Activity-Based Nitric Oxide-Responsive Porphyrin for Site-Selective and Nascent Cancer Ablation.

Nitric oxide (NO) generated within the tumor microenvironment is an established driver of cancer progression and metastasis. Recent efforts have focused on leveraging this feature to target cancer through the development of diagnostic imaging agents and activatable chemotherapeutics. In this context, porphyrins represent an extraordinarily promising class of molecules, owing to their demonstrated use within both modalities. However, the remodeling of a standard porphyrin to afford a responsive chemical that can distinguish elevated NO from physiological levels has remained a significant research challenge. In this study, we employed a photoinduced electron transfer strategy to develop a panel of NO-activatable porphyrin photosensitizers (NOxPorfins) augmented with real-time fluorescence monitoring capabilities. The lead compound, NOxPorfin-1, features an o-phenylenediamine trigger that can effectively capture NO (via N2O3) to yield a triazole product that exhibits a 7.5-fold enhancement and a 70-fold turn-on response in the singlet oxygen quantum yield and fluorescence signal, respectively. Beyond demonstrating excellent in vitro responsiveness and selectivity toward NO, we showcase the potent photodynamic therapy (PDT) effect of NOxPorfin-1 in murine breast cancer and human non-small cellular lung cancer cells. Further, to highlight the in vivo efficacy, two key studies were executed. First, we utilized NOxPorfin-1 to ablate murine breast tumors in a site-selective manner without causing substantial collateral damage to healthy tissue. Second, we established a nascent human lung cancer model to demonstrate the unprecedented ability of NOxPorfin-1 to halt tumor growth and progression completely. The results of the latter study have tremendous implications for applying PDT to target metastatic lesions.

Factores dependientes del paciente adulto y su relación con la hemorragia y el dolor postamigdalectomía en régimen ambulatorio / Dependent factors in the adult patient and their relationship with post-tonsillectomy bleeding and pain in an outpatient setting

Introducción y objetivo: La amigdalectomía realizada de forma ambulatoria en pacientes adultos presenta como principales complicaciones postoperatorias la hemorragia y el dolor.El seguimiento de directrices como la técnica quirúrgica fría, protocolos analgésicos, entrevista preoperatoria y seguimiento postoperatorio ayudan a un mejor control del proceso. No obstante, existen factores dependientes del paciente como el sexo, la edad, la indicación de la amigdalectomía y el tiempo transcurrido entre la última infección amigdalar y la intervención quirúrgica que pueden influir en las complicaciones postoperatorias y deben ser considerados.El objetivo de este trabajo es evaluar la influencia de la edad, el sexo, la indicación de la amigdalectomía y el periodo transcurrido entre la última infección amigdalar y la intervención quirúrgica sobre la hemorragia y el control del dolor.MétodosPara ello se realizó un estudio prospectivo, descriptivo, observacional, con 96 pacientes adultos que fueron intervenidos en régimen ambulatorio bajo anestesia general, empleando técnica quirúrgica fría, evaluando estas complicaciones en función de la edad, sexo, indicación para la amigdalectomía y el tiempo transcurrido tras la última amigdalitis.ResultadosLos pacientes intervenidos a lo largo de las cuatro semanas posteriores a un episodio de amigdalitis presentaron más dolor postoperatorio. No se encontró relación entre este periodo de tiempo y la hemorragia postoperatoria. (AU)

Introduction and objective: Tonsillectomy performed on an outpatient basis in adult patients presents bleeding and pain as main postoperative complications.Following rules such as cold surgical technique, analgesic protocols, preoperative interview, and postoperative follow-up help to better control the process. However, there are patient-dependent factors such as sex, age, indication for tonsillectomy and the time elapsed between the last tonsil infection and surgical intervention that can influence postoperative complications and should be considered.The objective of this work is to evaluate the influence of age, sex, the indication for tonsillectomy and the period elapsed between the last tonsil infection and surgery on bleeding and pain control.MethodsA prospective, descriptive, and observational study was carried out in 96 adult patients who underwent outpatient surgery under general anaesthesia, using cold surgical technique, evaluating these complications based on age, sex, indication for tonsillectomy and time elapsed after the last tonsillitis.ResultsThe patients operated on during the 4 weeks after an episode of tonsillitis presented more postoperative pain. No relationship was found between this period and postoperative bleeding.ConclusionsMale patients had a higher incidence of bleeding than women.The period elapsed between the last tonsil infection and the surgical procedure was associated with greater postoperative pain, but not with greater postoperative bleeding. (AU)

Dependent factors in the adult patient and their relationship with post-tonsillectomy bleeding and pain in an outpatient setting.

