Nasopalatine Duct Cyst in a 31 Year-Old Male: Imaging Findings in Computed Tomography / Quiste del Canal Nasopalatino en un Hombre de 31 años: Hallazgos en Imágenes de Tomografía Computarizada

A 31-year-old man is presented and is evaluated by panoramic radiography. As a finding, an extensive lesion with a cystic appearance was detected in the anterior part of the maxilla. Computed tomography shows a lesion corresponding to the characteristics of a cyst. In the histology the combination of two types of epithelium is observed, pseudostratified columnar and stratified squamous, confirming that this was a nasopalatine duct cyst.

Se presenta el caso de un hombre de 31 años, evaluado mediante radiografía panorámica. Como hallazgo se detecta una extensa lesión de aspecto quístico en la parte anterior del maxilar. En la tomografía computada se observa una lesión que corresponde a las carácterísticas de un quiste. La histología muestra una combinación de dos tipos de epitelio, pseudostratificado columnar y estratificado escamoso, confirmando que se trataba de un quiste del canal nasopalatino.

Effect of rumen-protected lysine supplementation of diets based on corn protein fed to lactating dairy cows.

This trial tested whether rumen-protected Lys (RPL) supplementation would improve the nutritive value of rumen-undegradable protein (RUP) from corn protein. Thirty-two lactating Holstein cows were blocked by days in milk and parity into 8 squares of 4 cows each in replicated 4 × 4 Latin squares. Treatments provided all supplemental crude protein from: (1) soy protein (67% expeller soybean meal plus 33% solvent soybean meal); (2) a blend of soy and corn protein (33% expeller soybean meal, 17% solvent soybean meal, 25% corn gluten meal plus 25% distillers dried grains with solubles); (3) corn protein (50% corn gluten meal plus 50% distillers dried grains with solubles); or (4) corn protein plus RPL [diet 3 top-dressed with RPL (125 g/d of AjiPro-L Generation 1, supplying an estimated 20 g of absorbable Lys/d)]. Diets contained (dry matter basis) 22% alfalfa silage, 43% corn silage, 18% ground high-moisture and dry corn, 2.4% mineral-vitamin premix, 1.5 to 3.9% soy hulls, 15% crude protein, 30 to 32% neutral detergent fiber and predicted to contain equal rumen-degradable protein, RUP, and metabolizable protein. Cows within squares were randomly assigned to treatment sequences and fed diets for 4-wk periods before switching; production data and blood samples were collected during last 2 wk of each period. Data were analyzed using the mixed procedures of SAS. Intake was highest on diet 1, intermediate on diets 2 and 3, and lowest on diet 4; body weight gain was highest on diet 3, intermediate on diets 1 and 2 and lowest on diet 4. Intakes and body weight changes were reflected by differences in milk/dry matter intake, which was highest on diets 2 and 4 and lowest on diet 3. Milk yield was lower on diet 3 (44.3 kg/d) than on diets 1, 2, and 4 (average 45.8 kg/d) and protein yield was highest on diets 1 and 2 (average 1.35 kg/d), intermediate on diet 4 (1.30 kg/d), and lowest on diet 3 (1.25 kg/d). No effects of diet were detected on ruminal metabolites. Free nonessential amino acids and total protein AA were elevated in blood plasma on diet 3, reflecting reduced utilization for milk protein synthesis. These results indicated that 50% dilution of soybean meal RUP with that from corn protein did not reduce yield and that supplementing RPL to the corn protein-based diet increased yield 1.1 kg of milk/d and 50 g of true protein/d.

