Biocompatibility analysis and chemical characterization of Mn-doped hydroxyapatite.

The present work studies the effect of Mn doping on the crystalline structure of the Hap synthesized by the hydrothermal method at 200 °C for 24 h, from Ca(OH)2 and (NH4)2HPO4, incorporating MnCl2 to 0.1, 0.5, 1.0, 1.5 and 2.0 %wt of Mn concentrations. Samples were characterized by the X-Ray Diffraction technique, which revealed the diffraction peaks that corresponded to the hexagonal and monoclinic phase of the Hap; it was observed that the average size of crystallite decreased from 23.67 to 22.69 nm as the concentration of Mn increased. TEM shows that in all samples, there are two distributions of particle sizes; one corresponds to nanorods with several tens of nanometers in length, and the other in which the diameter and length are very close. FTIR analysis revealed absorption bands corresponding to the PO4-3 and OH- groups characteristic of the Hap. It was possible to establish a substitution mechanism between the Mn and the ions of Ca+2 of the Hap. From the Alamar blue test, a cell viability of 86.88% ± 5 corresponding to the sample of Hap at 1.5 %wt Mn was obtained, considered non-cytotoxic according to ISO 10993-5. It also evaluated and demonstrated the good osteoinductive properties of the materials, which were verified by histology and immunofluorescence expression of osteogenic markers. Adhesion, viability, biocompatibility and osteoinductive properties, make these materials candidates for future applications in bone tissue engineering with likely uses in regenerative medicine.

3D scaffolds of caprolactone/chitosan/polyvinyl alcohol/hydroxyapatite stabilized by physical bonds seeded with swine dental pulp stem cell for bone tissue engineering.

Bone Regeneration represents a clinical need, related to bone defects such as congenital anomalies, trauma with bone loss, and/or some pathologies such as cysts or tumors This is why a polymeric biomaterial that mimics the osteogenic composition and structure represents a high potential to face this problem. The method of obtaining these materials was first to prepare a stabilized hydrogel by means of physical bonds and then to make use of the lyophilization technique to obtain the 3D porous scaffolds with temperature conditions of -58 °C and pressure of 1 Pa for 16 h. The physicochemical and bioactive properties of the scaffolds were studied. FTIR and TGA results confirm the presence of the initial components in the 3d matrix of the scaffold. The scaffolds exhibited a morphology with pore size and interconnectivity that promote good cell viability. Together, the cell viability and proliferation test, Alamar BlueTM and the differentiation test: alizarin staining, showed the ability of physically stabilized scaffolds to proliferate and differentiate swine dental pulp stem cell (DPSCs) followed by mineralization. Therefore, the Cs-PCL-PVA-HA scaffold stabilized by physical bonds has characteristics that suggest great utility for future complementary in vitro tests and in vivo studies on bone defects. Likewise, this biomaterial was enhanced with the addition of HA, providing a scaffold with osteoconductive properties necessary for good regeneration of bone tissue. Graphical abstract.

Multiwall carbon nanotubes/polycaprolactone scaffolds seeded with human dental pulp stem cells for bone tissue regeneration.

Conventional approaches to bone regeneration rarely use multiwall carbon nanotubes (MWCNTs) but instead use polymeric matrices filled with hydroxyapatite, calcium phosphates and bioactive glasses. In this study, we prepared composites of MWCNTs/polycaprolactone (PCL) for bone regeneration as follows: (a) MWCNTs randomly dispersed on PCL, (b) MWCNTs aligned with an electrical field to determine if the orientation favors the growing of human dental pulp stem cells (HDPSCs), and (c) MWCNTs modified with ß-glycerol phosphate (BGP) to analyze its osteogenic potential. Raman spectroscopy confirmed the presence of MWCNTs and BGP on PCL, whereas the increase in crystallinity by the addition of MWCNTs to PCL was confirmed by X-ray diffraction and differential scanning calorimetry. A higher elastic modulus (608 ± 4.3 MPa), maximum stress (42 ± 6.1 MPa) and electrical conductivity (1.67 × 10(-7) S/m) were observed in non-aligned MWCNTs compared with the pristine PCL. Cell viability at 14 days was similar in all samples according to the live/dead assay, but the 21 day cell proliferation, measured by MTT was higher in MWCNTs aligned with BGP. Von Kossa and Alizarin red showed larger amounts of mineral deposits on MWCNTs aligned with BGP, indicating that at 21 days, this scaffold promotes osteogenic differentiation of HDPSCs.