INTRODUCTION AND OBJECTIVE: Tonsillectomy performed on an outpatient basis in adult patients presents bleeding and pain as main postoperative complications. Following rules such as cold surgical technique, analgesic protocols, preoperative interview, and postoperative follow-up help to better control the process. However, there are patient-dependent factors such as sex, age, indication for tonsillectomy and the time elapsed between the last tonsil infection and surgical intervention that can influence postoperative complications and should be considered. The objective of this work is to evaluate the influence of age, sex, the indication for tonsillectomy and the period elapsed between the last tonsil infection and surgery on bleeding and pain control. METHODS: A prospective, descriptive, and observational study was carried out in 96 adult patients who underwent outpatient surgery under general anaesthesia, using cold surgical technique, evaluating these complications based on age, sex, indication for tonsillectomy and time elapsed after the last tonsillitis. RESULTS: The patients operated on during the 4 weeks after an episode of tonsillitis presented more postoperative pain. No relationship was found between this period and postoperative bleeding. CONCLUSIONS: Male patients had a higher incidence of bleeding than women. The period elapsed between the last tonsil infection and the surgical procedure was associated with greater postoperative pain, but not with greater postoperative bleeding.

Classification of follicular-patterned thyroid lesions using a minimal set of epigenetic biomarkers.

Objective: The minimally invasive fine-needle aspiration cytology (FNAC) is the current gold standard for the diagnosis of thyroid nodule malignancy. However, the correct discrimination of follicular neoplasia often requires more invasive diagnostic techniques. The lack of suitable immunohistochemical markers to distinguish between follicular thyroid carcinoma and other types of follicular-derived lesions complicates diagnosis, and despite most of these tumours being surgically resected, only a small number will test positive for malignancy. As such, the development of new orthogonal diagnostic approaches may improve the accuracy of diagnosing thyroid nodules. Design: This study includes a retrospective, multi-centre training cohort including 54 fresh-frozen follicular-patterned thyroid samples and two independent, multi-centre validation cohorts of 103 snap-frozen biopsies and 33 FNAC samples, respectively. Methods: We performed a genome-wide genetic and epigenetic profiling of 54 fresh-frozen follicular-patterned thyroid samples using exome sequencing and the Illumina Human DNA Methylation EPIC platform. An extensive validation was performed using the bisulfite pyrosequencing technique. Results: Using a random forest approach, we developed a three-CpG marker-based diagnostic model that was subsequently validated using bisulfite pyrosequencing experiments. According to the validation cohort, this cost-effective method discriminates between benign and malignant nodules with a sensitivity and specificity of 97 and 88%, respectively (positive predictive value (PPV): 0.85, negative predictive value (NPV): 0.98). Conclusions: Our classification system based on a minimal set of epigenetic biomarkers can complement the potential of the diagnostic techniques currently available and would prioritize a considerable number of surgical interventions that are often performed due to uncertain cytology. Significance statement: In recent years, there has been a significant increase in the number of people diagnosed with thyroid nodules. The current challenge is their etiological diagnosis to discount malignancy without resorting to thyroidectomy. The method proposed here, based on DNA pyrosequencing assays, has high sensitivity (0.97) and specificity (0.88) for the identification of malignant thyroid nodules. This simple and cost-effective approach can complement expert pathologist evaluation to prioritize the classification of difficult-to-diagnose follicular-patterned thyroid lesions and track tumor evolution, including real-time monitoring of treatment efficacy, thereby stimulating adherence to health promotion programs.

