Explicación ontogénica para la asociación entre dehiscencia del tegmen tympani y dehiscencia del canal semicircular superior / Ontogenetic explanation for tegmen tympani dehiscence and superior semicircular canal dehiscence association

Objetivos: Analizar la ontogenia del canal semicircular superior y del tegmen tympani y determinar si hay factores embriológicos comunes que expliquen la dehiscencia asociada de ambos. Métodos: Se han analizado 77 series embriológicas humanas de edades comprendidas entre las 6 semanas y recién nacidos. Las preparaciones estaban cortadas en serie y teñidas con la técnica de tricrómico de Martins. Resultados: La prolongación tegmentaria del tegmen tympani y el canal semicircular superior se originan de la misma estructura, la cápsula ótica, y poseen el mismo tipo de osificación endocondral; mientras que la prolongación escamosa del tegmen tympani se desarrolla desde la escama del temporal y su osificación es de tipo directa o intramembranosa. En la osificación de la prolongación tegmentaria colaboran los núcleos de osificación de los canales semicirculares superior, externo y accesorio del tegmen, los cuales por crecimiento se extienden hasta la prolongación tegmentaria, este hecho sumado a que ambas estructuras comparten una capa común de periostio externo podría explicar la coexistencia de falta de cobertura ósea en el tegmen y en el canal. Conclusión: El desarrollo del canal semicircular y tegmen tympani podrían explicar las causas de la asociación de ambas dehiscencias (AU)

Objectives: To analyze the ontogeny of the superior semicircular canal and tegmen tympani and determine if there are common embryological factors explaining both associated dehiscence. Methods: We analyzed 77 human embryological series aged between 6 weeks and newborn. Preparations were serially cut and stained with Masson's trichrome technique. Results: The tegmental prolongation of tegmen tympani and superior semicircular canal originate from the same structure, the otic capsule, and have the same type of endochondral ossification; while the extension of the squamous prolongation of tegmen tympani runs from the temporal squama and ossification is directly of intramembranous type. The nuclei of ossification of the superior and external semicircular canals and accessory of tegmen collaborate in the ossification of the tegmental extension and by growth extend to the tegmental prolongation. This fact plus the fact that both structures share a common layer of external periosteum could explain the coexistence of lack of bone coverage in tegmen and superior semicircular canal. Conclusion: The development of the semicircular canal and tegmen tympani could explain the causes of the association of both dehiscences (AU)

Ontogenetic explanation for tegmen tympani dehiscence and superior semicircular canal dehiscence association. / Explicación ontogénica para la asociación entre dehiscencia del tegmen tympani y dehiscencia del canal semicircular superior.

OBJECTIVES: To analyze the ontogeny of the superior semicircular canal and tegmen tympani and determine if there are common embryological factors explaining both associated dehiscence. METHODS: We analyzed 77 human embryological series aged between 6 weeks and newborn. Preparations were serially cut and stained with Masson's trichrome technique. RESULTS: The tegmental prolongation of tegmen tympani and superior semicircular canal originate from the same structure, the otic capsule, and have the same type of endochondral ossification; while the extension of the squamous prolongation of tegmen tympani runs from the temporal squama and ossification is directly of intramembranous type. The nuclei of ossification of the superior and external semicircular canals and accessory of tegmen collaborate in the ossification of the tegmental extension and by growth extend to the tegmental prolongation. This fact plus the fact that both structures share a common layer of external periosteum could explain the coexistence of lack of bone coverage in tegmen and superior semicircular canal. CONCLUSION: The development of the semicircular canal and tegmen tympani could explain the causes of the association of both dehiscences.

Peculiaridades en el desarrollo del canal semicircular superior / Peculiarities in the development of the superior semicircular canal

Objetivos: Realizar un estudio sobre la ontogénesis del canal semicircular superior con el fin de describir sus peculiaridades. Métodos: Para ello se han analizado 76 series embriológicas humanas de edades comprendidas entre los 32 días (6 mm) y recién nacidos. Las preparaciones estaban cortadas en serie y teñidas con la técnica de tricrómico de Martins. Resultados: En el desarrollo del canal semicircular hemos observado una serie de peculiaridades, como: secuencia cronológica definida de su osteogénesis con un ritmo de osificación variable, cada núcleo de osificación interviene en la formación de una de sus cubiertas, el superior de la superficial y el inferior de la profunda; la aparición de una dehiscencia transitoria, y el cierre del canal por hueso de tipo laminar con un grosor mínimo de 0,1 mm. Conclusión: Las peculiaridades en el desarrollo del canal podrían explicar las causas del origen de la dehiscencia patológica del mismo, ya sean congénitas o adquiridas (AU)

Objective: Our objective was to study the ontogeny of the superior semicircular canal in order to describe its peculiarities. Methods: We analyzed 76 series of human embryos aged between 32 days (6 mm) and newborns. The samples were cut serially and stained using Martin's trichrome technique. Results: In semicircular canal development there were a number of peculiarities, such as: a defined chronological sequence of osteogenesis with a variable rate of ossification; the fact that each nucleus of ossification was involved in the formation of one of its covers (the upper in the superficial and the lower in the deep); the appearance of transitory dehiscence; and canal closure by means of bone with laminar pattern, with a minimum thickness of 0.1 mm. Conclusion: The peculiarities in canal development could explain the origin of pathological dehiscence in the canal, whether congenital or acquired (AU)

Age differences in presentation, diagnosis pathway and management of colorectal cancer.

