Intravenous leiomyomatosis: Case report and review of the literature / Leiomiomatosis intravenosa: a propósito de un caso y revisión de la literatura

Introduction: We retrospectively reviewed a case of a 42-year-old woman with intravenous leiomyomatosis. Clinical findings: The present study describes a case of IVL extending into the right internal and common iliac veins. Diagnosis: The patient was diagnosed by definitive pathological examination after a hysterectomy and double salpingectomy. Hypovolaemic shock due to delayed intraperitoneal bleeding from the ovarian vessels pedicle was observed. An emergent laparotomy for haemostasis was performed. A follow-up MRI, 2 months later, showed a polylobulated mass extending inside the right internal and common iliac veins. Intervention and result: The patient underwent a third laparotomic procedure with the removal of the right pelvic mass together with the involved veins. The postoperative course was uneventful, and the patient remains well at 3-month follow-up, with no signs of lower limb edema or venous disorders. Conclusion: Intracardiac leiomyomatosis is mostly diagnosed in premenopausal women. The most severe manifestation could be a vascular thrombosis or a right atrial tumor in the case of intracardiac involvement. Early and appropriate diagnosis is essential for optimal treatment. Surgery is the best treatment.(AU)

Introducción: Presentamos el caso de una paciente de 42 años con leiomiomatosis intravenosa. Hallazgos clínicos: El estudio presente describe un caso de IVL con afectación de las venas ilíaca común e interna derecha. Diagnóstico: La paciente fue diagnosticada mediante el examen histológico definitivo tras una histerectomía total con doble salpingectomía. Se objetivó un shock hipovolémico por sangrado intraperitoneal tardío del pedículo de vasos ováricos. Se realizó una laparotomía urgente para hemostasia. Una RMN durante el seguimiento, 2 meses después, mostró una masa polilobulada con afectación de la vena ilíaca común y la vena ilíaca interna derecha. Intervención y resultado: A la paciente se le realizó una tercera laparotomía con la extirpación de la masa pélvica derecha. El curso postoperatorio fue satisfactorio y la paciente permaneció asintomática a los 3 meses de seguimiento, sin signos de edema en extremidades inferiores ni otras afectaciones vasculares. Conclusión. La leiomiomatosis intracardíaca se diagnostica más frecuentemente en mujeres premenopáusicas. La forma de manifestación más severa sería una trombosis vascular o un tumor intracardíaco en la aurícula derecha, en el caso de afectación intracardíaca. Un diagnóstico precoz es esencial para un tratamiento óptimo. La cirugía es el mejor tratamiento.(AU)

[Solid-cystic supratentorial hemangioblastoma affecting the falx cerebri. Report of a case]. / Hemangioblastoma sólido-quístico supratentorial afectando la hoz del cerebro. Presentación de un caso.

INTRODUCTION: hemangioblastomas are benign neoplasias that are originated in the central nervous system and constitute between 1.5-2.5% of intracranial tumors. The majority of them are infratentorial, mainly affecting the cerebellum (76%). Supratentorial lessions are rare, being in these cases the frontal, parietal or temporal lobes the most common locations. Meningeal involvement is infrequent. Only eight cases have been reported in the literature. In 30% of the cases, these tumors are associated with von Hippel Lindau syndrome (VHL). CASE REPORT: 67 year old woman without any medical or family history. She presented with 4 month evolution neurological symptoms. The cranial MRI scan showed a solitary solid-cystic lesion on the right paramedian frontal lobe, in contact with the falx cerebri. The pathological analysis showed a cellular proliferation composed of polygonal cells with clear cytoplasm due to the presence of intracytoplasmic vacuoles and round or oval nucleus without cytologic atypia. These cells were accompanied by a rich vascular network of capillary type and blood extravasation. She was diagnosed of supratentorial hemangioblastoma. CONCLUSION: the preoperative diagnosis of these neoplasms is difficult because the clinical suspicion is low in supratentorial location. Imaging techniques are useful but definitive diagnosis is made through pathologic examination. The use of immunohistochemical techniques is helpful for the differential diagnosis with lesions that are more common in this region. The importance of a correct diagnosis of these histologically benign tumors, lies on the possible association with VHL syndrome and its complications.