Surveillance of seasonal respiratory viruses among Chilean patients during the COVID-19 pandemic

The StudySARS-CoV-2 has generated over 122 million cases worldwide. Non-pharmaceuticals interventions such as confinements and lockdowns started in Chile on March 18th 2020. In Europe, confinements and lockdowns have been accompanied by a decrease in the circulation of other respiratory viruses such as Influenza A virus(IAV), Influenza B virus(IBV) or respiratory syncytial virus(RSV) (1). Although changes in circulation patterns of respiratory viruses have been reported, limited information regarding the southern hemisphere is available where the SARS-CoV-2 pandemic merged with the winter season. We conducted viral surveillance of respiratory viruses and we evaluated their presence and establishing whether they were co-circulating with SARS-CoV-2.

Wall teichoic acids govern cationic gold nanoparticle interaction with Gram-positive bacterial cell walls.

Molecular-level understanding of nanomaterial interactions with bacterial cell surfaces can facilitate design of antimicrobial and antifouling surfaces and inform assessment of potential consequences of nanomaterial release into the environment. Here, we investigate the interaction of cationic nanoparticles with the main surface components of Gram-positive bacteria: peptidoglycan and teichoic acids. We employed intact cells and isolated cell walls from wild type Bacillus subtilis and two mutant strains differing in wall teichoic acid composition to investigate interaction with gold nanoparticles functionalized with cationic, branched polyethylenimine. We quantified nanoparticle association with intact cells by flow cytometry and determined sites of interaction by solid-state 31P- and 13C-NMR spectroscopy. We find that wall teichoic acid structure and composition were important determinants for the extent of interaction with cationic gold nanoparticles. The nanoparticles interacted more with wall teichoic acids from the wild type and mutant lacking glucose in its wall teichoic acids than those from the mutant having wall teichoic acids lacking alanine and exhibiting more restricted molecular motion. Our experimental evidence supports the interpretation that electrostatic forces contributed to nanoparticle-cell interactions and that the accessibility of negatively charged moieties in teichoic acid chains influences the degree of interaction. The approaches employed in this study can be applied to engineered nanomaterials differing in core composition, shape, or surface functional groups as well as to other types of bacteria to elucidate the influence of nanoparticle and cell surface properties on interactions with Gram-positive bacteria.

Biological impact of nanoscale lithium intercalating complex metal oxides to model bacterium B. subtilis.

The wide applications of lithium intercalating complex metal oxides in energy storage devices call for a better understanding of their environmental impact at the end of their life cycle. In this study, we examine the biological impact of a panel of nanoscale lithium nickel manganese cobalt oxides (Li x Ni y Mn z Co1-y-z O2, 0 < x, y, z < 1, abbreviated to NMCs) to a model Gram-positive bacterium, Bacillus subtilis, in terms of cellular respiration and growth. A highly sensitive single-cell gel electrophoresis method is also applied for the first time to understand the genotoxicity of these nanomaterials to bacterial cells. Results from these assays indicate that the free Ni and Co ions released from the incongruent dissolution of the NMC material in B. subtilis growth medium induced both hindered growth and cellular respiration. More remarkably, the DNA damage induced by the combination of the two ions in solution is comparable to that induced by the NMC material, which suggests that the free Ni and Co ions are responsible for the toxicity observed. A material redesign by enriching Mn is also presented. The combined approaches of evaluating their impact on bacterial growth, respiration, and DNA damage at a single-cell level, as well as other phenotypical changes allows us to probe the nanomaterials and bacterial cells from a mechanistic prospective, and provides a useful means to an understanding of bacterial response to new potential environmental stressors.

Chronic exposure to complex metal oxide nanoparticles elicits rapid resistance in Shewanella oneidensis MR-1.

Engineered nanoparticles are incorporated into numerous emerging technologies because of their unique physical and chemical properties. Many of these properties facilitate novel interactions, including both intentional and accidental effects on biological systems. Silver-containing particles are widely used as antimicrobial agents and recent evidence indicates that bacteria rapidly become resistant to these nanoparticles. Much less studied is the chronic exposure of bacteria to particles that were not designed to interact with microorganisms. For example, previous work has demonstrated that the lithium intercalated battery cathode nanosheet, nickel manganese cobalt oxide (NMC), is cytotoxic and causes a significant delay in growth of Shewanella oneidensis MR-1 upon acute exposure. Here, we report that S. oneidensis MR-1 rapidly adapts to chronic NMC exposure and is subsequently able to survive in much higher concentrations of these particles, providing the first evidence of permanent bacterial resistance following exposure to nanoparticles that were not intended as antibacterial agents. We also found that when NMC-adapted bacteria were subjected to only the metal ions released from this material, their specific growth rates were higher than when exposed to the nanoparticle. As such, we provide here the first demonstration of bacterial resistance to complex metal oxide nanoparticles with an adaptation mechanism that cannot be fully explained by multi-metal adaptation. Importantly, this adaptation persists even after the organism has been grown in pristine media for multiple generations, indicating that S. oneidensis MR-1 has developed permanent resistance to NMC.

