Presence and progression of non-motor symptoms in relation to uric acid in de novo Parkinson's disease.

BACKGROUND AND PURPOSE: Uric acid (UA) has been studied extensively as a valuable biomarker of Parkinson's disease (PD), but its relationship with non-motor symptoms (NMS) in de novo PD has been poorly investigated. Our aim was to evaluate the usefulness of baseline serum UA as a marker of NMS progression in newly diagnosed PD. METHODS: Sixty-nine newly diagnosed PD patients were enrolled. At baseline, all patients completed the NMS questionnaire (NMSQuest), and serum UA levels were measured. After 2 years, the NMSQuest was completed again and patients were categorized into four groups: NMS improvement (domain involvement at baseline but not at 2-year follow-up visit), NMS absence (domain not involved at baseline or 2-year follow-up visits), NMS presence (domain involvement both at baseline and 2-year follow-up visits) and NMS worsening (domain not involved at baseline but involved at 2-year follow-up). RESULTS: ANOVA with post hoc Bonferroni correction showed that patients with NMS absence presented significantly higher UA values than patients with NMS presence with regard to the attention/memory (P = 0.023), depression/anxiety (P = 0.028) and cardiovascular domains (P = 0.002), whilst no differences were found with regard to both the NMS improvement and worsening groups. In addition, multinomial regression analysis showed that the lowest tertile of NMS progression presented higher UA levels (P = 0.023; odds ratio 0.488) compared with patients with greater NMS progression. CONCLUSIONS: This is the first report of a relationship between serum UA and presence/progression of multiple NMS in de novo PD, providing additional evidence of the reliability of UA as a biomarker of PD and opening new insights on PD neuroprotection.

Coexistence of flavum ligament ossification with diffuse idiopathic skeletal hyperostosis in the cervical spine: Review of literature and technical note starting from a rare case.

BACKGROUND: Cervical flavum ligament ossification (C-OLF) is very rare source of myeloradiculopathy. Less than 100 cases have been reported in modern English literature up to 2020. Association between C-OLF and Diffuse Idiopathic Skeletal Hyperostosis (DISH) at cervical level has never been described. METHODS: In this article we performed a systematic review about epidemiology, physiopathology, clinical and surgical management of C-OLF. Moreover, we research its possible association with other cervical spine ligament ossification and in particular with anterior longitudinal ligament ossification. We report a case of 73 years-old woman experiencing mild cervical myeloradiculopathy caused by C6-C7 C-OLF compression and coexistence of DISH at cervico-thoracic level. A brief technical note about intraoperative management of C-OLF has also been described. RESULT: Our research found 81 previous reported case of C-OLF. The coexistence of Posterior longitudinal ligament ossification has been reported in 21.3% of C-OLF case. Conversely, we reported the first case describing the association between DISH and C-OLF. Posterior surgical decompression is the only useful treatment providing good long-term functional outcome. Instrumentation should be tailored according to pre-operative findings. CONCLUSIONS: C-OLF is a rare source of myeloradiculopathy and it may coexists with DISH probably due to alteration in the cervical mechanical stress and tendency of bone formation in patients harboring coexistent ligament ossifications. According to our result, skip en-bloc microsurgical laminectomy is safe and less invasive method to avoid complication and to provide optimal cervical spinal cord and nerve decompression avoiding CSF-leak.

[Testicular microlithiasis. Clinical significance and therapeutic implications]. / Microlitiasis testicular. Significado clínico e implicaciones terapéuticas.

Testicular microlithiasis is a rare condition usually diagnosed by scrotal ultrasound and associated with pathology of the testis. We report two pediatric cases presented with acute scrotum. Testicular sonography revealed significant bilateral testicular microlithiasis. One case was diagnosed as having torsion of the right testis and the other case as orchiepididymitis. A careful review of the literature is made and a periodic follow-up of this disease is advocated.

[Bladder metastasis of a stomach carcinoma. Presentation of a case]. / Metástasis de carcinoma gástrico en vejiga. Presentación de un caso.

Metastatic tumors account for a small percentage within bladder neoplastic pathology. The presence of signs of bladder neoplasm in a patient with malignancies in other location must aware us about its metastatic origin. One of the most frequent locations of the primary tumor is the stomach. Its evolution is always bad. We present a case of a woman who previously had undergone surgery for a gastric carcinoma, and later suffered a metastatic bladder affectation. We make special attention in the clinic presentation, very similar to the typical transitional cell carcinoma, its anatomopathological diagnosis after transurethral resection (T.U.R.), and its evolution. We make a brief revision of the bladder metastatic pathology.

[Typical renal metanephric adenoma. Conservative surgery]. / Adenoma metanéfrico renal típico. Cirugía conservadora.