Hemangioblastoma sólido-quístico supratentorial afectando la hoz del cerebro. Presentación de un caso / Solid-cystic supratentorial hemangioblastoma affecting the falx cerebri. Report of a case

Introducción. Los hemangioblastomas son neoplasias benignas que se originan en el sistema nervioso central y constituyen entre un 1,5-2,5% de los tumores intracraneales. Mayoritariamente son de localización infratentorial, afectando principalmente al cerebelo (76%). Las lesiones supratentoriales son sumamente raras, siendo en estos casos la localización más habitual el lóbulo frontal, parietal o temporal. La afectación meníngea es excepcional, habiéndose descrito sólo ocho casos en la literatura. En un 30% de los casos, estos tumores se asocian al síndrome de von Hippel Lindau (VHL).Caso clínico. Mujer de 67 años sin antecedentes patológicos ni familiares de interés que se presentó conclínica neurológica de 4 meses de evolución. El estudio de resonancia magnética craneal demostró una lesión única sólido-quística frontal paramedial derecha, encontacto con la hoz del cerebro, que se orientó como meningioma. El estudio anatomo-patológico de la pieza quirúrgica objetivó una proliferación celular constituida por células poligonales con citoplasma claro debido a la presencia de vacuolas intracitoplasmáticas y núcleo redondo u oval sin atipia citológica. Estas células estaban acompañadas de una rica red vascular de tipocapilar, con anastomosis y extravasación sanguínea. Se diagnosticó de hemangioblastoma supratentorial. Discusión. El diagnóstico preoperatorio de estas neoplasias es difícil debido a que la sospecha clínica esbaja cuando se halla en localización supratentorial. Las técnicas de imagen son de utilidad, realizándose el diagnóstico definitivo a través del estudio anatomopatológico. El uso de técnicas de inmunohistoquímica es de gran ayuda para el diagnóstico diferencial con lesiones que habitualmente se localizan en esta región. La importancia de un diagnóstico correcto de estos tumores histológicamente benignos, radica, entre otras cosas,en la posible asociación con en síndrome de VHL y suscomplicaciones (AU)

Hemangioblastomas are benign neoplasias that are originated in the central nervous systemand constitute between 1.5-2.5% of intracranial tumors.The majority of them are infratentorial, mainly affectingthe cerebellum (76%). Supratentorial lessions are rare,being in these cases the frontal, parietal or temporallobes the most common locations. Meningeal involvementis in frequent. Only eight cases have been reported in the literature. In 30% of the cases, these tumors areas sociated with von Hippel Lindau syndrome (VHL).Case report. 67 year old woman without any medicalor family history. She presented with 4 month evolution neurological symptoms. The cranial MRI scan showed a solitary solid-cystic lesion on the right paramedianfrontal lobe, in contact with the falx cerebri. The pathological analysis showed a cellular proliferation composed of polygonal cells with clear cytoplasm due to the presence of intracytoplasmic vacuoles and round oroval nucleus without cytologic atypia. These cells wereaccompanied by a rich vascular network of capillarytype and blood extravasation. She was diagnosed ofsupratentorial hemangioblastoma. Conclusion. The preoperative diagnosis of these neoplasmsis difficult because the clinical suspicion is low in supratentorial location. Imaging techniques are useful but definitive diagnosis is made through pathologic examination. The use of immunohistochemical techniquesis helpful for the differential diagnosis with lesions that are more common in this region. The importance of acorrect diagnosis of these histologically benign tumors,lies on the possible association with VHL syndrome and its complications (AU)

Al(2)O(3(w))-Al(2)O(3(n))-ZrO(2) (TZ-3Y)(n) multi-scale nanocomposite: an alternative for different dental applications?