Enfermedad de Rosai-Dorfman mamario / Mammary Rosai Dorfman disease

Background: Rosai Dorfman disease is uncommon and consists in a benign fibrous and hematopoietic tissue proliferation, usually located in the head or neck. It is self-limited and the treatment is the surgical excision of the lesion. Case Report: We report a 69 years old woman consulting for a palpable right breast nodule with a mammography and mammary ultrasound informed as BIRADS 4 and 5, respectively. A core biopsy was informed as a mammary Rosai Dorfman disease. Two years later, due to a lesion growth, the patient was subjected to a partial mastectomy. The pathological study of the surgical piece confirmed the diagnosis of the core biopsy. This disease may resemble a malignant disease and the clue for its diagnosis is the pathological study.

Introducción: La enfermedad de Rosai Dorfman es una entidad infrecuente, que consiste en la proliferación benigna del tejido fibroso y hematopoyético ubicado generalmente en cabeza y cuello. Se trata de una enfermedad benigna, autolimitada, cuyo tratamiento generalmente se limita a la resección quirúrgica, con elevada tasa de recidiva. Objetivo: Exposición de un caso de Enfermedad de Rosai Dorfman mamario, inicial-mente sugerente de patología maligna. caso clínico: Mujer 69 años derivada de atención primaria por nódulo palpable en mama derecha, mamografía y ecografía mamaria BIRADS 4 y 5, respectivamente. Biopsia Core informa Enfermedad de Rosai Dorfman mamaria. A los dos años de diagnóstico se objetiva lesión de mayor tamaño. Se realizó mastectomía parcial con biopsia de pieza quirúrgica compatible con diagnóstico de Biopsia Core previa. Discusión: La similitud clínica de esta enfermedad con patologías malignas mamarias, asociado a su baja prevalencia, dificultan la pesquisa de casos como el expuesto. En los estudios de imágenes raramente se sospecha. La clave del diagnóstico son los hallazgos histológicos en el que característicamente se observa emperipolesis con tinciones inmunohistoquímicas positivas para S 100 y negativo para CD 1. Dado que es una enfermedad benigna y autolimitada su tratamiento generalmente se limita a la resección quirúrgica. Este permite extirpar el tumor en estudio, realizar el diagnóstico, y aliviar la sintomatología producida por el efecto masa de la lesión. A pesar de lo anterior la recidiva es alta, por lo que el seguimiento debe ser a largo plazo.

Hamartoma e hiperplasia estromal pseudoangiomatosa de la mama, diagnósticos diferenciales infrecuentes de cáncer de mama / Hamartoma and nodular pseudoangiomatous stromal hyperplasia: differential diagnosis

Introducción: Los hamartomas y la hiperplasia estromal pseudoangiomatosa nodular (PASH) son entidades infrecuentes en la patología tumoral mamaria, sin embargo, pueden simular al cáncer de mama. La única herramienta certera preoperatoria es la biopsia. El tratamiento quirúrgico es curativo con bajo índice de recurrencia. Objetivo: El objetivo de este trabajo es exponer un caso de hamartoma mamario con PASH asociado cuya presentación inicial fue sugerente de probable patología maligna. Caso Clínico: Mujer de 44 años, ingresa a controles por probable patología mamaria maligna, la mamografía fue informada como BIRADS 0, la ecografía mamaria como BIRADS US: 5, la biopsia CORE informó PASH. Se realizó mastectomía parcial objetivando en la biopsia diferida un hamartoma mamario con extensa hiperplasia estromal pseudoangiomatosa. Discusión: Los hamartomas y la PASH son patologías sin presentación clínica específica, los hallazgos radiológicos del hamartoma pueden ser patognomónicos, no así en la PASH; en el caso expuesto el estudio anatomopatológico demostró una asociación de estas patologías, la cual se describe desde un 16 por ciento a un 71 por ciento de los casos de hamartoma mamario. El análisis de toda la pieza quirúrgica es fundamental para establecer un diagnóstico definitivo.

