[Hematuria as the first sign of pelvic chondrosarcoma]. / Hematuria como primer signo del condrosarcoma de pelvis.

Chondrosarcoma is a malignant tumor which often affects the pelvic ring and its symptomathology is non-specific and insidious. We display a case of a right iliopubic branch chondrosarcoma in a 62-year-old male whose first sing was a four-year history of sporadic macroscopic haematuria, related to efforts. After being studied by the Urology Department by cystoscopy and biopsy of bladder tumor, chondral cells were appreciated. Further study with imaging tests diagnosed low-grade chondrosarcoma with bladder infringement. The case is assessed by Musculoskeletal Tumors Committee and a multidisciplinary approach is carried out through en bloc resection and pelvic floor reconstruction. Currently the patient remains asymptomatic.

El condrosarcoma es un tumor maligno que afecta con frecuencia la pelvis y su sintomatología es inespecífica e insidiosa. Describimos el caso de un condrosarcoma de la rama iliopubiana derecha en un varón de 62 años cuyo primer signo de aparición fue una hematuria macroscópica esporádica, relacionada con esfuerzos y de cuatro meses de evolución. Tras ser estudiado por el servicio de urología mediante cistoscopía con biopsia de tumoración en pared vesical se aprecian células de estirpe condral. Tras posterior estudio con pruebas de imagen se diagnostica condrosarcoma de bajo grado con invasión de la vejiga, por lo que es valorado en el comité de tumores musculoesqueléticos y se realiza un abordaje multidisciplinar mediante exéresis en bloque y reconstrucción del suelo pélvico. Actualmente el paciente continúa asintomático.

Dormancy induction by summer temperatures and/or desiccation in imbibed seeds of trumpet daffodils Narcissus alcaracensis and N. longispathus (Amaryllidaceae).

We analysed the effects of summer temperatures (28/14 °C) and/or desiccation (from 48% to 8% humidity) on imbibed Narcissus alcaracensis and N. longispathus seeds with an elongating embryo. In the N. alcaracensis seeds that overcame dormancy (embryo elongation = 27.14%), exposure to high temperatures induced secondary dormancy and reduced subsequent embryo growth. A further 3-month cold stratification (5 °C) was required to break secondary dormancy. Desiccation in early embryo growth stages (elongation = 11.42%) also reduced germination. Desiccation in the seeds in a more advanced growth stage (i.e. embryo elongation = 27.14%) induced secondary dormancy, which the further 3-month cold stratification did not overcome. When desiccation was preceded by high temperatures, seeds better overcame secondary dormancy (i.e. longer embryo elongation and seed germination). Treatments did not affect seed viability. In the N. longispathus seeds that overcame dormancy (embryo elongation = 59.21%), exposure to high temperatures induced secondary dormancy and they needed a further 1-month stratification at 15/4 °C + 2 months at 5 °C to reactivate the germination process. When embryo elongation was 42.10%, seed desiccation totally impeded subsequent germination. When embryo elongation reached 59.21%, desiccation induced secondary dormancy, which was not overcome by the above-described stratification treatment. When desiccation was preceded by high temperatures, seeds better overcame dormancy. Stress treatments killed 5-10% of seeds. This study suggests that the seeds of species with complex morphophysiological dormancy (MPD) levels are sensitive to desiccation in early embryo development stages, as opposed to the seeds of species with deep simple epicotyl MPD, which better tolerate water stress.

Subcutaneous lymphoid follicular hyperplasia secondary to vaccination: correlation of ultrasound findings with clinical and histological findings. / Hiperplasia folicular linfoide subcutánea secundaria a vacunas: descripción de los hallazgos ecográficos y correlación clínico-patológica.

In recent years, the use of vaccines has been standardized within vaccination programs. Adverse effects at the puncture site are usually mild and transient. Nevertheless, in some cases, persistence subcutaneous nodules can develop; these are often underdiagnosed because they are so rare and because of the long time that can transpire between the vaccination and their appearance. Histologically, they consist of a lymphoid follicular hyperplasia that occurs as a reaction to the aluminum particles usually used as an adjuvant in some vaccines. We were unable to find any reference in the radiological literature to these soft-tissue nodules secondary to vaccination. We report the characteristic ultrasound findings that will enable radiologists to identify or strongly suspect these lesions and thereby avoid unnecessary imaging tests that might lead to confusion and inadequate management of these patients.