The influence of the addition of Al(2)O(3) whiskers (2.5wt.% up to 30wt.%) on Vickers hardness and fracture toughness in an Al(2)O(3(n))+ZrO(2) (TZ-3Y)(n) (90, 80 and 70wt.%) composite was investigated. Green compacts were obtained by uniaxial pressing at 50MPa and pressureless sintering at 1500 degrees C in air for 2h. After sintering, relative densities ranging from 75% to 97% were reached. The whiskers resisted particle rearrangement owing to the extensive sliding distances along the whisker boundaries during sintering and the high length/diameter ratios. Sintering becomes more difficult with increasing whisker content, because whiskers come into contact with each other, forming a rigid network which hinders densification. The 2.5wt.% Al(2)O(3) whiskers+27.5wt.% Al(2)O(3) nanoparticles+70wt.% TZ-3Y composite showed a hardness>13GPa and a maximum fracture toughness of 6.9MPam(-1/2), with an average grain size of 0.4+/-0.17microm. The observed crack deflection was an important mechanism in the improved fracture toughness of the composite. In addition, the grain size and residual porosity also seem to be factors in obtaining a wide range of hardness as well as fracture toughness by varying the Al(2)O(3) whiskers and ZrO(2) (TZ-3Y) content. The use of alumina-whisker-reinforced composites in dental applications could be promising for increasing hardness and fracture toughness compared with other materials. The reported values for these composites can compete with those of commercially available materials in different dental applications.

In situ study of the metal-insulator transition in VO2 by EELS and ab initio calculations.

Changes in the dielectric properties during the thermochromic transition of commercial VO(2) powders were determined in situ, by analyzing the low-loss region of the electron energy-loss spectroscopy (EELS) spectra in a transmission electron microscope at room temperature (insulator phase) and 100 degrees C (metallic phase). A comparison of experimental EELS spectra and ab initio density-functional theory calculations (WIEN2k code) within the generalized gradient approximation (GGA) is presented. A characteristic peak around 5.6 eV appears in the energy-loss function in metallic phase, which is absent in insulator phase. The origin of the characteristic peak is analyzed by means of energy-band structure calculations.

Experimental and theoretical determination of the low-loss electron energy loss spectroscopy of LiMn2O4.

The dielectric properties of cubic spinel-type LiMn(2)O(4), used as cathode material in lithium ion secondary batteries, are studied by analyzing the low-loss region of the electron energy loss spectroscopy (EELS) spectrum in a transmission electron microscope. A comparison of experimental EELS spectra and ab initio density-functional theory calculations (WIEN2k code) within the generalized gradient approximation (GGA) is presented. The origins of interband transitions are identified in the electronic band structure, by calculating the partial imaginary part of the dielectric function and the partial density of states of Li, Mn and O. Good agreement with experimental spectra is observed which allowed interpreting main features of the EELS spectrum.

Evidence of multi-walled carbon nanotube fragmentation induced by sonication during nanotube encapsulation via bulk-suspension polymerization.

The synthesis of multi-walled carbon nanotube/polystyrene composites, with nanotube concentrations of 0.04, 0.08 and 0.16 wt%, was carried out by in situ bulk-suspension polymerization with the assistance of sonication. By using this method both encapsulation and exfoliation of the nanotubes into the polymer host were achieved. Evidence of significant nanotube fragmentation was found by scanning electron microscopy; the cause of such fragmentation was attributed to the induction of strong cavitation due to the application of ultrasound during the synthesis. Infrared spectroscopy showed no evidence of the formation of covalent bonds between the nanotubes and the polystyrene during the process of synthesis. The thermal stability was not improved by the inclusion of the nanotubes, it was attributed to the low nanotube concentrations; however, composites glass transition temperature showed improvements.

Phenol sorption on surfactant-modified Mexican zeolitic-rich tuff in batch and continuous systems.

Surfactant modified clinoptilolite-rich tuff was used for the removal of phenol from aqueous solutions. The zeolitic rock from Oaxaca (Mexico) was treated with sodium chloride and then modified with hexadecyltrimethylammonium chloride or bencylcetildimethylammonium chloride in different experimental conditions. Phenol sorption isotherms and column experiments were performed; in both cases, phenol was determined in the aqueous solutions by UV-vis spectroscopy. The results showed that the sorption of phenol depends on the quantities of surfactant in the zeolitic rocks, the kind of surfactant, modification conditions and pH of the solutions. When the initial concentration of phenol increased, the adsorption of phenol in the surfactant-modified zeolite increased and the experimental data was best adjusted to the Langmuir model. The saturation of the columns rapidly reached high percentages.