Introduction: Hamartoma and nodular pseudoangiomatous stromal hyperplasia (PASH) are inusual breast tumor entities, however, can simulate breast cancer. The only accurate tool is preoperative biopsy. Surgical treatment is curative with low recurrence rate. Objective: To present a case of mammary hamartoma associated with PASH whose initial presentation was suggestive of probable malignancy. Case Report: Woman, 44 years old, admitted to controls because of probable malignant breast disease, mammography was reported as BIRADS 0, breast ultrasound as BIRADS U.S: 5, CORE biopsy reported PASH. Partial mastectomy was performed. On delayed biopsy mammary hamartoma with extensive stromal hyperplasia pseudoangiomatosa was diagnosed. Discussion: PASH and hamartomas are diseases with no specific clinical presentation, radiological findings may be pathognomonic of hamartoma, while not in PASH. In the reported case the pathological study showed an association of these conditions, described in a 16% to 71% breast hamartoma cases. The analysis of the entire surgical specimen is essential for a definitive diagnosis.

Reconstrucción mamaria con colgajo TRAM pediculado / Breast reconstruction with pedicled TRAM flap

The pedicle transverse rectus abdominus myocutaneous flap (TRAM) is widely used for breast reconstruction, however is not exempt from complications. Between 2004 and 2010 the authors performed breast reconstruction after total mastectomy in 52 patients with pedicled TRAM flaps. Purpose: To describe the demography, outcomes and complications in patients operated for breast cancer and reconstructed with TRAM flap. To assess the influence of smoking, the laterality and timing of reconstruction. Material and Method: Retrospective, observational and comparative. We reviewed the medical records of 52 patients operated by the authors between 2004 and 2010. Four cases were excluded due to incomplete data. Results: In the 48 patients studied were 50 TRAM flaps. The most frequent comorbidity was smoking (27 percent). Regarding the timing of reconstruction, 74 percent (37) was performed immediately post-mastectomy and 26 percent (13) was deferred. Was used by 78 percent (39) ipsilateral TRAM, 18 percent (9) contralateral and 4 percent (2) bilateral. Only minor complications were observed and the cosmetic result evaluated by the surgeon's satisfaction was very good or excellent in 62 percent (31). Smoking, timing of reconstruction and laterality did not affect in complications or cosmetic outcome (p > 0.05). Conclusions: The pedicled TRAM flap is an excellent alternative for reconstruction in breast cancer patients. It is not exempt from complications, with a tendency to get better cosmetic results in the non-smoker group.

El colgajo de recto abdominal con isla transversal de piel infraumbilical (TRAM) pediculado es ampliamente utilizado para la reconstrucción mamaria, sin embargo, no está exento de complicaciones. Entre los años 2004 y 2010 los autores realizaron reconstrucción mamaria post-mastectomía total en 52 pacientes con colgajos TRAM pediculados. Objetivo: Describir la demografía, resultados y complicaciones de las pacientes operadas por cáncer de mama y reconstruidas con colgajo TRAM. Evaluar la influencia del tabaquismo, la lateralidad y el momento de la reconstrucción en dichos resultados. Material y Método: Diseño retrospectivo, observacional y comparativo. Se revisaron las historias clínicas de las 52 pacientes operadas por los autores entre los años 2004-2010. Se excluyeron 4 casos por datos incompletos. Resultados: En las 48 pacientes estudiadas se realizaron 50 colgajos TRAM. La comorbilidad más frecuente fue el tabaquismo (27 por ciento). La reconstrucción se realizó en un 74 por ciento (37) de manera inmediata postmastectomía y en un 26 por ciento (13) fue diferido. Se utilizó en un 78 por ciento (39) TRAM ipsilateral, 18 por ciento (9) contralateral y 4 por ciento (2) bilateral. Sólo se observaron complicaciones menores; el resultado estético evaluado por la satisfacción del cirujano fue muy bueno o excelente en un 62 por ciento (31). El tabaquismo, momento de la reconstrucción y la lateralidad no influyeron en las complicaciones ni en el resultado estético (p > 0,05). Conclusiones: El colgajo TRAM pediculado es una excelente alternativa de reconstrucción en pacientes mastectomizadas. No está exento de complicaciones, con una tendencia a obtener mejores resultados estéticos en el grupo no fumador.