Metanephric Adenoma is uncommon renal tumor included in the complex group of the embryologics or nefroblastics renal tumors. Generally occurs in young females and usually has excellent prognosis. It's important to differentiate of malignant variants, particularly renal cell papillary carcinoma, metanephric adenosarcoma and adult Wilms tumor. The suspicion and intraoperative analysis of the tumor can to facilitate the use of conservative renal surgery in order to avoid unnecessary radical and aggressive surgery. To exist cases of metastatic metanephric adenoma, and the totally benign characteristic of the metanephric adenoma and the malignant potential isn't totally clarify.

Functional assessment of cryopreserved human femoral arteries for pharmaceutical research.

An established method for cryopreservation that might preserve the vascular and endothelial responses of human femoral arteries (HFAs) to be transplanted as allografts was studied. HFAs were harvested from multiorgan donors and stored at 4 degrees C in saline solution before cryostorage. Thirty HFA rings were isolated and randomly assigned to one control group of unfrozen HFAs (eight rings) and one group of cryopreserved HFAs (22 rings). Cryopreservation was performed in RPMI solution containing dimethylsulfoxide (DMSO) and the rate of cooling was -1 degrees C/min until -40 degrees C and faster rates until -150 degrees C was reached. The contractile and relaxant responses of unfrozen and frozen/thawed arteries were assessed in organ bath by measurement of isometric force generated by the HFAs. After thawing, the maximal contractile responses to the contracting agonist tested (noradrenaline) were in the range of 43% of the responses in unfrozen HFAs. The endothelium-independent responses to sodium nitroprusside were not altered whereas the endothelium-dependent relaxant responses to acetylcholine were weakly altered. The cryopreservation method used provided a limited preservation of contractility of HFAs, a good preservation of the endothelium-independent relaxant responses, and a good preservation of endothelium-dependent relaxation. It is possible that further refinements of the cryopreservation protocol, such as a slower rate of cooling and a more controlled stepwise addition of DMSO, might allow better post-thaw functional recovery.

Functional assessment of cryopreserved pig aortas for pharmaceutical research.

Several in vitro studies have demonstrated diminished post-thaw functional activity. Therefore, the aim of this study was to investigate the consequences of thawing and storage method used on the post-thaw functional activity of cryopreserved pig aortas with the aim of adjusting the freezing and thawing protocol so that the vascular segments are preserved in the best possible state, maintaining structure and functionality so that they can later be transplanted with success. In vitro responses of frozen, thawed pig aortas were used to investigate the functional activity after thawing at 15 degrees C and 100 degrees C/min and after storage in gas or liquid phase of liquid nitrogen. Cryopreservation was performed in RPMI 1640 medium + 10% dimethylsulfoxide and the rate of cooling was -1 degrees C/min, until -150 degrees C was reached. After thawing the maximal contractile responses to all the contracting agonists tested (KCl, noradrenaline) were in the ranges of 13-27% compared with the responses in unfrozen pig aortas. Contractile responses were slightly better when thawing was performed at 15 degrees C/min compared with 100 degrees C/min. The endothelium independent relaxant responses to sodium nitroprusside were reduced ( P < 0.05). Cryostorage of pig arteries also resulted in a loss of the endothelium-dependent relaxant response to acetylcholine. The cryopreservation method used provided a limited preservation of pig aorta contractibility, a reduction of the endothelium independent relaxant responses, and no apparent preservation of the endothelium-dependent relaxation. It is possible that further refinements of the cryopreservation protocol might allow better post-thaw functional recovery of pig aortas.

Functional assessment of cryopreserved human aortas for pharmaceutical research.

We evaluated the impact of standard cryopreservation on functional properties of human aortic homografts. From seven human donors, the thoracic descending aorta was obtained. Effects of cryopreservation on contractibility and endothelium function were tested. After cryopreservation no endothelium-dependent or endothelium-independent relaxation was found and the contractibility was strongly affected. Arteries showed no function and loss of endothelial integrity after cryopreservation and thawing.

Functional assessment of human femoral arteries after cryopreservation.

An established method for the cryopreservation of human femoral arteries for subsequent transplantation as allografts has been studied with particular attention to preservation of smooth muscle and endothelium. Human femoral arteries (HFAs) were harvested from multi-organ donors. Two groups were established; a control group of unfrozen HFAs and a group of cryopreserved HFAs. Cryopreservation was performed using RPMI solution containing dimethyl sulfoxide and the rate of cooling was 1 degrees C/min to -40 degrees C and faster thereafter until -150 degrees C was reached. The contraction and relaxation responses of unfrozen and frozen/thawed arteries were assessed by measurement of the isometric force generated by the HFAs in an organ bath. After thawing (warming was at 15 degrees C/min) the maximal contractile response to noradrenaline was 43% of the response of unfrozen HFAs. The endothelium-independent response to sodium nitroprusside was not altered, whereas the endothelium-dependent relaxation response to acetylcholine was slightly altered. The cryopreservation method used provided limited preservation of the contractility of human femoral arteries, and good preservation of both endothelium-independent and endothelium-dependent relaxation responses.

