of ambulatory pacemaker surgery. One hundred seventy seven patients from an ambulatory program and 95 from a traditional program were included. Hospitalization time was 15.7±15.1 hours in the first group and 238± 188 hours for the second, prevalence of complications was 2.2% in the 272 patients. Complications for both groups were similar and were solved, without mortality. We conclude that the ambulatory pacemaker surgery is effective and safe for patients and is cheaper for hospitals. The success of this program depends on the number of implants in each hospital and the operator's experience.

Tratamiento del carcinoma hepatocelular mediante la inyección intratumoral de etanol / Processing of the carcinoma to hepatocelular by means of the intratumorlike ethanol injection

Reportamos el caso de un paciente con cirrosis hepática de etiología viral con HbsAg y Anti VHC positivos, que se diagnostica por ecografía y por TC de un carcinoma hepatocelular (CHC) y la punción aspirativa con aguja fina (PAAF) reporta: material hemorrágico con escasas células epiteliales y con cambios degenerativos. El paciente fue sometido a tratamiento médico mediante inyecciones intratumorales de etanol (HE). Dado que el CHC acostumbra asentar sobre una cirrosis, sus manifestaciones clínicas son en gran parte superponibles a las de esta enfermedad y en el momento del diagnóstico dependerán tanto del grado de reserva funcional de la cirrosis hepática de base como del estadío evolutivo del tumor. En este sentido debe remarcarse que más del 50 por ciento de los nódulos menores de 3cm de diámetro detectados mediante ecografía en pacientes cirróticos corresponden a un CHC. No obstante sólo se establece el diagnóstico por PAAF en el 75 por ciento de los casos y en estos casos debe basar la presunción diagnóstica en la coincidencia de dos técnicas por imagen.

Reporte de casos clínicos: caso No. 1: diagnóstico endoscópico de cáncer gástrico / Report of clinical cases: Nro. case 1 endoscópico diagnosis of gastric cancer

Reportamos una paciente con diagnóstico de neoplasia gástrica, cuyas características morfológicas son: lesión polipoidea, triloculada, irregular, ulcerada, localizada a nivel de fornix y región sub-cardial; dicha lesión fue biopsiada por 3 ocasiones, siendo la Anatomía Patológica negativa para células neoplásticas. Los tumores del cardias y del estómago proximal representan alrededor del 10xciento de todas las neoplasias en las series más antiguas pero en fecha más reciente se observó una mayor incidencia de cáncer gástrico proximal. No se sabe con certeza si este incremento refleja un verdadero aumento de la incidencia de las neoplasias en esa ubicación o una disminución de la incidencia del cáncer gástrico distal...

Comportamiento de los valores de IgET del suero y de los eosinofilos en sangre periferica en pacientes asmáticos atópicos / Behavior of IgET valves of peripheric blood serum in atopical asthmatic patients

En 56 pacientes asmáticos atópicos fue determinada la concentración de IgET del suero y en 46 de ellos la de eosinófilos en sangre periférica. Se encontró IgET elevada en 49 pacientes (87,6 por ciento) y eosinofilia en 18 de los 46 individuos en que se practicó la determinación (39,3 por ciento).Se observó, por otra parte, eosinofilia en el 41,5 por ciento de los pacientes con IgET elevada y sólo en 14,3 por ciento de ellos con IgET normal. En cambio, en todos los pacientes con eosinofilia, la concentración de IgET se encontró elevada. Los resultados ratifican que el valor de IgET del suero cuando elevado, y descartadas otras posibles causas del fenómeno, es un buen instrumento para el diagnóstico de atopía. Pero un valor normal de ese parámetro no lo descarta

Absceso cerebral amibiano. Informe de un paciente / Amebie brain abscess: a case report

La amibiasis es una enfermedad parasitaria causada por la Entamoeba histolytica, que afecta principalmente el tracto gastrointestinal provocando síntomas en dicha área (forma intestinal). Puede provocar complicaciones intra y extraintestinales graves, como los abscesos hepáticos y/o pulmonares y en raras ocasiones, abscesos cerebrales lo que representa una complicación tardía. Se informan los hallazgos en un paciente con absceso cerebral amibiano, sin síntomas digestivos o pulmonares. La tomografía computada de cráneo, mostró un área de baja absorción en la región frontotemporal izquierdo con desplazamiento de línea media y edema perilesional difuso, y un anillo hiperdenso bien definido periférico que se diagnosticó como absceso cerebral. El diagnóstico de amibiasis se sospechó durante la cirugía al drenal líquido cremoso achocolatado y se confirmó al encontrar trofozoitos en la pared de la cápsula. El tratamiento se realizó con metronidazol siendo la evolución satisfactoria.

Hipertrofia parcial congenita: descripcion de cinco casos con compromiso de MMII / Congenital partial hypertrophy: description of five cases with compromise of lower limbs

Se describen los hallazgos clinicos de cinco pacientes con hipertrofia parcial congenita, tipo segmentario. Se realiza una revision de la literatura y se establecen comparaciones con los resultados obtenidos en el presente estudio