Guía de práctica para el manejo de melanoma cutáneo primario de la Sociedad Chilena de Dermatología / Practice guideline for the management of melanoma primary skin cancer of the Chilean Society of Dermatology

Introducción: Desde el año 2011 a la fecha se han realizado grandes avances en el diagnóstico y el tratamiento del melanoma cutáneo. Las diferentes sociedades dermatológicas internacionales han actualizado sus recomendaciones y guías de manejo, tomando en consideración los nuevos avances científicos y resultados de ensayos clínicos. Objetivo: El objetivo de la presente revisión es proponer recomendaciones basadas en la evidencia sobre del rol del dermatólogo en el manejo del melanoma cutáneo en el sistema de salud de Chile. Diseño: Revisión sistemática de la literatura en cinco bases de datos: Pubmed/Medline, Embase, Web of Science, Lilacs/SciELO y Cochrane Library; desde julio del 2016 a julio del 2021. Resultados: 1306 registros fueron identificados y 153 cumplieron los criterios de inclusión. Se exponen recomendaciones actualizadas con respecto al diagnóstico y manejo del melanoma cutáneo en Chile. El panel de expertos presenta un diagrama de flujo del proceso de atención de una lesión sospechosa de melanoma, la participación global del equipo médico encargado del cuidado paciente y el rol del dermatólogo. Conclusión: El rol del dermatólogo es central e indispensable en todas las etapas de atención del melanoma cutáneo.

Introduction: Since 2011 great advances have been made in the diagnosis and treatment of cutaneous melanoma. The different international dermatological societies have updated their recommendations and clinical guidelines taking into account new scientific advances and the results of clinical trials. Objective: The aim of this review is to propose evidence-based recommendations on the role of the dermatologist in the diagnosis and management of cutaneous melanoma in the Chilean healthcare system. Design. Systematic review of the literature in five databases: Pubmed/Medline, Embase, Web of Science, Lilacs/SciELO and Cochrane Library; from July 2016 to July 2021. Results: 1306 records were identified and 153 met the inclusion criteria. Updated recommendations regarding the diagnosis and management of cutaneous melanoma in Chile are presented. The expert panel presents a flowchart of the process of care of a suspected melanoma lesion, the overall involvement of the medical team in charge of patient care, and the role of the dermatologist. Conclusion: The role of the dermatologist is central and critical in all stages of cutaneous melanoma care

Effect of feeding rumen-protected methionine on productive and reproductive performance of dairy cows.

The objectives of this study were to evaluate the effects of daily top-dressing (individually feeding on the top of the total mixed ration) with rumen-protected methionine (RPM) from 30 ± 3 until 126 ± 3 Days in milk on productive and reproductive performance in lactating dairy cows. A total of 309 lactating dairy Holstein cows (138 primiparous and 171 multiparous) were randomly assigned to treatment diets containing either RPM (21.2 g of RPM + 38.8 g of dried distillers grain; 2.34% Methionine [Met] of metabolizable protein [MP]) or Control (CON; 60 g of dried distillers grain; 1.87% Met of MP). Plasma amino acids were evaluated at the time of artificial insemination (AI) and near pregnancy diagnosis. Milk production and milk composition were evaluated monthly. Pregnancy was diagnosed on Day 28 (by Pregnancy-specific protein B [PSPB]), 32, 47, and 61 (by ultrasound) and sizes of embryonic and amniotic vesicle were determined by ultrasound on Day 33 after AI. Feeding RPM increased plasma Met at 6, 9, 12, and 18 hours after top-dressing with a peak at 12 hours (52.4 vs 26.0 µM; P < 0.001) and returned to basal by 24 hours. Cows fed RPM had a small increase in milk protein percentage (3.08 vs 3.00%; P = 0.04) with no differences on milk yield and milk protein yield. Additionally, in multiparous cows, RPM feeding increased milk protein (3.03 vs 2.95%; P = 0.05) and fat (3.45 vs 3.14%; P = 0.01) percentages, although no effects were observed in primiparous cows. In multiparous cows fed RPM, pregnancy loss was lower between Days 28 to 61 (19.6 [10/51] vs. 6.1% [3/49]; P = 0.03) or between Days 32 to 61 (8.9 [4/45] vs. 0 [0/0] %; P = 0.03), although, there was no effect of treatment on pregnancy loss in primiparous cows. Consistent with data on pregnancy loss, RPM feeding increased embryonic abdominal diameter (P = 0.01) and volume (P = 0.009) and amniotic vesicle volume (P = 0.04) on Day 33 of pregnancy in multiparous cows but had no effect on embryonic size in primiparous cows. Thus, the increase in plasma Met concentrations after feeding RPM was sufficient to produce a small increase in milk protein percentage and to improve embryonic size and pregnancy maintenance in multiparous cows. Further studies are needed to confirm these responses and understand the biological mechanisms that underlie these responses as well as the timing and concentrations of circulating Met that are needed to produce this effect.

