[Distal pancreatectomy as surgical option in Pancreas divisum associated with Rubinstein-Taybi syndrome]. / Pancreatectomía distal como opción quirúrgica en Páncreas divisum asociado a síndrome de Rubinstein-Taybi.

INTRODUCTION: The Rubinstein-Taybi syndrome and pancreas divisum are uncommon diseases in children. The Rubinstein-Taybi syndrome diagnosis is only clinical, and mental retardation and dysmorphic features mainly characterize it. The PD relates to idiopathic pancreatitis in 7.5% of patients suffering from this disorder. It has not been found any cases reported where these diseases are associated and the management of patients with pancreatitis associated with PD is still a challenge. CLINICAL CASE: A patient diagnosed with Rubinstein-Taybi syndrome has recurrent abdominal pain of six months and elevated pancreatic enzymes, he underwent a magnetic resonance imaging where pancreas divisum is suspected. Endoscopic drainage was foiled so he underwent intraoperative retrograde pancreatography where aberrant pancreas is confirmed and a distal pancreactectomy and yeyunopancreatic anastomosis is the chosen option. COMMENTS: The pancreatectomy with pancreato-jejunal anastomosis is an excellent therapeutic option surgical is proposed for a patient with difficulty endoscopic approach and chronic pancreatitis.

INTRODUCCION: El síndrome de Rubinstein-Taybi (SRT) y Páncreas Divisum (PD) son patologías poco frecuentes en la población infantil. El diagnóstico del síndrome Rubinstein-Taybi es clínico, principalmente presenta discapacidad intelectual y rasgos dismórficos. El páncreas divisum se relaciona con pancreatitis idiopática en el 7,5% de pacientes con esta alteración. No se ha encontrado bibliografía que asocie ambas patologías y continúa siendo un reto el manejo de pancreatitis asociado a páncreas divisum. CASO CLINICO: Paciente con diagnóstico de síndrome Rubinstein-Taybi presenta dolor abdominal recurrente de 6 meses de evolución y enzimas pancreáticas elevadas; se realizó una resonancia magnética donde se sospecha de páncreas divisum. El drenaje endoscópico fue frustro, por lo que se realizó una pancreatografía retrógrada intraoperatoria donde se confirma páncreas aberrante y se opta por pancreactectomía distal y anastomosis yeyunopancreática. COMENTARIOS: La pancreatectomía con anastomosis pancreato-yeyunal es una excelente opción terapéutica en pacientes con abordaje endoscópico complicado y pancreatitis crónica.

Severe calcinosis cutis associated with treatment of hypoparathyroidism in a dog.

A 6-month-old, female border collie was referred for evaluation of hypocalcemia, hyperphosphatemia, fever, and painful ventral abdominal skin. She had recently been treated intravenously and subcutaneously (SC) with a diluted 10% calcium gluconate solution. The medical evaluation supported the diagnosis of primary hypoparathyroidism, but the subsequent hospital course was complicated by severe calcinosis cutis, which caused extensive skin necrosis and marked debilitation. This patient illustrates that administration of a calcium gluconate solution SC can be associated with extensive morbidity when administered to hyperphosphatemic patients.

Labelling of Re-ABP with 188Re for bone pain palliation.

Etidronate and medronate have been labelled with technetium-99m (99mTc-HEDP, 99mTc-MDP) for bone scanning and, with rhenium-188 (188Re-HEDP) to palliate the pain resulting from bone metastases. The objective of this study was to label alendronate, ABP, a new bisphosphonate, with SnF2-reduced-188Re. The reagents for the 5 mg ABP kit were SnF2, KReO4 and gentisic acid at acid pH. The chemical, spectroscopic and microscopic characteristics, quality control, rat bone uptake of [188Re]Re-ABP and similarities with 99mTc-ABP are presented. We conclude that this is a promising new radiopharmaceutical for bone metastases pain palliation.

Evolution of beta-amylase: patterns of variation and conservation in subfamily sequences in relation to parsimony mechanisms.

Soybean and sweet potato beta-amylases are structured as alpha/beta barrels and the same kind of folding may account for all known beta-amylases. We provide a comprehensive analysis of both protein and DNA (coding region) sequences of beta-amylases. The aim of the study is to contribute to the knowledge of the evolutionary molecular relationships among all known beta-amylases. Our approach combines the identification of the putative eightfold structural core formed by beta-strands with a complete multi-alignment analysis of all known sequences. Comparing putative beta-amylase (alpha/beta)8 cores from plants and microorganisms, two differentiated versions of residues at the packing sites, and a unique set of eight identical residues at the C-terminal catalytical site are observed, indicating early evolutionary divergence and absence of localized three-dimensional evolution, respectively. A new analytical approach has been developed in order to work out conserved motifs for beta-amylases, mostly related with the enzyme activity. This approach appears useful as a new routine to find sets of motifs (each set being known as a fingerprint) in protein families. We demonstrate that the evolutionary mechanism for beta-amylases is a combination of parsimonious divergence at three distinguishable rates in relation to the functional signatures, the barrel scaffold, and alpha-helix-containing loops.