Comparación de los efectos de la radioterapia sobre los resultados estéticos y complicaciones en reconstrucciones mamarias inmediatas versus diferidas con TRAM pediculado / Comparison of the effects of radiotherapy on the aesthetic results and complications in immediate versus delayed breast reconstruction with pedicled TRAM

Negative effect of post-mastectomy radiotherapy in transverse rectus abdominus myocutaneous (TRAM) flap breast reconstruction remains unclear. The immediate post-mastectomy TRAM has shown better cosmetic results than delayed reconstruction, making it necessary to define the effects of radiation on this type of reconstruction. The aim of this study is to compare the effect of radiotherapy on immediate and delayed reconstruction with TRAM, analyzing aesthetic results and complications. We reviewed medical records of 23 patients undergoing mastectomy with TRAM reconstruction and radiation therapy between 2004-2009, distributed in those undergoing immediate reconstruction (n=12) and delayed post-radiotherapy (n=11). Cosmetic results and complications were compared between the groups. There were no differences in age, prevalence of comorbidities or clinical stage. Regarding the aesthetic result of immediate TRAM, 50 percent were classified as excellent, 20 percent very well, 20 percent good and 10 percent regular, while in delayed reconstructions, 64 percent was excellent, 18 percent very good and 18 percent good, no differences between both groups (p=0.51). There were no differences in local complications. Although the study population is insufficient to draw conclusions comparable, our results are comparable to those of other studies showing no deleterious effect of radiotherapy on immediate TRAM reconstructions. Additional studies are needed to recommend the treatment of choice.

Tumor filoides de la mama / Phyllodes tumor of the breast

Introduction: The phyllodes tumor (PT) of the breast is a rare disease of unknown origin. Despite its classification into benign, borderline and malignant, their behavior tends to be uncertain. Because of this, treatment remains controversial. Objective: To describe the management of the FT in breast pathology unit of our hospital and their outcomes. Material and Methods: We retrospectively reviewed the files of the patients with PT, operated in our hospital between 2001 and 2008. We analyzed the clinical characteristics, diagnostic studies, treatment and outcomes. Results: During this period 12 patients were operated. The ave-rage age was 42 +/- 15.2 years (16-64) and usually the form of presentation was painless palpable nodule. Both mammography and ultrasound were unable to suggest the diagnosis. Eight patients had core biopsy, which revealed the diagnosis of PT in 5, while in the other 3 was fibroadenoma. All patients underwent a partial mastectomy. The biopsy showed six benign, two borderline and two malignant PT. The latter two patients received adjuvant radiotherapy. At the end of this study, 2 patients had relapsed at 12 and 30 months (borderline and benign, respectively). There were no cases of lymphatic or distant metastases. Conclusions: The PT has a low frequency of presentation and preoperative diagnosis is difficult, so we recommend a core biopsy, but it can confuse with fibroadenoma. The management with partial mastectomy and negative borders had a recurrence rate of 18 percent in this series.

Introducción: El tumor filoides (TF) de la mama es una patología poco frecuente y origen desconocido. A pesar de su clasificación en benignos, borderline y malignos, su comportamiento tiende a ser incierto. Debido a esto su tratamiento sigue siendo controversial. Objetivo: Describir el manejo del TF en la unidad de patología mamaria del Hospital San José y sus resultados. Material y Método: Se revisaron las fichas de las pacientes con diagnóstico de TF, operadas en nuestro hospital entre los años 2001 y 2009. Se analizaron las características clínicas, estudios diagnósticos, tratamiento y resultados. Resultados: Durante este período se operaron 12 pacientes. El promedio de edad fue 42 +/- 15,2 años (16-64) y habitualmente la forma de presentación fue nodulo palpable indoloro. Tanto la mamografía como la ecografía fueron incapaces de sugerir el diagnóstico. Ocho pacientes tenían biopsia core, la cual evidenció el diagnóstico de TF en 5, mientras que en las otras 3 resultó fibroadenoma. Todas las pacientes fueron sometidas a mastectomía parcial. En seis pacientes resultó ser TF benigno, en dos borderline y en dos maligno. Estas últimas dos pacientes recibieron radioterapia adyuvante. Al término de este estudio 2 pacientes habían recidivado a los 12 y 30 meses (borderline y benigno respectivamente). No hubo casos de metástasis linfáticas ni a distancia. Conclusiones: El TF tiene una baja frecuencia de presentación, su diagnóstico preoperatorio es difícil recomendándose la biopsia core, sin embargo, suele confundirse con el fibroadenoma. El manejo con mastectomía parcial y bordes negativos tuvo una recidiva del 18 por ciento en esta serie.