Color Doppler Ultrasound Assessment of Activity in Keloids.

BACKGROUND: The assessment of activity in keloids may be critical for defining their management. There is a lack of clinical scorings designed for the evaluation of keloids and biopsies may be contraindicated. OBJECTIVE: To assess the sonographic activity of keloids in comparison with clinical scoring. MATERIALS AND METHODS: A retrospective study of the clinical and color Doppler ultrasound (CDU) images of patients medically derived to CDU with the diagnosis of keloid was performed. Activity was evaluated clinically (modified Seattle Scar Scale) and CDU. Keloids were considered active when CDU detected vascularity within the lesion. Statistical analysis was performed (Wilcoxon-Mann-Whitney, Student t-test, and interobserver agreement). RESULTS: Thirty-five patients with 42 keloids were evaluated. Color Doppler ultrasound provided the diameters, including depth, and vascularity. On CDU, 76% were active and 24% inactive. Clinically, Observer 1 found 55% and Observer 2 found 88% of active keloids. Interobserver agreement between clinical observers was moderate (k = 0.42). Subclinical fistulous tracts, involvement of the hypodermis, muscle, and calcifications were also found on CDU. CONCLUSION: Color Doppler ultrasound can support the assessment of activity in keloids. Clinical evaluation alone can underestimate the activity in keloids. Relevant anatomical and subclinical features can be detected by CDU.

Multidimensional Ultrasound and Computed Tomography Imaging Support in Bleeding Plexiform Neurofibromatosis of the Scalp: A Case Report and Literature Review.

Active bleeding in plexiform neurofibromatosis can be a life-threatening complication in neurofibromatosis type 1 (NF1). The prompt imaging support of 2D-3D ultrasound (US) and computed tomography (CT) during the active hemorrhage phase of cutaneous neurofibromas has not been previously reported. We report a case with NF1 who experienced a sudden swelling in the parieto-temporal region that corresponded to a massive and active hemorrhage within a plexiform neurofibroma. The US and CT imaging characteristics of this bleeding tumor are shown. Active hemorrhage in a plexiform neurofibroma of the scalp appeared in US as a heterogeneous hypodermal mass. CT demonstrated a fully hyperdense soft tissue mass. These characteristics differ from the non-complicated or old hemorrhagic imaging appearances of scalp plexiform neurofibromas and encourage prompt surgical treatment. This case report demonstrates the usefulness of imaging support in the early diagnosis of this hemorrhagic complication of NF1 in the scalp and also stimulates multispecialty management.

Human papillomavirus infection in oral squamous cell carcinomas from Chilean patients.

Human papillomavirus (HPV) is the causal agent of cervical, anogenital and a subset of oropharyngeal carcinomas. In addition, the role of HPV in oral carcinogenesis has been suggested, although the findings are inconclusive. In this study, using conventional polymerase chain reaction (PCR) and genotyping by specific PCR and DNA sequencing, we analyzed the HPV presence in 80 oral squamous cell carcinomas (OSCCs) from Chilean subjects. In addition, we determined the expression of p16, p53, pRb and Ki-67 using immunohistochemistry (IHC). The CDKN2A (p16) promoter methylation was evaluated using methylation-specific PCR (MSP). HPV sequences were found in 9/80 (11%) OSCCs. Non-statistically significant association with p53, pRb, Ki-67 and p16 levels were found (p=0.77; 0.29; 0.83; 0.21, respectively). HPV-16 and 18 were the most prevalent HPV genotypes in 8/9 (89%) OSCCs. In addition, CDKN2A (p16) was methylated in 39% of OSCCs. No association with HPV presence (p=0.917) was found. These results suggest that HPV positive OSCCs are entities that do not resemble the molecular alterations of HPV-associated tumors in a Chilean population. More studies are warranted to determine the role of HPV in OSCCs.