[Laparoscopic nephron-sparing surgery for Wilms tumor: description of two cases]. / Cirugía ahorradora de nefronas laparoscópica para tumor de Wilms.

Surgical resection is the mainstay of treatment for Wilms tumor. The research progress of the large study groups worldwide has reduced mortality. However, searching to minimize morbidity, the minimally invasive approach has been applied in selected patients. This article describes two cases of Wilms tumor managed with laparoscopic nephron sparing surgery. The case 1 with Beckwith-Wiedemann syndrome and bilateral disease, and the case 2 non-syndromic unilateral. The approach was intraperitoneally, without intraoperative complications. The follow-up to 18 months (case 1) and six months (case 2) did not have recurrence or metastatic disease.

La resección quirúrgica es el pilar del tratamiento en el tumor de Wilms. Los adelantos de investigación de los grandes grupos de estudio a nivel mundial han logrado disminuir la mortalidad. Sin embargo, en busca de minimizar la morbilidad, el abordaje mínimamente invasivo se ha aplicado en pacientes seleccionados. En este trabajo se describen dos casos de tumor de Wilms manejados con cirugía ahorradora de nefronas vía laparoscópica. Un paciente (caso 1) con antecedente de síndrome de Beckwith-Wiedemann y enfermedad bilateral y otro (caso 2) con afectación unilateral no sindrómico. El abordaje fue intraperitoneal y ninguno presentó complicaciones intraoperatorias. Durante el seguimiento a los 18 meses (caso 1) y a los 6 meses (caso 2), no se presentó recurrencia ni enfermedad metastásica.

Cirugía ahorradora de nefronas laparoscópica para tumor de Wilms / Laparoscopic nephron-sparing surgery for Wilms tumor: description of two cases

La resección quirúrgica es el pilar del tratamiento en el tumor de Wilms. Los adelantos de investigación de los grandes grupos de estudio a nivel mundial han logrado disminuir la mortalidad. Sin embargo, en busca de minimizar la morbilidad, el abordaje mínimamente invasivo se ha aplicado en pacientes seleccionados. En este trabajo se describen dos casos de tumor de Wilms manejados con cirugía ahorradora de nefronas vía laparoscópica. Un paciente (caso 1) con antecedente de síndrome de Beckwith-Wiedemann y enfermedad bilateral y otro (caso 2) con afectación unilateral no sindrómico. El abordaje fue intraperitoneal y ninguno presentó complicaciones intraoperatorias. Durante el seguimiento a los 18 meses (caso 1) y a los 6 meses (caso 2), no se presentó recurrencia ni enfermedad metastásica

Surgical resection is the mainstay of treatment for Wilms tumor. The research progress of the large study groups worldwide has reduced mortality. However, searching to minimize morbidity, the minimally invasive approach has been applied in selected patients. This article describes two cases of Wilms tumor managed with laparoscopic nephron sparing surgery. The case 1 with Beckwith-Wiedemann syndrome and bilateral disease, and the case 2 non-syndromic unilateral. The approach was intraperitoneally, without intraoperative complications. The followup to 18 months (case 1) and six months (case 2) did not have recurrence or metastatic disease

¿Debemos redefinir la población diana en el cribado de cáncer cervical con la técnica de Papanicolaou? / Should we redefine the target population in cervical cancer screening with the Pap test?