Microlitiasis testicular. Significado clínico e implicaciones terapéuticas / Testicular microlithiasis: clinical significance and therapeutic implications

La microlitiasis testicular es un hallazgo ecográfico poco frecuente que habitualmente suele asociarse con patología intraescrotal. Presentamos 2 casos clínicos de pacientes pediátricos de 11 y 12 años de edad que debutaron con un cuadro de torsión de teste derecho y orquiepididimitis izquierda respectivamente con la existencia de microcalcificaciones múltiples testiculares bilaterales. Revisamos la literatura internacional sobre esta entidad y proponemos una actitud a seguir ante este diagnóstico (AU)

Tumor glómico en la región coccígea (glomus coccygeum) en edad pediátrica / Coccygeal glomus tumor in a pediatric patient

El tumor glómico coccígeo se localiza en la punta del cóccix y se describe como una "estructura benigna" que en ocasiones puede asociarse a coccigodinia. Su descripción en pacientes pediátricos es excepcional. Presentamos un caso de tumor glómico coccígeo diagnosticado incidentalmente tras la exéresis de un sinus pilonidal en una paciente de 3 años. No hemos encontrado ningún otro caso pediátrico publicado en la bibliografía que haga referencia a un tumor glómico sintomático (AU)

Metástasis de carcinoma gástrico en vejiga. Presentación de un caso / Gastric metastatic carcinoma to the bladder. A case report

Los tumores de origen metastático suponen un porcentaje mínimo dentro de la patología neoplásica vesical. La aparición de datos compatibles con neoplasia vesical en un paciente con antecedentes tumorales en otra localización debe hacernos pensar en un origen metastático de la lesión vesical. Una de las localizaciones más frecuentes de la neoplasia primaria es el estómago. La evolución es indefectiblemente ominosa. Presentamos el caso de una mujer operada previamente de una neoplasia gástrica que más tarde metastatiza a vejiga. Hacemos hincapié en la presentación clínica, similar a la de una neoplasia vesical de células transicionales, su diagnóstico anatomopatológico tras resección transuretral (R.T.U.), y su mala evolución. Se realiza breve revisión de la patología vesical metastática (AU)

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Adenoma metanéfrico renal típico. Cirugía conservadora / Tipical metanephric renal adenoma. Conservative surgery

El Adenoma Metanéfrico es un infrecuente tumor renal clasificado dentro del grupo complejo de los tumores embrionarios renales o nefroblásticos. Afecta generalmente a mujeres jóvenes y tiene un buen pronóstico en la mayoría de los casos. Debe diferenciarse fundamentalmente de variantes de carácter maligno como el carcinoma papilar de células renales, del adenosarcoma metanéfrico y del tumor de Wilms del adulto. La sospecha del mismo junto con un análisis intraoperatorio del tumor puede facilitar el empleo de cirugía renal conservadora como tratamiento evitando una cirugía radical agresiva e innecesaria. Existen casos de Adenoma Metanéfrico metastásico, con lo que el carácter totalmente benigno de esta patología y su potencial maligno no se encuentran aún totalmente esclarecidos. (AU)

Cambios histopatológicos en arterias humanas sometidas a procesos de isquemia fría y criopreservación / Histopathological changes in human arteries following cold ischemia and cryo preservation processes

Introducción. La creciente demanda de injertos vasculares ha provocado una búsqueda continua del método `ideal' para minimizar los daños vasculares durante el proceso de conservación. Objetivo. Estudiar la repercusión sobre la histología arterial del proceso de preservación del tejido en sus distintas fases. Pacientes y métodos. Hemos analizado 86 segmentos arteriales (ilíaca y femoral superficial) procedentes de 50 donantes. De cada segmento se obtuvieron tres muestras en distintas fases del proceso, y se establecieron otros tantos grupos de estudio: arterias frescas; postisquemia fría y poscriopreservación. El tiempo máximo de isquemia fria fue de 20 horas y las muestras se mantuvieron en solución antibiótica a 4 °C. La criopreservación se realizó en una solución con dimetil sufóxido (DMSO) con descenso térmico programado de 1 ºC / min con almacenamiento en fase gas (-150 °C a -190 °C). Se valoraron parámetros como la preservación del endotelio, la intensidad de cambios degenerativos (degeneración mixoide, apoptosis) en la pared arterial y la presencia de fracturas, comparando los resultados entre los distintos grupos. Se estudiaron igualmente las causas que llevaron al fracaso de algunos injertos. Resultados. El 81,4 por ciento de las arterias criopreservadas mostró una pérdida prácticamente total del endotelio (3,5 por ciento en los otros dos grupos) y más del 50 por ciento, importantes cambios degenerativos en su pared frente al 3,5 y 8,1 por ciento de los grupos 1 y 2. Conclusiones. El proceso de criopreservación provoca una importante pérdida endotelial y cambios degenerativos en la pared arterial. El tiempo de isquemia fría que se empleó en nuestro estudio no tiene repercusión en la estructura arterial (AU)