Color Doppler Ultrasound Follow-Up of Infantile Hemangiomas and Peripheral Vascularity in Patients Treated with Propranolol.

BACKGROUND: Infantile hemangiomas (IHs) are the most common vascular tumors in childhood. Diagnosis of IHs is usually clinical, however, to determine the actual dimensions of the lesion or the anatomic changes that occur during its evolution and treatment, a color Doppler ultrasound (CDU) examination can be performed. To date, there are few publications that assess the sonographic response to propranolol in IHs, and to our knowledge, none that consider simultaneous evaluation of both intralesional and normal peripheral blood vessels in these cases. OBJECTIVE: Evaluation of the anatomic effect of propranolol in IHs and peripheral blood vessels using CDU. METHODS: A cohort study was performed in 10 pediatric patients with a diagnosis of IH in whom systemic therapy with propranolol was indicated. The patients underwent a baseline and 3-month follow-up CDUs of the tumor and the main peripheral vessels of the right upper extremity. RESULTS: The group was composed of 7 (70%) girls and 3 (30%) boys. The average CDU decrease in size of the longitudinal axis was 11%; of the transverse axis, 24%; tumor thickness, 30%; and intralesional vessel thickness, 46%. Hemangioma volume measured by CDU decreased an average of 51%. The thickness of the peripheral vessels did not change significantly between the baseline and 3-month follow-up CDUs. CONCLUSION: CDU permits noninvasive quantification of the changes in IHs and peripheral vessels in patients receiving propranolol therapy. In our cohort of cases there was a significant reduction in tumor volume; however, peripheral vascularity was not significantly affected.

The unusual evolution of a simple bone cyst in the mandible: A case report.

The simple bone cyst, as newly classified by WHO in 2005, is a lesion related to the jawbones. Therefore, it is not a cyst, since it is a cavity devoid of epithelial tissue. It is a rare pathology affecting the mandible more than the maxilla. Its onset occurs mainly during the first two decades of life, irrespective of sex. The purpose of our report is to exhibit the particular case of a 17-year-old male patient whose radiography showed an osteolytic lesion in his right mandibular body. Exploratory surgery and biopsy are performed showing a simple bone cyst. Since then, he is controlled through imaging studies, but presenting an atypical evolution, with its size increasing considerably within a 4-year follow-up. Key words:Case report, simple bone cyst, hemorrhagic bone cyst, solitary bone cyst, idiophatic bone cyst, mandible.

Oral malignant tumours: a report on 728 cases in Chile.

The objective of this study was to describe the main clinical characteristics and the relative frequency of each type of oral malignancies received at the Oral Pathology Reference Institute (IREPO) of the Faculty of Odontology; University of Chile, since 1975 to 2006. Studies were performed of 728 cases of biopsies recorded in the IREPO data base with a diagnosis corresponding to some type of Oral Malignant Tumour (OMT) and which counted with all required clinical and demographic data. Histological sections were observed by two oral pathologists with the purpose of confirming the original diagnosis. 61.6% of OMTs were observed in males and 38.4% in females. Patients average age was 65.3 years, and the most frequent localization was the alveolar/gums ridge (20% of the cases) being the squamous cell carcinoma (SCC) the most frequent pathology (58.4%) These results are similar to the frequencies of oral malignancies reported for other countries as to distribution per gender, age, histological diagnosis. Nevertheless, frequency distribution of each of the OMTs is different to that indicated in most publications.