BACKGROUND: The gap in survival between older and younger European cancer patients is getting wider. It is possible that cancer in the elderly is being managed or treated differently than in their younger counterparts. This study aims to explore age disparities with respect to the clinical characteristics of the tumour, diagnostic pathway and treatment of colorectal cancer patients. METHODS: We conducted a multicenter cross sectional study in 5 Spanish regions. Consecutive incident cases of CRC were identified from pathology services. MEASUREMENTS: From patient interviews, hospital and primary care clinical records, we collected data on symptoms, stage, doctors investigations, time duration to diagnosis/treatment, quality of care and treatment. RESULTS: 777 symptomatic cases, 154 were older than 80 years. Stage was similar by age group. General symptoms were more frequent in the eldest and abdominal symptoms in the youngest. No differences were found regarding perception of symptom seriousness and symptom disclosure between age groups as no longer duration to diagnosis or treatment was observed in the oldest groups. In primary care, only ultrasound is more frequently ordered in those <65 years. Those >80 years had a significantly higher proportion of iron testing and abdominal XR requested in hospital. We observed a high resection rate independently of age but less adjuvant chemotherapy in Stage III colon cancer, and of radiotherapy in stage II and III rectal cancer as age increases. CONCLUSION: There are no relevant age disparities in the CRC diagnosis process with similar stage, duration to diagnosis, investigations and surgery. However, further improvements have to be made with respect to adjuvant therapy.

[Peculiarities in the development of the superior semicircular canal]. / Peculiaridades en el desarrollo del canal semicircular superior.

OBJECTIVE: Our objective was to study the ontogeny of the superior semicircular canal in order to describe its peculiarities. METHODS: We analyzed 76 series of human embryos aged between 32 days (6mm) and newborns. The samples were cut serially and stained using Martin's trichrome technique. RESULTS: In semicircular canal development there were a number of peculiarities, such as: a defined chronological sequence of osteogenesis with a variable rate of ossification; the fact that each nucleus of ossification was involved in the formation of one of its covers (the upper in the superficial and the lower in the deep); the appearance of transitory dehiscence; and canal closure by means of bone with laminar pattern, with a minimum thickness of 0.1mm. CONCLUSION: The peculiarities in canal development could explain the origin of pathological dehiscence in the canal, whether congenital or acquired.

Micosis fungoide granulomatosa unilesional / Unilesional granulomatous mycosis fungoides

La presencia de granulomas en el estudio histológico define una rara variante de micosis fungoide: la micosis fungoide granulomatosa. Presentamos el caso de una mujer de 68 años con una placa eritematoedematosa de 5 5 cm en región mandibular, estable durante 12 años y biopsiada con resultados similares en varias ocasiones. (AU)

Enfermedad de Whipple de manifestación exclusivamente intestinal. Presentación de un caso y actualización bibliográfica / Whipple’s disease restricted to intestine. Case report and review of literature

La enfermedad de Whipple (EW) es una rara enfermedad sistémica que afecta preferente- mente al tracto gastrointestinal, causada por la infección de una bacteria, la Tropheryma whippelii, que ha podido ser cultivada recientemente. El estudio histológico es el método estandar para el diagnóstico de EW, siendo la característica principal la presencia de macrófagos con inclusiones intracelulares, PAS positivo, en la lámina propia del intestino delgado. Describimos el caso de una mujer de 44 años que presentaba un cuadro diarreico severo sin manifestaciones extraintestinales, lo que dificultó el diagnóstico que se alcanzó definitivamente tras el estudio histopatológico de biopsias endoscópicas múltiples. Asimismo, se revisan las últimas teorías epidemiológicas y patogénicas (AU)

Whipple ́s disease (WD) is a rare systemic disease with a tendency to involve the gastrointestinal tract, and is due to the infection by a bacteria named Tropheryma whippelii, recently cultured. Histological study is the standard method for diagnosis of WD, the characteristic feature is the presence of macrophages with intracellular inclusions, that react with the periodic acid-Schiff stain, in the lamina propria of the small intestine. We report a case of a 44 year-old female who displayed an intense diarrhea without systemic manifestations, making difficult the diagnosis, that was definitively achieved by the histopathological study of multiple endoscopic samples. A review of the recent epidemiologic and pathogenic theories is made (AU)

Infección cutánea esporotricoide por Mycobacterium chelonae en paciente inmunocompetente / Sporotrichoid cutaneous infection due to Mycrobacterium chelonae in a immunocompent patient

Una mujer de 58 años consultó por múltiples lesiones cutáneas en su pierna derecha en un patrón lineal ascendente (diseminación esporotricoide) hacia la rodilla. En el cultivo de la biopsia realizada se aisló Mycobacterium chelonae. No existía ninguna situación de inmunodepresión en la paciente. La anamnesis reveló la existencia de un traumatismo en esa pierna con una hamaca de playa 1 año antes (AU)