Surgical approach with minimally invasive intervention in lusoria dysphagia.

The lusoria artery has a prevalence of 0.5-2% in the general population. The abnormal development of the aortic arch forms vascular rings around the trachea and esophagus, causing pressure on them and leading to characteristic symptoms such as chest pain, difficulty breathing, and/or swallowing. Conventionally, only the subclavian artery was severed to release the esophagus, as done in neonates. However, this can lead to long-term hypotrophy of the thoracic limb. The surgical intervention remains controversial, with limitations, and it is only to be performed when the patient presents with symptoms. In the following two cases, a two-stage minimally invasive approach is described: first, a left lateral minithoracotomy for lusoria artery sectioning, and second, a supraclavicular approach for reimplantation into the right carotid artery.

La arteria lusoria tiene una prevalencia del 0.5% al 2% en la población general. Se trata de un arco aórtico izquierdo con arteria subclavia derecha aberrante, resulta de la regresión del cuarto arco derecho y la aorta dorsal derecha proximal. La anormalidad del desarrollo del arco aórtico forma anillos vasculares alrededor de la tráquea y el esófago ocasionando una presión hacia ellos y dar clínica característica de dolor torácico, dificultad para la respiración y/o deglución. Tradicionalmente solo seccionábamos la subclavia para liberar el esófago como se realiza en la edad neonatal, sin embargo, esto puede condicionar hipotrofia del miembro torácico a largo plazo. La intervención quirúrgica sigue siendo controvertida, con limitaciones y se decide realizarse cuando el paciente presenta sintomatología. En este reporte de dos casos se describe un abordaje por incisiones mínimamente invasiva en dos tiempos: primero por mini toracotomía lateral izquierda para sección de la arteria lusoria; segundo abordaje supraclavicular para reimplantación en la carótida derecha.

[Regulación de la expresión de IL-33 e IL-17 por la modulación farmacológica de HIF-1 en un modelo murino de inflamación alérgica pulmonar].

Objective: To evaluate the effect of pharmacological modulation of HIF-1 on the expression of IL-33 and IL-17 in a murine model of allergic pulmonary inflam- mation (API) with different degrees of severity. Methods: 5 mice/group received ovalbumin (OVA) 1(mild), 2(moderate) or 3(severe) challenges via i.t. prior to allergen sensitization, in addition to the HIF-1 induction or inhibition groups, received EDHB (OVA+EDHB) i.p. or 2ME (OVA+2ME) i.t. respectively. Control groups received saline solution (SS) in the same way. HE (inflammatory infiltrate), PAS (mucus production) and immunohistochemical staining for HIF-1a, IL-33, IL-17 were performed, quantitatively analyzing by digital pathology. Results: We obtained different degrees of severity with a greater number of challenges, increasing the expression of HIF-1, correlating with the expression of IL-33/IL-17. Increasing or decreasing, respectively by pharmacological modulation. Conclusions: The above suggests that the high expression of HIF-1 favors the production of IL-33 and IL-17 contributing to the damage in lung tissue and the severity of the disease and these can be regulated through the modulation of HIF- 1.

Objetivo: Evaluar el efecto de la modulación farmacológica de HIF-1 en la expresión de IL-33 e IL-17 en un modelo murino de inflamación alérgica pulmonar (IAP) con diferentes grados de severidad. Métodos: 5 ratones/grupo recibieron ovoalbúmina (OVA) 1(leve), 2(moderada) o 3(severa) retos vía i.t. previa sensibilización como alergeno, además los grupos de inducción o inhibición de HIF-1a, recibieron EDHB (OVA+EDHB) i.p. o 2ME (OVA+2ME) i.t. respectivamente. Los grupos controles recibieron solución salina (SS) de igual forma. Se realizaron tinciones de HE (infiltrado inflamatorio), PAS (producción de moco) e inmunohistoquímicas de HIF-1a, IL-33, IL-17, analizando cuantitativamente por patología digital. Resultados: Obtuvimos diferentes grados de severidad a mayor número de retos, incrementando la expresión de HIF-1, correlacionando con la expresión de IL- 33/IL-17. Aumentando o disminuyendo, respectivamente por la modulación farmacológica. Conclusiones: Lo anterior sugiere que la alta expresión de HIF-1 favorece la producción de IL-33 e IL-17 contribuyendo al daño en el tejido pulmonar y la severi- dad de la enfermedad y estas pueden ser reguladas a través de la modulación de HIF-1.

Baculovirus Display of Peptides and Proteins for Medical Applications.

Baculoviridae is a large family of arthropod-infective viruses. Recombinant baculoviruses have many applications, the best known is as a system for large scale protein production in combination with insect cell cultures. More recently recombinant baculoviruses have been utilized for the display of proteins of interest with applications in medicine. In the present review we analyze the different strategies for the display of proteins and peptides on the surface of recombinant baculoviruses and provide some examples of the different proteins displayed. We analyze briefly the commercially available systems for recombinant baculovirus production and display and discuss the future of this emerging and powerful technology.