Objetivo: Conocer los resultados de las citologías realizadas en un centro de salud en un año, así como cuál es el manejo de las alteraciones detectadas. Material y método: Estudio transversal, realizado en un centro de salud urbano. Se incluyeron 1.314 mujeres citadas para realización de citología vaginal entre el 1 de marzo de 2011 y el 29 de febrero de 2012. A partir de la información incluida en la historia clínica se registró: fecha de nacimiento, nacionalidad, fecha de citas y asistencia, resultado de citología, tratamiento por médico de familia o ginecólogo, cumplimiento de criterios de inclusión en este servicio (SESCAM), y uso de anticoncepción. Resultados: La mediana de edad de las mujeres citadas era 40 años (rango: 17-82). Se analizaron 1.028 citologías. El 81,9% eran normales. Presentaron alguna alteración inflamatoria/infecciosa 166, en 7 se detectó ASCUS, y en 6 y en 4 SIL de bajo y alto grado, respectivamente. Precisaron valoración por ginecología 30 mujeres, 3 de las cuales fueron sometidas a biopsia (resultados: normal, CIN I y CIN III). De las 1.254 mujeres en que se registró el criterio de inclusión, 29% no cumplían los establecidos en la cartera de servicios del SESCAM. Conclusiones: Algo más de la cuarta parte de las mujeres que toman cita para realización de citología no reúnen criterios de inclusión en el mismo. Los hallazgos patológicos son muy infrecuentes. Estas circunstancias deben hacernos reconsiderar las condiciones de prestación del servicio

Objective: To identify the results of the Pap tests performed in a health center in a 1-year period and the management of the changes detected. Material and methods: This cross-sectional survey, carried out in an urban health center, included 1314 women with an appointment for a Pap smear between March 1, 2011 and February 29, 2012. Based on information in the medical history, we recorded date of birth, nationality, date of appointment and attendance, Pap result, medical treatment by the family physician or gynecologist, whether the patient met the criteria for inclusion in this service (SESCAM), and contraception use. Results: The median age of the women was 40 years (range: 17-82). We analyzed 1028 Pap tests; 81.9% were normal. Some inflammatory/infectious alterations were detected in 166 women, ASCUS was detected in 7, low-grade SIL in 6, and high-grade SIL in 4. Thirty women were referred to a gynecologist and a biopsy was performed in 3 (results: normal, CIN I and CIN III). Of the 1254 women with recorded inclusion criteria, 29% did not meet those of the SESCAM. Conclusions: Just over a quarter of the women attending appointments for Pap smears did not meet the criteria for this test. Pathological findings were infrequent. These findings indicate the need to reconsider the conditions for this service

Annual dormancy cycles in buried seeds of shrub species: germination ecology of Sideritis serrata (Labiatae).

The germination ecology of Sideritis serrata was investigated in order to improve ex-situ propagation techniques and management of their habitat. Specifically, we analysed: (i) influence of temperature, light conditions and seed age on germination patterns; (ii) phenology of germination; (iii) germinative response of buried seeds to seasonal temperature changes; (iv) temperature requirements for induction and breaking of secondary dormancy; (v) ability to form persistent soil seed banks; and (vi) seed bank dynamics. Freshly matured seeds showed conditional physiological dormancy, germinating at low and cool temperatures but not at high ones (28/14 and 32/18 °C). Germination ability increased with time of dry storage, suggesting the existence of non-deep physiological dormancy. Under unheated shade-house conditions, germination was concentrated in the first autumn. S. serrata seeds buried and exposed to natural seasonal temperature variations in the shade-house, exhibited an annual conditional dormancy/non-dormancy cycle, coming out of conditional dormancy in summer and re-entering it in winter. Non-dormant seeds were clearly induced into dormancy when stratified at 5 or 15/4 °C for 8 weeks. Dormant seeds, stratified at 28/14 or 32/18 °C for 16 weeks, became non-dormant if they were subsequently incubated over a temperature range from 15/4 to 32/18 °C. S. serrata is able to form small persistent soil seed banks. The maximum seed life span in the soil was 4 years, decreasing with burial depth. This is the second report of an annual conditional dormancy/non-dormancy cycle in seeds of shrub species.