Elastic structures in the vocalization apparatus of the Túngara frog Physalaemus pustulosus (Leptodactylidae).

Histological analysis of the vocal sac and body wall in the leptodactylid frog Physalaemus pustulosus suggests that both muscle and elastic fibers are important in call production. Abdominal musculature as well as abdominal bands of elastin (the lineae masculinae) provide the energy required for exhalation and sound production. Air flowing through the larynx inflates a highly extensible vocal sac lined with muscle and a network of elastic fibers. Inherent elasticity together with muscular activity of the vocal sac likely increase the speed and possibly decrease the energetic costs of lung reinflation following vocalization. The mechanics of call production in P. pustulosus thus involve not only laryngeal activation but also elastic transfer of air between the supralaryngeal vocal sac and abdominal respiratory structures.

[Extrahepatic portal hypertension. Azygos-portal disconnection]. / Hipertensión portal extrahepática. Desconexión ácigos-portal.

The partial or complete obstruction of portal vein and or one of its branches is the most frequent cause of portal hypertension in children. A patient with extrahepatic portal hypertension and progressive course is presented, with great development of esophagogastric varices and multiple episodes of upper gastrointestinal hemorrhage. At the age of 9 years he was submitted to an azygos-portal disconnection by abdominal route, with manual transection of the esophagus, covered and protected by a gastric fundoplication. Postoperative endoscopic control demonstrated significant reduction in the size of esophageal varices and disappearance of gastric varices. Eleven months after surgery the patient was asymptomatic and a new endoscopic control showed no recurrence of varices.

Non-genomic mechanism of action of delta-4 and 5-reduced androgens and progestins on the contractility of the isolated rat myometrium.

Effective concentrations50 of androgens, i.e. testosterone, androsterone, androstanediol, 5 beta-dihydrotestosterone and progestins: progesterone, pregnanolone, pregnanedione, epipregnanolone, allopregnanolone and allopregnanedione were assayed on the tonic contractions of the isolated rat myometrium induced by calcium in high-potassium calcium-free depolarizant solutions. Steroids showed their relaxant effect by fadding the sustained contraction induced by calcium in a depolarized state. Also, the addition of the calcium ionophores A-23187 and X-537A reversed the steroid relaxant effect by increasing sharply the tonic contraction. The possibility of steroid-induced relaxation through release of noradrenaline or histamine was discarded by blocking their specific receptors. From the results it is concluded that delta-4 and 5-reduced androgens and progestins produce relaxation by a myogenic mechanism acting on the smooth muscle cell, most likely by directly blocking the calcium channels they causing modulation of: the contraction-relaxation cycle.

Insuficiencia respiratoria aguda en la unidad de cuidados intensivos. Estudio de 76 casos, año 1983 / Acute respiratory insufficiency in a intensive care hospital. Study of 76 cases in 1983

Durante el año 1983, ingresaron en la Unidad de Cuidados Intensivos del Hospital Pediátrico Provincial Docente "Jose Luis Miranda" de Villa Clara, un total de 531 pacientes. 76 de estos casos, presentaron criterios clínicos, hemogasométricos, o uno de ellos, por lo que se les diagnosticó Insuficiencia Respiratoria Aguda. Nuestro estudio se basó en la revisión de las Historias Clínicas de los 76 pacientes ingresados en este síndrome. Se realizó para este fin una encuesta donde se contemplaron: edad, enfermedad de base, manifestaciones clínicas, así como los estudios hemogasométrico y radiológico, que fueron de utilidad en el diagnóstico del cuadro. Se relacionó el estado final del paciente con la duración del tratamiento y las complicaciones que presentaron durante su evolución. Se hacen conclusiones acerca de la edad, las manifestaciones de este síndrome, así como en relación con los complementarios y tratamiento