Giant chondroid syringoma on the upper lip: a case report.

Chondroid syringoma is a benign, rare, asymptomatic, slow-growing mixed tumor. Tumors larger than 3cm are considered giant and may be malignant. We present a 65-year-old man with a chronic, indolent, subcutaneous tumor with upper lip deformity. An excisional biopsy was performed under local anesthesia. Based on histopathological analysis, the resected lesion was identified as a chondroid syringoma of the apocrine type. There was no recurrence during the one-year follow-up after surgery. The occurrence of a large chondroid syringoma in the upper lip is rare.

Pentacyclic triterpenes and other constituents in propolis extract from Melipona beecheii collected in Yucatan, México

ABSTRACT Thirteen pentacyclic triterpenes, methyl 3-oxours-12-en-23-oate, marsformosanone, taraxerone, β-amyrenone, α-amyrenone, lupenone, 24-methylencycloartan-3-one, moretenol acetate, β-amyrin acetate, germanicol acetate, 24-methylencycloartanyl acetate, β-amyrin, and α-amyrin were identified in a chloroform-methanol propolis extract from Melipona beecheii. Additionally, were identified in this propolis, hexadecanoic acid, methyl ester, octadecanoic acid, methyl ester and 1-triacontanol. The purification of the propolis extract was carried out using different chromatographic techniques, including vacuum liquid chromatography, gravity column chromatography and gel filtration chromatography Sephadex LH-20. The identification of the metabolites was performed using mass spectrometry.

Characterization of the Small RNA Transcriptome of the Marine Coccolithophorid, Emiliania huxleyi.

Small RNAs (smRNAs) control a variety of cellular processes by silencing target genes at the transcriptional or post-transcription level. While extensively studied in plants, relatively little is known about smRNAs and their targets in marine phytoplankton, such as Emiliania huxleyi (E. huxleyi). Deep sequencing was performed of smRNAs extracted at different time points as E. huxleyi cells transition from logarithmic to stationary phase growth in batch culture. Computational analyses predicted 18 E. huxleyi specific miRNAs. The 18 miRNA candidates and their precursors vary in length (18-24 nt and 71-252 nt, respectively), genome copy number (3-1,459), and the number of genes targeted (2-107). Stem-loop real time reverse transcriptase (RT) PCR was used to validate miRNA expression which varied by nearly three orders of magnitude when growth slows and cells enter stationary phase. Stem-loop RT PCR was also used to examine the expression profiles of miRNA in calcifying and non-calcifying cultures, and a small subset was found to be differentially expressed when nutrients become limiting and calcification is enhanced. In addition to miRNAs, endogenous small RNAs such as ra-siRNAs, ta-siRNAs, nat-siRNAs, and piwiRNAs were predicted along with the machinery for the biogenesis and processing of si-RNAs. This study is the first genome-wide investigation smRNAs pathways in E. huxleyi. Results provide new insights into the importance of smRNAs in regulating aspects of physiological growth and adaptation in marine phytoplankton and further challenge the notion that smRNAs evolved with multicellularity, expanding our perspective of these ancient regulatory pathways.

Performance of the SAPS 3 admission score as a predictor of ICU mortality in a Philippine private tertiary medical center intensive care unit.

BACKGROUND: This study aimed to assess the performance of the Simplified Acute Physiology Score 3 (SAPS 3) as a predictor of ICU mortality in critically ill patients of different case mixes admitted to an intensive care unit. METHODS: This retrospective cohort study was performed from January 2011 to August 2013 in the intensive care unit of a private tertiary referral center in the Philippines. Predicted ICU mortality was calculated using the SAPS 3 global model. Observed versus predicted mortality rates were compared, and the standardized mortality ratio (SMR) was calculated. The discrimination and calibration characteristics of the SAPS 3 system to predict ICU mortality were assessed. RESULTS: A total of 2,426 patients were included. The observed ICU mortality was 277 (11.42%). The SAPS 3 global model had fair to good discrimination with an area under the receiver operating characteristic curve of 0.80 (CI 0.78-0.81). Good calibration was seen with the Hosmer-Lemeshow goodness of fit at C = 11.51 (p = 0.175). Standardized mortality ratio was 0.36 (0.26-0.81). CONCLUSION: The global SAPS 3 prediction model showed fair to good discrimination and good calibration in predicting mortality in our intensive care unit. Different levels of discrimination and calibration across the different subgroups analyzed suggest that overall ICU performance seemed to be affected by case mix variations.

The nucleosomal barrier to promoter escape by RNA polymerase II is overcome by the chromatin remodeler Chd1.