Varices en el ligamento redondo / Varices in the round ligament

Las varices del ligamento redondo son una entidad muy poco frecuente que sólo se ha descrito en mujeres embarazadas como una masa inguinal, normalmente en el tercer trimestre de gestación.La ecografía en modo B y Doppler color constituyen una herramienta diagnóstica fundamental, ya que permiten realizar un diagnóstico radiológico de certeza, excluyendo otras posibilidades clínicas de masa inguinal.Dado que el tratamiento es conservador, es imprescindible que el radiólogo conozca esta entidad y sus características ecográficas, lo que permitirá la realización de un diagnóstico correcto que evitará una exploración quirúrgica innecesaria (AU)

Varices in the round ligament are very rare and have only been reported in pregnant women as an inguinal mass normally detected in the third trimester of gestation.AbstractB-mode and Doppler color ultrasonography are fundamental tools in the diagnosis, because they make it possible to reach a conclusive diagnosis and to rule out other clinically possible inguinal masses.AbstractGiven that the treatment is conservative, it is essential for the radiologist to be familiar with this condition and its ultrasonographic characteristics to enable the correct diagnosis and avoid unnecessary surgical exploration (AU)

[Varices in the round ligament]. / Varices en el ligamento redondo.

Varices in the round ligament are very rare and have only been reported in pregnant women as an inguinal mass normally detected in the third trimester of gestation. B-mode and Doppler color ultrasonography are fundamental tools in the diagnosis, because they make it possible to reach a conclusive diagnosis and to rule out other clinically possible inguinal masses. Given that the treatment is conservative, it is essential for the radiologist to be familiar with this condition and its ultrasonographic characteristics to enable the correct diagnosis and avoid unnecessary surgical exploration.

Haloanisole and halophenol contamination in Spanish aged red wines.

This is the first study to be carried out on the incidence of halophenols and haloanisoles, including trichloroanisole, in aged red wines. A total of 966 red wines, aged for 6, 12 and 24 months in oak barrels and from different Spanish production areas, were analysed by stir bar sorptive extraction followed by gas chromatography/mass spectrometry (GC/MS). From the wines sampled, 155 (16.1%) were contaminated with one or several compounds, with 7.6, 6.9 and 1.5% corresponding to the 12- (aged-12), 6- (aged-6) and 24-month-aged (aged-24) wines, respectively. The most abundant compounds causing taint were 2,3,4,6-tetrachloroanisole and 2,4,6-trichloroanisol (6.8 and 5.3%, respectively). No 2,4,6-tribromophenol was found in any of the samples. Contamination with halo compounds was highest in samples from South-West Spain, followed by those from Northern Spain. The mean concentration for all compounds were always higher than their respective olfactory threshold, but none of these halo compounds represent a health hazard to humans through the consumption of commercial red aged wines.

[Tumors of the oral cavity: the usefulness of dynamic CT]. / Neoplasias de la cavidad oral. Aportaciones del estudio de tomografía axial computarizada dinámica.

OBJECTIVE: To demonstrate the usefulness and importance of including "puffed-cheek" dynamic CT (PCCT) in the protocol for the diagnosis and staging of tumors of the oral cavity. MATERIAL AND METHODS: This is a prospective study of 62 (38 male and 24 female) patients with epidermoid carcinoma of the oral cavity diagnosed and treated at our hospital during an 18-month period. The site of the primary tumor was the tongue (n=19), floor of the mouth (n=3), lip (n=3), gums (n=6), retromolar trigone (n=7), buccal mucosa (n=8), and a combination of the last three locations (n=16). In addition to conventional CT examination, all patients underwent dynamic CT of the oral cavity while maintaining their cheeks puffed out. RESULTS: PCCT provided additional information in 39 patients (63%), giving a better view of the tumor, its extension, or both. PCCT detected eight lesions (17%) that were not visible on the conventional CT study; these lesions were located in the tongue (n=3), retromolar trigone (n=1), buccal mucosa (n=3), and upper gum (n=1). PCCT was especially useful for evaluating lesions with superficial extension, in particular those in the buccal mucosa, retromolar trigone, and gums. PCCT provided no additional information about the tumors on the floor of the mouth. CONCLUSIONS: The habitual contact between the mucosal surfaces of the oral cavity makes some clinically obvious lesions difficult to identify at CT. The interposition of air acts as a natural contrast, separating the gums from the mucosa of the buccomaseteric region; PCCT provides relevant information and should be included in the imaging workup in patients with tumors of the oral cavity.

