Endonasal clipping of unruptured right paraclinoid aneurysm. Case report in a third level center in Mexico City.

Paraclinoid aneurysms take importance due to the technical difficulty due to anatomical relationships, which is why different approaches have been sought for their proper management. This is a female patient with a finding of a paraclinoid aneurysm and treatment using an endonasal approach with adequate angiographic support. Knowledge of the anatomy and surgical skill are required for the management of these lesions, assisted by angiographic controls for successful treatment. The endoscopic endonasal approach is adequate if the anatomy allows it and the basic hospital infrastructure is available to obtain high success rates.

Los aneurismas paraclinoideos cobran importancia debido a la dificultad técnica por sus relaciones anatómicas, por lo que se han buscado diferentes abordajes para su adecuado manejo. Se presenta el caso de una paciente con un aneurisma paraclinoideo y tratamiento mediante abordaje endonasal con apoyo angiográfico adecuado. Se requieren conocimientos de la anatomía y habilidad quirúrgica para el manejo de estas lesiones, así como asistencia de controles angiográficos para el éxito del tratamiento. El abordaje endonasal endoscópico es adecuado en caso de que la anatomía lo permita y se tenga la infraestructura hospitalaria básica para obtener un alto índice de éxitos.

Biofabrication of Gold Nanotriangles Using Liposomes as a Dual Functional Reductant and Stabilizer.

Negatively charged liposomes accomplished both functions as a reducing and stabilizing agent in the synthesis of gold nanotriangles (GNTs). Liposomes are based on a mixture of phospholipids phosphatidylcholine/phosphoglycerol, and they were used as a template phase to perform the GNTs. The method was evaluated under different conditions such as temperature, reaction time, phosphoglycerol chain length, and precursor concentration. Isotropic and anisotropic gold nanoparticles are formed simultaneously during the synthesis. Therefore, by combining centrifugation and depletion flocculation strategies, the sample was concentrated in terms of GNTs from 15% crude to 80% by using sodium dodecyl sulfate (SDS). As a result, a green colored dispersion was obtained containing highly purified, well-defined, negatively charged GNTs, where the edge length of most particles is centered in the range of 60-80 nm with an average thickness of 7.8 ± 0.1 nm. By this purification process, it was possible to highly increase the yield in terms of GNTs. Other surfactants [cetyltrimethylammonium chloride (CTAC), hexadecyltrimethylammonium bromide (CTAB), Tween 20, and dodecyldimethylammonium bromide] were evaluated during the purification stage, and both CTAB and CTAC show similar results to those obtained by using SDS. These GNTs are potential candidates for future applications in molecular imaging, photothermal therapy, drug delivery, biosensing, and photodynamic therapy.

Spinal drop of atypical choroid plexus papilloma in an adult patient: A case report and literature review.

BACKGROUND: Choroid plexus papillomas (CPPs) are benign extra-axial tumors that originate from the choroid plexus; these tumors rarely have metastases, being at the spinal level the location with few reported cases. CASE DESCRIPTION: We report the case of a 48-year-old man with a history of atypical fourth ventricular CPP and gross total resection (GTR) in 2008. In 2015, he presented with radicular pain, decreased strength, and paresthesia in the left leg. Magnetic resonance imaging revealed a well-defined intradural ovoid lesion in the vertebral canal at the level of the L3-L4 intersomatic space. Subtotal resection of the tumor was performed. The patient recovered well, with relief of pain and no neurological deficit. A literature research few cases of CPP metastasis in adults. We describe here a fifth-decade male patient with a lumbar neoplasm, which according to the histopathologic characteristics and location is the first case of an atypical papilloma implant of the choroid plexus at this spinal level. CONCLUSION: GTR of primary lesions and associated implants remains the gold standard for surgical treatment of CPP. Radiotherapy, stereotactic radiosurgery, and chemotherapy are adjuvant therapies for CPP but there is no definitive protocol for the management of implants. Proper follow-up of these patients is essential since spinal drop can appear many years after the initial presentation of CPP.

Ventriculopleural shunt dysfunction as the first sign of a hidden aneurysmal Subarachnoid Hemorrhage: A case report.

