Alx3-deficient mice exhibit decreased insulin in beta cells, altered glucose homeostasis and increased apoptosis in pancreatic islets.

AIMS/HYPOTHESIS: Homeodomain transcription factors play an important role in the regulation of pancreatic islet function. In previous studies we determined that aristaless-like homeobox 3 (ALX3) is produced in islet cells, binds to the promoter of the insulin gene and regulates its expression. The purpose of the present study was to investigate the functional role of ALX3 in pancreatic islets and its possible involvement in the regulation of glucose homeostasis in vivo. METHODS: Alx3-knockout mice were used. Glucose and insulin tolerance tests were carried out, and serum insulin concentrations were determined. Isolated islets were used to test insulin secretion and gene expression. The pancreatic islets were also studied using both confocal and conventional microscopy. RESULTS: ALX3 deficiency resulted in increased blood glucose levels and impaired glucose tolerance in the presence of normal serum insulin concentrations. Insulin, glucagon and glucokinase expression were reduced in Alx3-null pancreatic islets. Reduced insulin content was reflected by decreased insulin secretion from isolated islets. Alx3-deficient islets also showed increased apoptosis, and morphometric analyses indicated that they were, on average, of smaller size than islets from control mice. ALX3 deficiency resulted in reduced beta cell mass. Finally, mature Alx3-null mice developed age-dependent insulin resistance due to impaired peripheral insulin receptor signalling. CONCLUSIONS/INTERPRETATION: ALX3 participates in the regulation of the expression of essential genes for the function of pancreatic islets, and its deficiency alters the regulation of glucose homeostasis in vivo. We suggest that ALX3 constitutes a potential candidate to consider in the aetiopathogenesis of diabetes mellitus.

Structure and performance of Awassi and Assaf dairy sheep farms in northwestern Spain.

Data of 69 dairy sheep farms (70% Assaf and 30% Awassi crossbred), located in the Spanish Autonomous Community of Castilla y León and grouped for receiving technical advice, were used to study their structure and performance. Farm surface was 55.4ha, on average. Approximately 25% of the farms did not have cultivation land, and the other 75% had, on average, 73ha (from which 67% were devoted to forage). Farms used 2.1 annual work units (familiar, 90%), 493 ewes, and yielded 147,000 L/yr of milk. Farmers were tenant (84%), younger than 45 yr (70%), had new houses, and were grouped in cooperatives (83%). Sheep were fed indoors (occasional grazing only) in modern loose stalls and had machine milking. Planned mating (summer to fall) was done in 91% of farms (hormonal treatment, 54%) but artificial insemination was scarce (23%). Annual milk sales averaged 309 L/ewe (fat, 6.5%; protein, 5.3%; log(10) somatic cell count, 5.7), and milk was sent to local dairy industries for cheese production, and 1.35 lambs/ewe were harvested as milk-fed lambs (lechazo). Artificial lamb rearing was done in 38% of farms (automatic, 81%; manual, 19%). Total mixed rations were used in 33% of farms, and the rest used rationed concentrate (including self-produced cereals) according to physiological stage of the ewes (0.45 to 1.97 kg/d) and ad libitum forage (dehydrated, 70%; hay, 68%; fresh, 25%; silage, 12%). The concentrate-to-forage ratio ranged between 32 and 61%. In total, 68% of farms bought more than half of the forage, and 87% of them bought more than half of the required concentrates. According to structural, productive, and managerial traits, 4 types of farms were differentiated by using multiple correspondence analysis and cluster analysis. Type groups were: 1) large-surface farms, devoted to cereal and forage production, predominantly with Awassi crossbreed sheep and a high level of self-consumed commodities (12% of the farms); 2) large flocks with intermediate farm surfaces devoted to forage production and predominantly with Assaf sheep (30% of the farms); 3) high-yielding farms, with intermediate sized flocks of Assaf sheep and very intensive management (42% of the farms); and, 4) no-land farms predominantly with Assaf sheep (16% of the farms). In conclusion, the dairy sheep farms studied showed more adoption of intensive production systems than traditional farms, which resulted in higher milk and lamb yields. Despite all of them being based on familiar units, as traditional farms, they were highly dependent on external resources and became more vulnerable, faced with future uncertainties of the market.

