Quiste dermoide latero cervical / Dermoid cyst of the lateral neck

Resumen Introducción: Los quistes dermoides son lesiones de origen ectodérmico poco frecuentes. Solo un 1,6% de ellos, se presenta en el piso de la boca y de éstos, solo un 6% lateralmente en el espacio submandibular. Objetivo: Reporte de caso y revisión de la literatura. Caso clínico: Se presenta un caso de una paciente de 32 años, con un cuadro de 1 año de evolución caracterizado por una lesión de crecimiento lento pero sostenido. Se le realizó la resección de la lesión junto con una submandibulectomía ipsilateral resultando compatible con un quiste dermoide. Discusión: La localización de esta lesión es muy infrecuente. En el estudio histopatológico son lesiones con epitelio pluriestratificado cornificado y anexos cutáneos. El estudio de imágenes orienta a una lesión quística, siendo la resonancia nuclear hoy en día el mejor examen para caracterizar esta lesión. Es una lesión benigna, sin recidivas reportadas cuando la resección ha sido completa.

Introduction: Dermoid cysts are uncommon lesions from ectodermic origin. Only 1.6% arise in the floor of the mouth, and at this site only 6% arise laterally in the submandibular region. Aim: Case report and review of the literature. Clinical Case: 32 years old patient, with a slow growing lesion during 1 year. Complete resection with an ipisilateral submandibulectomy was performed. The pathologic report showed a dermoid cyst. Discussion: The localization of this lesion is very uncommon. In the pathologic report are lesion with pluri stratified cornified epthitelium with skin attachments. Image studies show a cystic lesion being the magnetic resonance the best study to characterize this lesions. Are benign lesions, without recurrence reported when the lesion has been fully excised.

Malformación arterio-venosa uterina y hemorragia obstétrica: diagnóstico y manejo en tres casos clínicos / Uterine arteriovenous malformation and obstetric hemorrhage: diagnosis and management in three cases

Las malformaciones vasculares uterinas son muy infrecuentes y se presentan asociadas a metrorragia con riesgo vital. Su incidencia no es conocida porque las series son de pocos casos. Presentamos tres pacientes con hemorragia obstétrica cuyo estudio diagnóstico con ultrasonido y angiografía, demostró malformación arteriovenosa uterina. En un caso, dada la extensión de la lesión, el tratamiento fue con embolización bilateral de arterias uterinas seguida de histerectomía. Otras dos pacientes, por preservación de fertilidad, fueron sometidas solo a embolización. La evolución clínica y las imágenes confirmaron que los procedimientos fueron exitosos. Se discute la importancia de la interpretación correcta de las imágenes para el diagnóstico, la adaptación de los métodos terapéuticos al caso individual y el manejo multidisciplinario.

The uterine vascular malformations are very infrequent and associated to maternal hemorrhage with vital risk. The incidence is unknown because the published series are little with few cases. We described three cases with obstetrical hemorrhage and the image study with ultrasound and angiography showed an arteriovenous malformation. One patient, for the extensive lesion, was treated with bilateral embolization of uterine arteries and then, histerectomy. The others patients, for preservation her fertility, were treated with embolization only. The clinical evolution and the vascular images study confirm the success of the procedures. We discuss the importance of images analysis for the diagnosis, the individual application of therapeutic methods and a multidisciplinary approach for this scope.

Hemangiopericitoma: reporte de 3 casos / Hemangiopericytoma: a report of 3 cases and a literature review

Introduction: The hemangiopericytoma (HPC) is a rare vascular tumor that can be potentially malignant. It can be found in any part of the body but usually in the lower extremities or the retroperitoneum. Because its potential malign nature, it's necessary to perform oncological resections when are operating on. Methods: Three cases are presented. Results: One of them was located at the sacrococcigeal space, being the second reported case in the international literature. The other cases were in cervical and adrenal localization.

Introducción: El hemangiopericitoma (HPC) es un tumor vascular raro y potencialmente maligno que puede localizarse en cualquier parte del cuerpo, con mayor frecuencia en extremidades inferiores y retrope-ritoneo. Su potencial malignidad da la necesidad de realizar resecciones oncológicas al operarlos. Material y Método: Se presentan tres casos tratados por nuestro grupo. Resultados: Uno de ellos tiene localización sacra siendo, hasta donde sabemos, el segundo en ser publicado. Otro es de localización suprarrenal y el tercero es cervical.

Mielolipoma suprarrenal gigante / Giant adrenal myelolipoma

Myelolipomas are rare benign tumors mostly located in the adrenal glands. They are usually asymptomatic with just a few millimeters in size, but they can grow over 30 cm becoming a life threat for the patient. This is a case of a 49 years old male patient who was diagnosed with a giant myelolipoma of the right adrenal gland while being studied for other reasons.

Los mielolipomas son tumoraciones benignas poco frecuentes con mayor localización en las glándulas suprarrenales. Su tamaño puede variar desde unos pocos milímetros hasta varias decenas de centímetros y dependiendo del tamaño pueden llegar a ser sintomáticos. Se presenta el caso de un paciente masculino de 49 años al que incidentalmente se le diagnostica un mielolipoma suprarrenal derecho gigante de 22 x 15 x 10 cm.

TWEAK: ¿una alternativa real en el diagnóstico de nefropatía lúpica? / TWEAK: a real alternative in the diagnosis of lupus nephritis?