Natural Organic Matter Concentration Impacts the Interaction of Functionalized Diamond Nanoparticles with Model and Actual Bacterial Membranes.

Changes to nanoparticle surface charge, colloidal stability, and hydrodynamic properties induced by interaction with natural organic matter (NOM) warrant consideration in assessing the potential for these materials to adversely impact organisms in the environment. Here, we show that acquisition of a coating, or "corona", of NOM alters the hydrodynamic and electrokinetic properties of diamond nanoparticles (DNPs) functionalized with the polycation poly(allylamine HCl) in a manner that depends on the NOM-to-DNP concentration ratio. The NOM-induced changes to DNP properties alter subsequent interactions with model biological membranes and the Gram-negative bacterium Shewanella oneidensis MR-1. Suwannee River NOM induces changes to DNP hydrodynamic diameter and apparent ζ-potential in a concentration-dependent manner. At low NOM-to-DNP ratios, DNPs aggregate to a limited extent but retain a positive ζ-potential apparently due to nonuniform adsorption of NOM molecules leading to attractive electrostatic interactions between oppositely charged regions on adjacent DNP surfaces. Diamond nanoparticles at low NOM-to-DNP ratios attach to model membranes to a larger extent than in the absence of NOM (including those incorporating lipopolysaccharide, a major bacterial outer membrane component) and induce a comparable degree of membrane damage and toxicity to S. oneidensis. At higher NOM-to-DNP ratios, DNP charge is reversed, and DNP aggregates remain stable in suspension. This charge reversal eliminates DNP attachment to model membranes containing the highest LPS contents studied due to electrostatic repulsion and abolishes membrane damage to S. oneidensis. Our results demonstrate that the effects of NOM coronas on nanoparticle properties and interactions with biological surfaces can depend on the relative amounts of NOM and nanoparticles.

Papilomas invertidos rinosinusales. Revisión de 61 casos / Inverted sinonasal papillomas. Review of 61 cases

Introducción: Los papilomas invertidos son neoplasias raras localizadas preferentemente en la pared lateral nasal, caracterizadas por la tendencia a recidivar y su potencial transformación en neoplasias malignas. El objetivo de este trabajo es analizar nuestra experiencia en el tratamiento de estas lesiones, especialmente el abordaje endoscópico. Material y métodos: Se realizó un estudio retrospectivo de 61 pacientes tratados en nuestro hospital desde 1983. Se recogieron los datos clinicopatológicos de los pacientes, el tratamiento aplicado y la evolución en el tiempo tras éste. El tiempo medio de seguimiento fue de 51 meses (rango: 6–228 meses). Resultados: Treinta y ocho de los pacientes (62%) eran hombres y 23 mujeres (38%), con una edad media de 58 años (rango: 22–80). El síntoma principal fue insuficiencia respiratoria nasal unilateral en el 91%, seguido de rinorrea en el 46%. La localización más frecuente fue el etmoides (51%), seguida del seno maxilar (28%) y la pared lateral nasal (21%). El 78% de los casos tenía sinusitis asociada y el 43%, poliposis. La clasificación por estadios de Krouse fue del 35% en estadio I, 37% en estadio II, 18% en estadio III y 8% en el IV. El 37% de los pacientes presentaba remodelación ósea en la TAC. Seis de los 42 pacientes operados por cirugía endoscópica nasal (CEN) presentaron recidiva (14%), mientras que de los pacientes a los que se operó por técnicas abiertas, presentaron recidiva 6 de 9 (67%). El tiempo medio a la recidiva fue de 41 meses. Diez de los pacientes presentaron papilomas invertidos malignizados, nueve de ellos fueron diagnosticados desde el principio como neoplasias malignizadas y uno se malignizó durante el seguimiento. Discusión y conclusiones: La CEN es el método de elección para el tratamiento de la mayor parte de los papilomas invertidos con resultados equiparables o, incluso, mejores que con las técnicas abiertas. El estrecho seguimiento de los pacientes por largos períodos de tiempo es necesario para detectar de forma precoz las recidivas y poder practicar cirugías de rescate (AU)