Lactancia materna. Estudio en el primer trimestre de vida / Maternal lactancy study within the first trimester of life

Se estudiaron 245 niños, que constituyen la totalidad de nacimientos ocurridos desde agosto de 1983 a febrero de 1984, pertenecientes al Policlínico Comunitario Docente "Marta Abreu" de la Ciudad de Santa Clara. Se confeccionó una encuesta para realizársela a la madre de cada niño objeto de estudio con el fin de observar la evolución mensual durante los tres primeros meses de vida, evaluando algunos aspectos en relación con la lactancia materna, así como datos de morbilidad y evaluación nutricional. El porciento de niños ingresados así como de niños que se enfermaron, resultó inferior en el grupo de mayor duración de la lactancia. Esto se hizó más evidente al relacionar la morbilidad por enfermedad diarreica aguda. Solo un 17.5 porciento de los niños recibieron lactancia materna hasta el tercer mes de vida. Se señala como la causa principal del destete, referido por la madre "no tener suficiente leche"

Relaxant action of androgens, progestins and corticosteroids on the isolated ileum of the guinea pig.

The action of three different kinds of progesterone related compounds was tested on the spontaneous contractility of the isolated guinea pig ileum. The results showed that this tissue was very sensitive to the action of androgens, progestins and corticosteroids. Relaxation was observed as dose-dependent; however, effective doses 50 were different, being related to the chemical structure of the compound. 5 beta-progestins were the most potent steroids followed by 5-reduced androgens (5 alpha or 5 beta). 4-en compounds such as testosterone, progesterone, 17 alpha-OH-progesterone, and corticosteroids were the lower in potency. 5 alpha-pregnanedione and pregnanediols were practically ineffective. The high sensitiveness of the ileum smooth muscle makes this organ a target for steroids. Thus, steroidal influence on the intestine might be related with contractility changes in some physiological circumstances, e.g., pregnancy.

Relaxant action of androgens, progestins and corticosteroids on the isolated ileum of the guinea pig.

The action of three different kinds of progesterone related compounds was tested on the spontaneous contractility of the isolated guinea pig ileum. The results showed that this tissue was very sensitive to the action of androgens, progestins and corticosteroids. Relaxation was observed as dose-dependent; however, effective doses 50 were different, being related to the chemical structure of the compound. 5 beta-progestins were the most potent steroids followed by 5-reduced androgens (5 alpha or 5 beta). 4-en compounds such as testosterone, progesterone, 17 alpha-OH-progesterone, and corticosteroids were the lower in potency. 5 alpha-pregnanedione and pregnanediols were practically ineffective. The high sensitiveness of the ileum smooth muscle makes this organ a target for steroids. Thus, steroidal influence on the intestine might be related with contractility changes in some physiological circumstances, e.g., pregnancy.

Obstruccion intestinal en ninos. / Intestinal obstruction in children

La principal causa de O.I en ninos, es la secundaria de bridas postoperatorias. Las principales patologias quirurgicas que dan lugar a la formacion de bridas fueron: la peritonitis apendicular y la apendicitis aguda. Un 11% hace una segunda obstruccion intestinal y generalmente por bridas postoperatorias. La mortalidad global por esta patologia es del 10%. En recien nacidos fue muy alta, 37% y nula en los escolares.La formacion de bridas se produce caso en un 80% antes del ano de la operacion original y en un 18% antes de los 10 dias (precoces). Un alto porcentaje (24%) necesito reseccion intestinal. La causa de O.I varia segun la edad del nino: ejmalformaciones en recien nacidos, invaginacion en lactantes, obstruccion intestinal por bridas en ninos mayores. Se recomienda el abordaje por via transversa por ser mejor para la exploracion abdominal en ninos