[Neuro-Behçet: clinicopathological findings in an autopsy case]. / Neurobehçet: hallazgos clinicopatológicos de un caso de autopsia.

INTRODUCTION: Behçet's disease (BD) was first described by Hulusi Behçet in 1937 as a triad of oral aphthae, genital ulcers and uveitis. It affects most of tissues and organs without exception and has a prevalence of neurologic involvement between 5 and 30%. Histopathological research of autopsy cases is limited, even though the cause of death is confirmed in this study. CASE REPORT: A 30-years-old man without prior medical history of interest debuting with a BD with progressive neurological manifestations and fatal evolution. The autopsy showed, in gross examination, oral and scrotal ulcers. Moreover, the brain revealed a marked cerebral edema, opaque leptomeninges and hemorrhagic infarction of the left frontal lobule extended to the homolateral ventricular cavity. In the brain stem, multiples hemorrhagic infarctions and hemorrhage in the fourth ventricle. The microscopic examination showed a generalized perivascular lymphocytic and neutrophilic inflammation in small and medium vessels with intense diapedesis bleeding. This phenomenon was predominant in brain stem. CONCLUSIONS: The necropsy studies of patients with neuro-Behcet's disease are scarce. We report the clinicopathological findings in a patient with BD and neurological involvement, in which stands out a cerebral vascular affectation predominant in brain stem.

Neurobehçet: hallazgos clinicopatológicos de un caso de autopsia / Neuro-behçet: Clinicopathological findings in an autopsy case

Introducción. La enfermedad de Behçet (EB) la describió por primera vez en 1937 Hulusi Behçet como la tríada deúlceras orales, úlceras genitales y uveítis. Involucra a casi todos los tejidos y órganos sin excepción, y la tasa de afectación del sistema nervioso central es del 5 al 30%. Los estudios histopatológicos de casos de necropsias son escasos, a pesar de que la causa de muerte se constata en este estudio. Caso clínico. Varón de 30 años que comenzó con EB con afectación neurológicade evolución progresiva y fatal. El estudio autópsico mostró en el examen externo úlceras orales y escrotales. El encéfalo presentaba marcado edema cerebral, meninges opacas y un infarto hemorrágico frontal izquierdo con extensión hacia el ventrículo lateral homólogo, y el tronco del encéfalo, infartos hemorrágicos confluentes y hemorragia del cuarto ventrículo. En el examen de los órganos restantes destacaban múltiples infartos pulmonares bilaterales. El estudio histológico del encéfalo mostró, de forma generalizada, predominante en el tronco del encéfalo, vasos de pequeño y mediano calibre rodeados por una corona de linfocitos y neutrófilos, con intensa extravasación eritrocitaria perivascular. Conclusiones. Los estudios denecropsias de pacientes con neurobehçet son escasos. Presentamos los hallazgos clínicos y patológicos de un paciente con EB con afectación neurológica, en el que destaca una afectación vascular cerebral predominante en el tronco del encéfalo

Introduction. Behçet’s disease (BD) was first described by Hulusi Behçet in 1937 as a triad of oral aphthae, genital ulcers and uveitis. It affects most of tissues and organs without exception and has a prevalence of neurologic involvement between 5 and 30%. Histopathological research of autopsy cases is limited, even though the cause of death is confirmed in thisstudy. Case report. A 30-years-old man without prior medical history of interest debuting with a BD with progressive neurological manifestations and fatal evolution. The autopsy showed, in gross examination, oral and scrotal ulcers. Moreover, the brain revealed a marked cerebral edema, opaque leptomeninges and hemorrhagic infarction of the left frontal lobuleextended to the homolateral ventricular cavity. In the brain stem, multiples hemorrhagic infarctions and hemorrhage in the fourth ventricle. The microscopic examination showed a generalized perivascular lymphocytic and neutrophilic inflammationin small and medium vessels with intense diapedesis bleeding. This phenomenon was predominant in brain stem. Conclusions. The necropsy studies of patients with neuro-Behçet’s disease are scarce. We report the clinicopathological findings in a patient with BD and neurological involvement, in which stands out a cerebral vascular affectation predominant in brain stem

Colgajo póstero-medial de muslo (adductor): a propósito de un caso / Postero-medial thigh flap (adductor flap): case report