RNA polymerase II (PolII) transcribes RNA within a chromatin context, with nucleosomes acting as barriers to transcription. Despite these barriers, transcription through chromatin in vivo is highly efficient, suggesting the existence of factors that overcome this obstacle. To increase the resolution obtained by standard chromatin immunoprecipitation, we developed a novel strategy using micrococcal nuclease digestion of cross-linked chromatin. We find that the chromatin remodeler Chd1 is recruited to promoter proximal nucleosomes of genes undergoing active transcription, where Chd1 is responsible for the vast majority of PolII-directed nucleosome turnover. The expression of a dominant negative form of Chd1 results in increased stalling of PolII past the entry site of the promoter proximal nucleosomes. We find that Chd1 evicts nucleosomes downstream of the promoter in order to overcome the nucleosomal barrier and enable PolII promoter escape, thus providing mechanistic insight into the role of Chd1 in transcription and pluripotency. DOI: http://dx.doi.org/10.7554/eLife.02042.001.

[Micosis among five highly underprivileged Mexican communities]. / Micosis observadas en cinco comunidades mexicanas con alto grado de marginación.

BACKGROUND: In many small rural communities in Mexico, medical care is deficient, empirical or absent. OBJECTIVE: In order to improve health coverage in rural areas, the Mexican Institute of Social Security organizes Medical and Surgical Meetings of various specialties including Dermatology and Mycology (MSDM). These include visits to rural hospitals by dermatologists and a mycologist to care for underprivileged communities. In addition to taking samples, they establish the clinical diagnosis and indicate medical and/or surgical treatment, with follow-up visits when needed. MATERIAL AND METHODS: In 2004 and 2005, five MSDM in Chiapas (two), Puebla (one), Michoacán (one) and Oaxaca (one) were organized. Mycoses were within the first four skin pathologies detected. RESULTS: Direct examination with potassium hydroxide led to the diagnosis of mycosis and other skin diseases such as scabies, pediculosis or hair disorders. The sample cultures showed, in addition to common fungi as dermatophytes (Trichophyton rubrum, 19 cases), other uncommon fungal agents such as Trichosporon spp, Chrysosporium spp, Cryptococcus, Geotrichum spp and Aspergillus spp. Most of the candidiasis cases were caused by Candida parapsilosis (nine cases) followed by C. albicans (three cases).

Micosis observadas en cinco comunidades mexicanas con alto grado de marginación / Micosis among five highly underprivileged Mexican communities

Antecedentes. En las pequeñas comunidades rurales de México la atención médica es deficiente, empírica o inexistente. Objetivo. Para mejorar la cobertura de salud en esas zonas, el Instituto Mexicano del Seguro Social (IMSS) organiza Encuentros Médico- Quirúrgicos de varias especialidades, entre ellos, los encuentros Médico- Quirúrgicos en Dermatología (EM-QD). Estos consisten en visitas de trabajo a hospitales rurales por parte de un grupo de especialistas en dermatología y micología durante los cuales se atiende a personas de comunidades marginadas. Además del diagnóstico clínico y toma de muestras se proporciona el tratamiento médico o quirúrgico. Posteriormente se hacen visitas de seguimiento a los pacientes que lo necesiten. Material y métodos. Durante 2004 y 2005 se realizaron cinco EM-QD: Chiapas (dos), Puebla, Michoacán y Oaxaca. Las micosis estuvieron entre las primeras cuatro causas de dermatosis. Resultados. El examen directo con hidróxido de potasio permitió diagnosticar micosis y otras patologías como escabiosis, pediculosis o alteraciones de pelo. El cultivo de las muestras demostró, además de los hongos habituales como los dermatofitos (Trichophyton rubrum 19 aislamientos), otros hongos poco habituales como causa de micosis cutáneas, entre ellos: Trichosporon spp., Chrysosporium spp., Cryptococcus spp., Geotrichum spp., y Aspergillus spp. Las candidosis en su mayoría fueron causadas por C. parapsilosis (9 casos) seguida en frecuencia por C. albicans (3 pacientes).

BACKGROUND: In many small rural communities in Mexico, medical care is deficient, empirical or absent. OBJECTIVE: In order to improve health coverage in rural areas, the Mexican Institute of Social Security organizes Medical and Surgical Meetings of various specialties including Dermatology and Mycology (MSDM). These include visits to rural hospitals by dermatologists and a mycologist to care for underprivileged communities. In addition to taking samples, they establish the clinical diagnosis and indicate medical and/or surgical treatment, with follow-up visits when needed. MATERIAL AND METHODS: In 2004 and 2005, five MSDM in Chiapas (two), Puebla (one), Michoacán (one) and Oaxaca (one) were organized. Mycoses were within the first four skin pathologies detected. RESULTS: Direct examination with potassium hydroxide led to the diagnosis of mycosis and other skin diseases such as scabies, pediculosis or hair disorders. The sample cultures showed, in addition to common fungi as dermatophytes (Trichophyton rubrum, 19 cases), other uncommon fungal agents such as Trichosporon spp, Chrysosporium spp, Cryptococcus, Geotrichum spp and Aspergillus spp. Most of the candidiasis cases were caused by Candida parapsilosis (nine cases) followed by C. albicans (three cases).