Introduction: Inverted papillomas are benign sinonasal lesions that arise primarily from the lateral nasal wall which are characterized by their tendency to recur and propensity to be associated with malignancy. The aim of this work is to analyze our experience in the treatment of these lesions, especially through the endoscopic approach. Material and method: We present 61 cases of sinonasal inverted papillomas that were treated at our hospital since 1983. The patients were studied by age, gender, site of presentation of the tumor, symptoms, radiologic studies, surgical treatment and evolution. The mean follow-up was 51 months (range 6–228 months). Results: Thirty eight of the patients (62%) were males and 23 females (38%). The average age was 58 years (range 22–80). The most common symptom was unilateral nasal obstruction in 91% of the cases, followed by rhinorrhea in 46%. The most frequent location was the ethmoid region in 51% of cases, followed by the maxillary sinus in 28% and the lateral nasal wall in 21% of the cases. 78% of cases had associated sinusitis and the 43% polyposis. Tumours were classified with the Krouse staging system as follows: 35% stage I, 37% stage II, 18% stage III and 8% stage IV. 37% of the patients had bony erosion in the CT scan. Six of the 42 patients treated by endoscopic procedures presented recurrence (14%), compared with 6 of the 9 patients (67%) who were treated by open approaches. The average time to the recurrence was 41 months. 17% of the patients had malignant inverted papillomas, nine of them diagnosed from the beginning as malignant neoplasies and one which became malignant during follow up. Discussion and conclusions: The endoscopic approach is the method of choice for the treatment of the majority of inverted papillomas. The close follow up of the patient for a large period of time is necessary for the early detection of recurrence and to allow for surgical salvage (AU)

[Inverted sinonasal papillomas. Review of 61 cases]. / Papilomas invertidos rinosinusales. Revisión de 61 casos.

INTRODUCTION: Inverted papillomas are benign sinonasal lesions that arise primarily from the lateral nasal wall which are characterized by their tendency to recur and propensity to be associated with malignancy. The aim of this work is to analyze our experience in the treatment of these lesions, especially through the endoscopic approach. MATERIAL AND METHOD: We present 61 cases of sinonasal inverted papillomas that were treated at our hospital since 1983. The patients were studied by age, gender, site of presentation of the tumor, symptoms, radiologic studies, surgical treatment and evolution. The mean follow-up was 51 months (range 6-228 months). RESULTS: Thirty eight of the patients (62%) were males and 23 females (38%). The average age was 58 years (range 22-80). The most common symptom was unilateral nasal obstruction in 91% of the cases, followed by rhinorrhea in 46%. The most frequent location was the ethmoid region in 51% of cases, followed by the maxillary sinus in 28% and the lateral nasal wall in 21% of the cases. 78% of cases had associated sinusitis and the 43% polyposis. Tumours were classified with the Krouse staging system as follows: 35% stage I, 37% stage II, 18% stage III and 8% stage IV. 37% of the patients had bony erosion in the CT scan. Six of the 42 patients treated by endoscopic procedures presented recurrence (14%), compared with 6 of the 9 patients (67%) who were treated by open approaches. The average time to the recurrence was 41 months. 17% of the patients had malignant inverted papillomas, nine of them diagnosed from the beginning as malignant neoplasies and one which became malignant during follow up. DISCUSSION AND CONCLUSIONS: The endoscopic approach is the method of choice for the treatment of the majority of inverted papillomas. The close follow up of the patient for a large period of time is necessary for the early detection of recurrence and to allow for surgical salvage.