Resolution of giant biliary collection by spontaneous colon fistulization. / Resolución de colección biliar gigante por fistulización espontánea al colon.

The treatment of bile collections is divided into: expectant attitude with radiological monitoring of the size and characteristics of the collection, percutaneous drainage guided by imaging tests (US/CT), endoscopic drainage depending on location and accessibility and surgical treatment. The clinical case of a man undergoing a scheduled hepatectomy was observerd, who presented a large asymptomatic subcapsular collection suggestive of bilioma, with progressive increase in size, spontaneously presenting a decrease until its resolution by fistulization to the hepatic angle of the colon confirmed by Radiological findings. The spontaneously formation of biliary fistulas to the colon is due to the extrinsic pressure of the collection on the intestinal wall with necrosis of the contact zone, being its presentation and radiological documentation exceptional.

[Oculomotor response to the vertical cephalic autorotatory test in patients with benign paroxistic positional vertigo of the posterior canal]. / Respuesta oculomotora al test de autorrotación cefálica vertical en pacientes con vértigo posicional paroxístico benigno del conducto posterior.

OBJECTIVE: To evaluate the eye movement response to the head auto-rotation test (HART) in the vertical plane in patients with benign paroxysmal positional vertigo. DESIGN: A transversal, descriptive study. SETTING UP: Outpatient clinic in a general Hospital. INDIVIDUALS: 34 posterior canal BPPV cases with a video-oculographic diagnosis, older than 18 years old, 7 of them were not able to perform the HART. INTERVENTION: HART was performed by a an electrooculographic system with simultaneous recording of head movement by an acelerometer in the vertical plane (Vorteq, Micromedical Instruments). The HART with eyes fixation was performed 3 times to determine its reliability. MAIN OUTCOME MEASURES: Gain, asymmetry and phase for the vertical VOR respectively. A statistical analysis was carried out to determine the test reliability and the number of individuals with an abnormal result. RESULTS: Gain is the only variable that showed a reproducible result in the HART for the active head movement at 1-2 Hz (test-retest reliability 0.83-0.89). The values of gain showed a moderate correlation at the frequencies 1-3 Hz (correlation 0.60-0.87). Asymmetry and phase were not reproducible variables (correlation < 0.55). Thirteen of 27 (48%) patients presented a decrease of the vertical gain, another 13 showed normal values and one case showed raised values. CONCLUSION: Gain is the only useful variable in the vertical HART. Forty-eight percent of patients with posterior canal BPPV have a reduced vertical gain, suggesting an impairment of inferior vestibular nerve function.

[Cervical cystic metastasis in ENT carcinoma. Differential diagnosis with the branchioma]. / Metástasis quística cervical en carcinomas O.R.L. diagnóstico diferencial con el tumor branquiogénico.

This study report 3 cases of nodal cystic metastasis in the neck. One of them was diagnosed as an epidermoid carcinoma of unknown origin and the other 2 were an epidermoid carcinoma and an mucoepidermoid carcinoma respectively, arising in the larynx. Treatment of these patients included removal of the cystic metastasis with or without neck dissection and irradiation. Cystic metastasis from squamous cell carcinoma have often been mistaken for primary squamous cell carcinoma of branchiogenic origin. The distinctive histological features of cystic metastasis reviewed after its correct identification, can lead to the discovery of an unsuspected primary lesion and result in specific treatment options.

[Therapeutic approach, phonatory results and prognostic factors in patients with nodules, polyps and Reinke's edema of the vocal cord]. / Enfoque terapéutico, resultados fonatorios y factores pronósticos en pacientes con nódulos, pólipos y edema de Reinke de la cuerda vocal.