INTRODUCTION: Subarachnoid Hemorrhage (SAH) is caused by an aneurysmatic origin in 80% of cases. In the adult population, the risk of shunt dysfunction is about 16% in the first year, with proximal mechanical obstruction being the most frequent cause. CASE REPORT: An 81-year-old man with a history of shunt system placement presented among clinical data of shunt dysfunction. The brain Computed Tomography (CT) showed dilation of the ventricular system, with no other associated injury. The cause of the dysfunction was a SAH determined by a lumbar puncture (LP) study. We performed an angiography reporting 3 aneurysms. DISCUSSION: The risk of shunt dysfunction at one year is 40% and at two years, the risk ups to 53% with obstruction of the system and infection being the two principal causes. The usefulness of a lumbar puncture for late detection of SAH lies in the red cells in the Cerebrospinal Fluid (CSF). When the CT is negative and the clinical suspicion remains, the lumbar puncture (LP) continues with higher sensitivity despite is over 12 hours of the onset clinic symptoms. CONCLUSION: This case encourages to follow a rigorous protocol study for patients with multiple shunt dysfunction and chronic hydrocephalus. Also, this case invites to consider a hidden SAH secondary to a vascular pathology as a differential diagnosis for a multiple shunt dysfunction.

High-risk human papilloma virus infection decreases the frequency of dendritic Langerhans' cells in the human female genital tract.

Dendritic cells (DC) are often arranged in planar layers in tissues with high antigenic exposure, such as skin and mucosae. Providing an en face view, this arrangement optimizes in situ analysis regarding morphology (even of individual dendrites), topographic distribution (regular/clustered) and quantification. The few reports on human genital DC usually utilize single markers and conventional sections, restricting immunolabelling only to cell parts sectioned by the cut. To better assess DC in situ, we labelled epithelial sheets, prepared from fresh cervix biopsies, with antibodies to major histocompatibility complex (MHC)-CII, CD1a and Langerin, revealing (with each of these markers) a dense DC network in a planar-like, regular distribution. Using the hybrid capture system to detect the high-risk mucotropic human papilloma virus (HPV) group, 16 positive and five negative women were studied and the results were compared between these groups. DC frequency per area was substantially reduced (to approximately 50% for the three markers) in samples from all HPV-infected patients compared with samples from controls. Unlike HPV(-) samples, Langerin(+) DC in HPV(+) cervix exhibited a highly accentuated dendritic appearance. We believe this to be the first study using these three DC-restricted markers (Langerin, CD1a and MHC-CII) in cervical epithelial sheets from high-risk HPV(+) donors and also the first study to demonstrate the morphological and quantitative changes triggered by high-risk HPV infection. Cervical DC reduction in early, premalignant high-risk HPV infection might represent viral subversion strategies interfering with efficient antigen handling by the immune system's peripheral sentinels, the DC, perhaps hampering appropriate recruitment and subsequent development of effector (cytotoxic) T cells.

Registro regional de tumores malignos para el sur de Sonora / Malignant tumors regional register for south Sonora

Se inició un registro regional de tumores malignos, para el sur de Sonora, México, con una población de 750 000 habitantes. Se hizo una pesquisa de cada caso nuevo de cáncer informado por centros hospitalarios, consulta externa y laboratorios de anatomía patológica, así como en certificados de defunción, durante el periodo de 1982 a 1983 (del 15 de marzo al 14 de marzo siguiente). Se informan cifras de cada grupo de tumores por sitio de origen, sexo y decenios de la vida en que se presentan. Se encontraron en total 1 123 casos, o sea una frecuencia de 1 497.3 por obs: 1 000 000 de habitantes por año, y entre éstos se encontraron 570 defunciones, que constituyen una tasa de mortalidad de 760 por obs: 1 000 000 por año. Fueron 490 los casos (43.6%) en varones y 633 (56.4%) en mujeres. La máxima frecuencia ocurrió a partir de los 40 años. El tumor más frecuente fue el del cuello uterino, 246 casos (21.9%), y lo siguieron los de bronquios y pulmón, glándula mamaria, los linfomas, las leucemias y de piel con 130 (11.6%), 92 (8.2%), 90 (8%) y 86 (7.6%) casos, respectivamente