Neoplasias de la cavidad oral. Aportaciones del estudio de tomografía axial computarizada dinámica / Tumors of the oral cavity: the usefulness of dynamic CT

Objetivos. Demostrar las aportaciones y la importancia en el diagnóstico y la estadificación de las neoplasias de cavidad oral de una tomografía computarizada dinámica hinchando los carrillos (TCHC) incluida en el protocolo de estudio. Material y métodos. Estudio prospectivo de 62 pacientes con carcinoma epidermoide de cavidad oral, diagnosticados y tratados en nuestro hospital en un periodo de 18 meses. Las localizaciones de la lesión tumoral primaria fueron: lengua (n = 19), suelo de la boca (n = 3), labio (n = 3), encía (n = 6), trígono retromolar (n = 7), mucosa bucal (n = 8) y una combinación de las tres últimas localizaciones (n = 16). En estos pacientes al estudio de TC convencional se añadió una TC dinámica restringida a la cavidad oral, en la que el paciente mantenía hinchados los carrillos. Resultados. Con la TCHC se obtuvo información adicional en 39 pacientes (63%), mejorando la visualización del tumor y/o su extensión. Se detectaron 8 lesiones (17%) no visibles en el estudio estándar (lengua [n = 3], trígono retro-molar [n = 1], mucosa bucal [n = 3] y encía superior [n = 1]). La maniobra fue de especial utilidad para evaluar lesiones con extensión superficial, especialmente en los tumores de la mucosa bucal, el trígono retromolar y la encía. No obtuvimos información adicional en las neoplasias del suelo de la boca. Conclusiones. El contacto habitual entre las superficies mucosas de la cavidad oral dificulta la identificación de algunas lesiones. La interposición de aire como contraste natural, separando la mucosa de la encía de la región bucomasetérica, aporta información relevante, por lo que hemos incluido la TCHC como exploración rutinaria adicional en el protocolo de estudio de los pacientes con neoplasia de la cavidad oral

Objective. To demonstrate the usefulness and importanceof including “puffed-cheek” dynamic CT (PCCT) in the protocol for the diagnosis and staging of tumors of the oral cavity. Material and methods. This is a prospective study of 62 (38 male and 24 female) patients with epidermoid carcinoma of the oral cavity diagnosed and treated at our hospital during an 18-month period. The site of the primary tumor was the tongue (n = 19), floor of the mouth (n = 3), lip (n = 3), gums (n = 6), retromolar trigone (n = 7), buccal mucosa (n = 8), and acombination of the last three locations (n = 16). In addition to conventional CT examination, all patients underwent dynamic CT of the oral cavity while maintaining their cheeks puffed out. Results. PCCT provided additional information in 39 patients(63%), giving a better view of the tumor, its extension,or both. PCCT detected eight lesions (17%) that were not visible on the conventional CT study; these lesions were located in the tongue (n = 3), retromolar trigone (n = 1), buccal mucosa (n = 3), and upper gum (n = 1). PCCT was especially useful for evaluating lesions with superficial extension, in particular those in the buccal mucosa, retromolar trigone, and gums. PCCT provided no additional information about the tumors on the floor of the mouth. Conclusions. The habitual contact between the mucosal surfaces of the oral cavity makes some clinically obvious lesions difficult to identify at CT. The interposition of air acts as a natural contrast, separating the gums from the mucosa of the buccomaseteric region; PCCT provides relevant informationand should be included in the imaging workup in patientswith tumors of the oral cavity

Large granular lymphocyte leukemia and its association with oral neutropenic ulcerations: a case report.

Large granular lymphocyte leukemia is a rare chronic indolent disorder commonly associated with severe neutropenia. The pathogenesis of the neutropenia is unclear. A case is presented of a 74-year-old man who had recurrent oral ulcerations for over a year before a diagnosis was made. These recurrent oral ulcers cleared with treatment and have not returned. The differential diagnosis of persistent oral ulcerations includes trauma; viral, fungal, and bacterial infections; systemic disease; or various malignant conditions. The oral ulcers in this man were likely infectious in nature and related to the severe chronic neutropenia. This case serves to illustrate the potentially complex nature of oral ulcers.