Retrospective study dealing with 100 cases of nodules, polyps and Reinke's edema of the vocal cord, characterizing this pathology classically considered as functional. Broad review of the subject's bibliography.

[Cervical granulomatous lymphadenitis: report of 13 cases]. / Linfadenitis granulomatosa cervical. A propósito de 13 casos.

The most common manifestation of mycobacterial infection encountered in E.N.T. practice is cervical lymphadenitis. Mycobacterial cervical lymphadenitis, the so-called scrofula, remains a diagnostic challenge, because it mimics other resembling processes. We present 13 cases of cervical granulomatous lymphadenitis treated from 1967 until 1990.

[Histopathological aspects of the benign lymphoreticulosis, cat scratch disease, or cervical localization]. / Aspectos histopatológicos de la linforreticulosis benigna o enfermedad por arañazo de gato de localización cervical.

Report about 2 children affected with the cat scratch disease or lymphoreticulosis. The AA. discuss some etiological and clinic features of the malady, especially emphasizing the typical anatomopathological findings, which in the majority of the occurrences, allow the actual diagnosis. This is a disease of low incidence, but must be bear in mind when dealing with any cervical lump.

[Osseous hemangioma of the upper jaw]. / Hemangioma óseo de maxilar superior.

Osseous hemangioma is a rare tumour of head and neck localisation. In this work the AA. present a case of the tumour located in the upper maxilla, considering the actual concept and the possibilities of differential diagnosis in relation with both radiologic and anatomopathological characteristics.

[Pharyngolaryngeal xanthomatosis: a case report]. / Xantomatosis faringolaríngea. Caso clínico.

A case occurring in a 62 year-old male with a xantomatous infiltrate taking the pharyngolarynx is reported. Basic features of xantomatosis are described as other manifestations encountered in the ENT-area.

[Kikuchi-Fujimoto's syndrome in ENT: a case report]. / Enfermedad de Kikuchi-Fujimoto en O.R.L. A propósito de un caso.

Kikuchi-Fujimoto disease (KFD) is a rare entity of uncertain cause which commonly presents as a lymphoadenopathy unresponsive to antibiotic therapy. Although usually it follows a benign self-limited course KFD has been repeatedly misdiagnosed as lymphoma. With this new case data about the etiology and clinical trend of KFD are added. Review of the literature.

[Solitary extramedullary plasmocytoma of the nasal cavity]. / Plasmocitomas extramedulares solitarios de fosa nasal.

It is described a case of solitary extramedullary plasmacytoma of nasal cavities. It's also made a review of the similar cases published about this infrequent but not extraordinary tumour to establish his diagnostic, prognosis and treatment.

[Contribution of clinical and diagnostic aspects of vocal cord nodules, polyps, and Reinke's edemas]. / Aportación a los aspectos clínicos y diagnósticos de los nódulos, pólipos y edemas de Reinke de la cuerda vocal.

We have made a retrospective study about 100 cases of vocal cords nodules, polyps and polypoid degeneration: we study the clinic and diagnostic aspects for this pathology that has been considered of functional cause. We also have made a review of literature.

[Anatomoclinical aspects of organic vocal cord lesions of functional origin]. / Aspectos anatomoclínicos de las lesiones glóticas orgánicas de origen funcional.

We have made a retrospective study about 100 cases of vocal cords nodules and polypoid degeneration, then we study the anatomo-clinic aspects for this pathology that has been consider of functional cause. We also have made a review of literature.

[Cranial nerve involvement as the primary manifestation of Guillain-Barré syndrome]. / Afectación de nervios craneales como manifestación primaria del síndrome de Guillain-Barre.

The presentation of a Guillain-Barre Syndrome in a initial paralysis form of cranial's nerves is strange. The remark in the event of an initial lonely velopalatinal paralysis, lead us to study the similar cases published in the literature to settle the characteristics which are typical of these cases.