Currently, there is not a marker for early diagnosis of Lupus Nephropathy. TWEAK is a weak Tumor Necrosis Factor whose interaction with the receptor Fn14 in kidney tissue exerts various biological activities including events related to cell proliferation, apoptosis, angiogenesis and inflammation. Because these processes seem to be involved in the pathogenesis of Lupus Nephropathy, it has been proposed that TWEAK could be a potential therapeutic target, but also a predictor of its appearance, and then a possible marker for early diagnosis. The purpose of this article is to discuss the current state of the art in research, of this potential diagnostic tool.

Influencia de componentes de la matriz extracelular en la agresividad y potencial invasor del cáncer cérvicouterino: ¿Qué hay de nuevo? / Influence of extracellular matrix components in aggressiveness and invasive potential of cervical cancer: What's new?

El cáncer cérvico uterino (CCU) es una patología de alta incidencia y mortalidad. La investigación hasta ahora se ha enfocado en estudiar su asociación con virus papiloma. Sin embargo, el estudio de la matriz extracelular (MEC) ha dado una nueva perspectiva para el estudio de factores inductores o perpetuadores de las neoplasias. En las neoplasias epiteliales como CCU el estroma tumoral presenta una composición dinámica de elementos celulares, destacando la presencia de miofibroblastos positivos a alfa actina de músculo liso (alfa SMA+) y fibrocitos CD34+. La MEC tiene un papel fundamental, ya que no sólo otorga las condiciones apropiadas para el desarrollo del tumor, sino que además condiciona el fenotipo de la población celular del estroma, donde la pérdida de fibrocitos CD34+ asociada a una ganancia de miofibroblastos alfa SMA+ podría ser un indicador muy sensible de invasión estromal, incluso en estadios iniciales. De la misma forma lo hace TGF-beta Ι, ya que su presencia es un reflejo de la síntesis de alfa SMA. Un nuevo elemento es versicán, un proteoglicano cuyas isoformas V0 y V1 se expresan también en tejidos neoplásicos de tumores ováricos, mama y cerebro, entre otros. Desempeña un papel muy importante en los fenómenos de adhesión celular, proliferación, migración y ensamblaje a la MEC. Por lo tanto, el análisis del estroma adyacente a las lesiones epiteliales del cuello uterino puede complementar el conocimiento sobre la conducta biológica de éstas, constituyendo una poderosa herramienta diagnóstica, de forma complementaria a los elementos utilizados hasta ahora.

Squamous cell carcinoma of the cervix (SCC) is a pathology that has high incidence and mortality. So far, research has been focused in the study of its association with papilloma virus. However, knowledge about extracellular matrix (ECM) has given a new perspective for the study of factors that induce or perpetuate neoplasms. In epithelial neoplasms like SCC, the tumoral stroma exhibits a dynamic composition of cellular elements, highlighting the presence of alpha actin of smooth muscle positive myofibroblasts (alpha SMA+) and CD34+ fibrocytes. ECM has an essential role, because it not only provides the appropriate conditions for tumor's development, but also affects stromal cell population phenotype, where a loss of CD34+ fibrocytes associated with a gain of alpha SMA+ myofibroblasts could be a sensitive indicator of stromal invasion, even in early stages. TGF-beta Ι does it in the same way, as its presence is a reflection of the synthesis of alpha SMA+. A new element is versican, a proteoglycan whose V0 and V1 isoforms expression is also observed in neoplastic tissues of ovary, breast and brain tumors, among others. It plays an important role in the phenomena of cellular adhesion, proliferation, migration and assembly of the ECM. Therefore, the analysis of the stroma adjacent to epithelial injuries of the cervix can complement the knowledge about the biological conducts of these, constituting a powerful diagnostic tool, as a complement to the elements used nowadays.

Farmers' perceptions, knowledge, and management of coffee pests and diseases and their natural enemies in Chiapas, Mexico.

Small farmers' perceptions of coffee Coffea arabica L. herbivores and their natural enemies, how those perceptions relate to field infestation levels, and pest management practices being implemented by members from two organic and nonorganic coffee grower organizations in the Soconusco region, southeastern Mexico, were analyzed through an interview survey, diagnostic workshops, and field sampling. The terms pest, disease, and damage were commonly used as synonyms. The major phytophagous species, as perceived by the interviewees, were Hypothenemus hampei (Ferrari), and to a lesser extent the fungi Corticium koleroga Cooke (Höhnel) and Hemileia vastatrix Berkeley & Broome. Among the nonorganic farmers, other nonpest-related constraints were regarded as more important. Awareness of the existence of natural enemies was low, despite more organic farmers have used the ectoparasitoid bethylid Cephalonomia stephanoderis Betrem against H. hampei. Labor supplied by household members was most frequent for pest control; only organic farmers exchanged labor for this purpose. The levels of infestation by H. hampei, Leucoptera coffeella Guérin-Méneville, and C. koleroga were lower within the organic coffee stands. However, a low effectiveness for pest control was commonly perceived, probably due to a feeling, among the organic farmers, of a low impact of their pest management extension service, whereas a lack of motivation was prevalent among the nonorganic farmers, shown by a concern with their low coffee yields and the emigration of youth. The importance of understanding farmers' perceptions and knowledge of pests and their natural enemies and the need for participatory pest management approaches, are discussed.

Selective indications for the use of praziquantel in the treatment of brain cysticercosis.

The selective use of praziquantel for the treatment of brain cysticercosis in human beings is described, based upon the results of clinical tests conducted during a 2 year period. Forty patients with clinical diagnosis of cysticercosis, confirmed and documented by CT, were treated. They are divided into four groups, representative of the various forms of the disease. The results assessed by clinical evaluation and sequential CT, give a ten point criterion of the indications for praziquantel.