En pacientes con úlceras masivas o confluentes en la región glútea, puede ser necesaria la amputación dela extremidad inferior y la reconstrucción mediante colgajos totales de muslo para la cobertura del defecto. Esta técnica es muy agresiva y además de las evidentes secuelas físicas que crea puede generar importantes trastornos psíquicos para el paciente. Presentamos el caso de una paciente con una granúlcera por decúbito en la región isquio-trocantéreosacra en la que se empleó el colgajo Adductor como alternativa a la amputación de la extremidad inferior (AU)

Amputation of the lower extremity and total thigh flaps may be necessary for coverage in patients with massive multiple or confluent sores in the buttock region. This is an aggressive technique with important physical and psychological consequences for the patient. The Adductor flap was used as an alternative of the amputation in a patient with a big ischial-trocanteric sacral pressure sore (AU)

Effects of preparation and experimental conditions on removal of phenol by surfactant-modified zeolites.

The removal of phenol from aqueous solutions using surfactant-modified clinoptilolite-rich tuffs (SMZ) prepared from two Mexican zeolitic tuffs (Chihuahua and Oaxaca) was investigated. Sodium homoionization of the zeolitic rocks was performed before they were modified with the surfactants: hexadecyltrimethylammonium chloride or bromide and bencylcetildimethylammonium chloride. The surfactants in the modified zeolitic materials were determined considering the total carbon in the samples. The phenol removal was determined in a batch system taking into consideration the different quantities of surfactants in the zeolitic tuffs, contact time, pH and initial phenol concentration. The phenol was determined in the aqueous solutions by UV/Vis spectroscopy. Results showed that the formation of a hemimicelle or admicelle on the zeolites depended on the initial surfactant concentration and they were responsible for the type of interactions between the phenol and the surfactant-modified zeolites. Phenol adsorption by the surfactant-modified zeolites was carried out in approximately three hours. Phenol adsorption data was best adjusted to the pseudo-second order kinetic model. Both, surface properties of the surfactant-modified zeolites and pH of solution play an important role in the removal of this pollutant from aqueous solutions and they are responsible for the type of mechanism involved.

Effect of dialysis treatment on the aggregation state of montmorillonite clay.

In this work dialysis was used as a technique to modify the aggregation state of montmorillonite clay. Na-montmorillonite clay suspension was treated by a dialysis process and the effect of dialysis time on the surface area of the treated clay was studied. In a clay suspension, a decrease in cation content increases the interparticle repulsion forces exponentially, leading to separation of clay into the elementary clusters of layers by osmotic swelling. During dialysis treatment, the classical delamination process and mechanism were not observed. According to N(2) adsorption isotherms, the increase of surface area concerns to the development of mesoporosity. Nevertheless, the surface area increase cannot be explained by the delamination or exfoliation of some layers, since an increase in the expected number of layers that would yield the surface area does not explain the mesoporosity observed after dialysis. Based on these results, a new mechanism of evolution of the clay aggregation state after dialysis and drying is proposed.

Ion exchange resins as catalyst for the isomerization of alpha-pinene to camphene.

Camphene is an industrial intermediate compound for commercial chemicals such as isoborneol, isobornyl acetate and camphor. Industrially, the conventional process for camphene production consists of the isomerization of alpha-pinene using acidic TiO2 as catalyst. The use of this catalyst presents problems such as considerable time for preparation, reproducibility and recovery of catalyst from products after the alpha-pinene isomerization. For the first time, a commercial exchange resin was used as catalyst for this reaction. Based on the concentration of product as a function of the reaction time, the path of the alpha-pinene transformation to camphene and byproducts is proposed. Temperature and alpha-pinene/catalyst ratio were studied in order to optimize the yield to camphene production. The obtained results were comparable with those reported for acidic TiO2.

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Resection of a vipoma of the pancreas in a 15-year-old girl.

A 15-year-old girl had massive watery and protein-losing diarrhea. She was found to have a pancreatic islet cell tumor secreting high levels of vasoactive intestinal polypeptide. Eighty-five percent pancreatic resection was needed to remove the tumor. She has normal serum VIP levels and no tumor recurrence 6 years later.