Synthesis and biological activity of 4-amino-7-oxo-substituted analogues of 5-deaza-5,6,7,8-tetrahydrofolic acid and 5,10-dideaza-5, 6,7,8-tetrahydrofolic acid.

The 4-amino-7-oxo-substituted analogues of 5-deaza-5,6,7, 8-tetrahydrofolic acid (5-DATHF) and 5,10-dideaza-5,6,7, 8-tetrahydrofolic acid (DDATHF) were synthesized as potential antifolates. Treatment of the alpha,beta-unsaturated esters 11a-c, obtained in one synthetic step from commercially available para-substituted methyl benzoates (9a-c) and methyl 2-(bromomethyl)acrylate (10), with malononitrile in NaOMe/MeOH afforded the corresponding pyridones 12a-c. Formation of the pyrido[2,3-d]pyrimidines 13a-c was accomplished upon treatment of 12a-c with guanidine in methanol. After the hydrolysis of the ester group present in 13a-c, the resulting carboxylic acids 14a-c were treated with diethyl cyanophosphonate in Et3N/DMF and coupled with L-glutamic acid dimethyl ester to give 15a-c. Finally, the basic hydrolysis of 15a-c yielded the desired 4-amino-7-oxo-substituted analogues 16a-c in 20-27% overall yield. Compounds 16a-c were tested in vitro against CCRF-CEM leukemia cells. The results obtained indicated that our 4-amino-7-oxo analogues are completely devoid of any activity, the IC50 being higher than 20 microg/mL for all cases except 14c for which a value of 6.7 microg/mL was obtained. These results seem to indicate that 16a-c are inactive precisely due to the presence of the carbonyl group in position C7, the distinctive feature of our synthetic methodology.

Solitary bone cyst of the jaws: radiographic review of 44 cases.

Solitary bone cyst is a radiolucent lesion classified as a pseudocyst with a variety of reported shapes including round, oval, and irregular. In the long bones, a truncated cone shape has been described, and the fallen trabecula sign is seen in association with pathologic fracture. The purpose of this study was to classify and document the various shapes, to describe the width versus height dimensions of jaw SBCs, to determine the identifying signs of trauma, and to evaluate other reported radiographic features. Radiographs of 44 SBCs in 43 patients were studied. Sixty-four percent demonstrated the cone shape, and four subtypes of this shape were identified. Other shapes included oval (16%), irregular (16%), and round (4%). Radiographic signs of trauma were observed in 28% of the cases. No evidence of the "fallen trabecula sign" was found in this series.

Expression of p53, Ki-67 and cytokeratin-4 (CK4) in oral papillomas.

P53 is overexpressed in more than 50% of all human cancers. A previous study suggested that p53 was also overexpressed in oral papillomas. This study was carried out to investigate whether p53 expression was correlated with expression of the cellular proliferation marker Ki-67 and the epithelial differentiation marker cytokeratin-4 (CK4) in oral papillomas. Formalin-fixed paraffin-embedded sections of 30 oral papilloma specimens and 30 unmatched normal oral mucosal specimens were processed for immunohistochemistry, using an avidin-biotin-peroxidase procedure and monoclonal antibodies. A semiquantification analysis on p53 and Ki-67 labeling indices was performed. Twenty-eight of 30 (93%) papilloma specimens were positive for p53. The percentage of p53-positive cells in the basal layer was 60.4 +/- 14.8 (mean +/- SD, n = 28), and that of Ki-67-positive cells was 26.7 +/- 14.4. There was no correlation between expression of p53 and that of Ki-67. Expression of CK4 was inversely correlated with the expression of Ki-67 but not correlated with the expression of p53.

Squamous carcinoma arising from a dentigerous cyst: report of a case.

A case of squamous carcinoma arising in the lining of a dentigerous cyst is presented. This case is interesting because, clinically and radiographically, the diagnosis was unexpected. The light-microscopy examination revealed the moderately well-differentiated squamous carcinoma. The presentations of the case are discussed.