Resultados de la preservación de órgano no quirúrgica en carcinomas de laringe e hipofaringe / Results of non-surgical organ preservation in carcinomas of the larynx and hypopharynx

El tratamiento quirúrgico del cáncer de laringe e hipofaringe localmente avanzado implica, en muchas ocasiones, la realización de una laringectomía total, procedimiento que implica una mutilación importante por la pérdida de la función vocal y la presencia de un traqueostoma permanente. Desde la publicación del estudio de la Veterans Affairs Laryngeal Cancer Study Group en 1991, que demostró la posibilidad de un tratamiento conservador con similares posibilidades de curación a la cirugía, se ha realizado un gran esfuerzo investigador para definir la opción terapéutica que obtiene las mejores tasas de preservación laríngea y la mayor supervivencia. En este artículo, se revisan los resultados de esta investigación, tanto en el aspecto oncológico como de función(AU)

Surgical treatment of locally advanced laryngeal and hypopharyngeal cancer often results in a total laryngectomy. This procedure leads to signifi cant mutilation, due to the loss of vocal function and the presence of a permanent stoma. Since the publication of the Veterans Affairs Laryngeal Cancer Study Group study in 1991, which demonstrated the feasibility of conservative treatment without compromising the chances of cure, intensive clinical research has been performed to defi ne the best therapeutic option in terms of laryngeal preservation and survival. In this article, we review the results of this clinical research, focusing both on oncological and functional results(AU)

[Sinonasal mucosal melanomas. Review of 17 case]. / Melanomas mucosos rinosinusales. Revisión de 17 casos.

INTRODUCTION: Mucosal melanomas (MM) represent 1.3 % of all melanomas; 55 % of them are located in the head and neck region mainly in the sinonasal and oropharyngeal cavity. Sinonasal mucosal melanomas have a high rate of local recurrence and a high risk of developing metastases, two reasons explaining the low survival rate. MATERIAL AND METHOD: We present 17 cases of sinonasal mucosal melanomas that were diagnosed and treated in our department from 1984 to July, 2008. The patients were studied by age, gender, site of presentation of the tumour, symptoms, radiology findings, treatment and course. RESULTS: Seventeen patients with sinonasal mucosal melanomas were studied. Of these 64.7 % were females and the mean age at presentation was 74 (range 48 to 93 years). Twelve cases developed in the nasal cavity and 5 in the paranasal sinuses. The most frequent site of presentation was the septum (35 %), and the most common symptom was epistaxis (77 %). Three patients rejected any treatment, 12 of the patients were treated surgically, one received chemotherapy and another chemotherapy plus radiotherapy. The 5 year disease-specific survival rate was 35.7 %. DISCUSSION AND CONCLUSIONS: Sinonasal mucosal melanomas are rare tumours with a high mortality. The treatment of choice is still surgical resection with wide surgical margins. Even so, the main cause of treatment failure is local recurrence, followed by the development of metastases. Because of the poor prognosis with this tumour, new treatment strategies are necessary.

Melanomas mucosos rinosinusales. Revisión de 17 casos / Sinonasal mucosal melanomas. Review of 17 cases

Introducción: Los melanomas mucosos (MM) representan el 1,3 % del total de melanomas. El 55 % de ellos se encuentra en la región de la cabeza y el cuello, principalmente en el área rinosinusal y la orofaringe. Los MM rinosinusales tienen una alta tasa de recurrencias locales y una gran capacidad para desarrollar metástasis, lo que se traduce en una supervivencia muy corta. Material y método: Se presentan los MM rinosinusales diagnosticados y tratados en nuestro servicio desde 1984 a julio de 2008. Se recogieron datos clínico patológicos que incluyen edad, sexo, sitio y síntomas de presentación, hallazgos radiológicos, tratamiento y evolución. Resultados: Se realiza una revisión de 17 pacientes. El 65% eran mujeres. La media (intervalo) de la edad a la presentación fue 74 (48-93) años. Los melanomas se originaron en la cavidad nasal en 12 pacientes y en los senos paranasales en 5. El lugar de presentación más frecuente fue el septum (67 %), y el síntoma de presentación fue la epistaxis (77 %).Tres pacientes rehusaron recibir tratamiento, 12 fueron tratados quirúrgicamente, 1 con quimioterapia y 1 con quimioterapia y radioterapia. La supervivencia específica a 5 años fue del 35,7 %. Discusión y conclusiones: Los melanomas rinosinusales son tumores raros pero con una elevada mortalidad. El tratamiento de elección sigue siendo la resección quirúrgica con amplios márgenes quirúrgicos. A pesar de ello, la principal causa de fracaso del tratamiento son las recidivas locales y el desarrollo de metástasis. Dado el mal pronóstico de este tumor, parecen necesarias nuevas estrategias terapéuticas (AU)