Oral malignant tumours: a report on 728 cases in Chile

The objective of this study was to describe the main clinical characteristics and the relative frequency of each type of oral malignancies received at the Oral Pathology Reference Institute (IREPO) of the Faculty of Odontology; University of Chile, since 1975 to 2006. Studies were performed of 728 cases of biopsies recorded in the IREPO data base with a diagnosis corresponding to some type of Oral Malignant Tumour (OMT) and which counted with all required clinical and demographic data. Histological sections were observed by two oral pathologists with the purpose of confirming the original diagnosis. 61.6% of OMTs were observed in males and 38.4% in females. Patients average age was 65.3 years, and the most frequent localization was the alveolar/gums ridge (20% of the cases) being the squamous cell carcinoma (SCC) the most frequent pathology (58.4%) These results are similar to the frequencies of oral malignancies reported for other countries as to distribution per gender, age, histological diagnosis. Nevertheless, frequency distribution of each of the OMTs is different to that indicated in most publications.

El objetivo de este estudio fue describir las principales caracteristicas clinicas y la frecuencia relativa de cada tipo de neoplasia maligna bucal recibidas en el Instituto de Referencia en Patologia Oral (IREPO) de la Facultad de Odontologia de la Universidad de Chile, entre los anos 1975 y 2006. Se seleccionaron todos los casos registrados en la base de datos del IREPO entre los anos 1975-2006 y que correspon - dieran a algun tipo de Tumor Maligno Oral (TMO) y de los que se contara con todos los datos clinicos y demograficos requeridos. Con el proposito de confirmar el diagnostico ori - gi nal, los cortes histologicos fueron observados por dos pato logos orales. El 61,6% de los TMO se presentaron en hombres y el 38,4% en mujeres. La edad promedio de los pacientes fue de 65,3 anos y la localizacion mas frecuente fue en las encias/reborde alveolar (20% de los casos), siendo el carcinoma de celulas escamosas (CCE) el tipo mas frecuente de TMO con un 58,4% de los casos. Estos resultados son similares a las frecuencias de tumores malignos orales reportadas en otros paises como tambien su distribucion por genero, edad y tipo histologico. Sin embargo, la distribucion de frecuencias de los diferentes TMO es distinta a la reportada en la mayoria de las publicaciones.

Ameloblastin and amelogenin expression in posnatal developing mouse molars.

Ameloblastin and amelogenin are structural proteins present in the enamel matrix of developing teeth. Here we report the results of in situ hybridization analyses with DNA probes of ameloblastin and amelogenin expression in the mandibular first molars of ICR/Jcl mice from postnatal day 1 to day 15. Ameloblastin mRNA expression was observed in ameloblasts at day 2 while amelogenin mRNA was detected in secretory ameloblasts at day 3. Significant expression of both molecules was observed at days 4, 5 and 6, after which the levels decreased. Amelogenin expression ended on day 10, while ameloblastin mRNA was only weakly detected on day 12. Neither amelogenin nor ameloblastin expression was observed in day 15 mouse molars. Amelogenin and ameloblastin mRNAs were restricted to ameloblasts. We conclude that amelogenin and ameloblastin expression is enamel-specific, and suggest that these genes might be involved in the mineralization of enamel. It is possible that ameloblastin could participate in the attachment of ameloblasts to the enamel surface. In this case, the downregulation of expression may indicate the beginning of the maturation stage in which the ameloblasts tend to detach from the enamel layer.

Mouse tooth development time sequence determination for the ICR/Jcl strain.

To establish the normal dental development pattern of the ICR/Jcl strain of mouse, we analyzed a significant number of observations of the different developmental stages of the first mandibular molar, accurately recording the chronology of their daily embryonic development. Proliferation of the dental sheet began at day 12.5 in utero (E-12.5), the bud stage appeared at days E-13.5 and E-14.5, the cap stage was observed at days E-14.5, E-15.5 and E-16.5 and the early bell stage at day E-17.5. The presence of predentin was observed at day E-18.5 and dentin was observed 1 and 2 days after birth (D-1 and D-2). The late bell stage with presence of enamel was detected more than 3 days after birth. Embryonic and dental development in the ICR/Jcl strain of mouse is faster than in other well-known strains. The establishment of this developmental pattern will be useful for future investigations of transgenic mice.