Introduction: Mucosal melanomas (MM) represent 1.3 % of all melanomas; 55 % of them are located in the head and neck region mainly in the sinonasal and oropharyngeal cavity. Sinonasal mucosal melanomas have a high rate of local recurrence and a high risk of developing metastases, two reasons explaining the low survival rate. Material and method: We present 17 cases of sinonasal mucosal melanomas that were diagnosed and treated in our department from 1984 to July, 2008. The patients were studied by age, gender, site of presentation of the tumour, symptoms, radiology findings, treatment and course. Results: Seventeen patients with sinonasal mucosal melanomas were studied. Of these 64.7% were females and the mean age at presentation was 74 (range 48 to 93 years).Twelve cases developed in the nasal cavity and 5 in the paranasal sinuses. The most frequent site of presentation was the septum (35 %), and the most common symptom was epistaxis (77 %). Three patients rejected any treatment, 12 of the patients were treated surgically, one received chemotherapy and another chemotherapy plus radiotherapy. The 5 year disease-specific survival rate was 35.7%. Discussion and conclusions: Sinonasal mucosal melanomas are rare tumours with a high mortality. The treatment of choice is still surgical resection with wide surgical margins. Even so, the main cause of treatment failure is local recurrence, followed by the development of metastases. Because of the poor prognosis with this tumour, new treatment strategies are necessary (AU)

[Reversible retrobulbar optic neuritis due to sphenoidal sinus disorders: two case studies]. / Neuritis óptica retrobulbar reversible por sinupatía esfenoidal: dos casos clínicos.

Optic neuritis are clinically demonstrated by a temporary but severe loss of vision and can be caused by a wide variety of diseases. It is unusual for sphenoidal sinusitis to co-exist with acute optic neuritis, so the simultaneous appearance of both diseases would invite aetiological suspicion. We present two cases where the first clinical manifestation of infectious sphenoidal pathology was retrobulbar optic neuritis, which reverted with treatment, medical in one case and surgical in the other, of the sinusitis.

Duplicación bilateral de la vena yugular interna / Bilateral duplication of the internal jugular vein

No disponible

No disponible

Neuritis óptica retrobulbar reversible por sinupatía esfenoidal: dos casos clínicos / Reversible retrobulbar optic neuritis due to sphenoidal sinus disorders: two case studies

Las neuritis ópticas pueden estar producidas por una gran variedad de enfermedades y se manifiestan clínicamente como una pérdida de visión temporal pero severa. Es raro que sinusitis esfenoidales coexistan con neuritis ópticas agudas, por lo que su relación invita a la sospecha etiológica. Presentamos 2 casos en los que la primera manifestación de una afección infecciosa esfenoidal fue una neuritis óptica retrobulbar que revirtió tras el tratamiento, médico, en un caso, y quirúrgico, en el otro, de la sinusitis

Optic neuritis are clinically demonstrated by a temporary but severe loss of vision and can be caused by a wide variety of diseases. It is unusual for sphenoidal sinusitis to co-exist with acute optic neuritis, so the simultaneous appearance of both diseases would invite aetiological suspicion. We present two cases where the first clinical manifestation of infectious sphenoidal pathology was retrobulbar optic neuritis, which reverted with treatment, medical in one case and surgical in the other, of the sinusitis

Giant cell tumor of the greater wing of the sphenoid: an unusual presentation.

We report a very unusual presentation of giant cell tumor probably originated on the greater wing of the sphenoid and show a review about the knowledge and the treatment of the lesion in this rare localization. We treated a 48-year-old man with a giant cell tumor of the infratemporal fossa. He presented with a right-side hearing loss and facial pain. The tumor was resected by means of a subtemporal-preauricular approach, and after 12 months of follow-up, the patient is free of recurrence. Giant cell tumors of the skull base are an extremely rare neoplasm, and there is not much information on the literature about the treatment and the prognostic. Wide resection ought to be made, and at the follow-up, the clinician must try to diagnose not only local recurrence but also the possibility of distant metastases to the lung.