[Translated article] Total hip arthroplasty with shelf acetabuloplasty in dysplastic coxarthrosis, mean follow-up of 7 years.

INTRODUCTION: Developmental dysplasia of the hip is the cause of approximately one third of secondary coxarthrosis. Anatomy alterations make it difficult to place a total hip prosthesis in its anatomical position and for it to be stable in the long term; there are several techniques to achieve this goal. In the present work, we used autograft of the femoral head (shelf graft or reinforced roof), to improve the coverage of the acetabular component with favourable results. MATERIALS AND METHODS: Sixteen cases were included in 14 patients with a diagnosis of developmental dysplasia of the hip (13 women and one man), the mean age was 44.3 years (range 35-68 years), with a mean follow-up of 7 years (range 1-15 years). All the cases were evaluated clinically and radiographically, to demonstrate the osseointegration of the graft and the functional results in the medium term. RESULTS: All the acetabular components were placed in anatomical position (Ranawat technique), the mean percentage of host bone coverage was 54.53% (range 43.28-79.05%), obtaining additional coverage with the bone graft of 45.13%. Osseointegration of the graft of 100% at 12 weeks, resorption of the graft from the sixth month, stabilising in the third postoperative year. Only one case of dislocation is reported, no cases of infection, loosening, heterotopic ossification or revision. CONCLUSION: This procedure has shown good functional results in the medium term with 100% osseointegration, despite cases of severe bone resorption of the graft that does not compromise the stability of the prosthesis.

Total hip arthroplasty with shelf acetabuloplasty in dysplastic coxarthrosis, mean follow-up of 7 years. / Artroplastia total de cadera no cementada con techo armado en coxartrosis displásica, seguimiento medio de 7 años.

Developmental dysplasia of the hip is the cause of approximately one third of secondary coxarthrosis. Anatomy alterations make it difficult to place a total hip prosthesis in its anatomical position and for it to be stable in the long term; there are several techniques to achieve this goal. In the present work, we used autograft of the femoral head (shelf graft or reinforced roof), to improve the coverage of the acetabular component with favorable results. MATERIALS AD METHODS: Sixteen cases were included in 14 patients with a diagnosis of developmental dysplasia of the hip (13 women and one man), the mean age was 44.3 years (range 35-68 years), with a mean follow-up of 7 years (range 1-15 years). All the cases were evaluated clinically and radiographically, to demonstrate the osseointegration of the graft and the functional results in the medium term. RESULTS: All the acetabular components were placed in anatomical position (Ranawat technique), the mean percentage of host bone coverage was 54.53% (range 43.28-79.05%), obtaining additional coverage with the bone graft of 45.13%. Osseointegration of the graft of 100% at 12 weeks, resorption of the graft from the sixth month, stabilizing in the third postoperative year. Only one case of dislocation is reported, no cases of infection, loosening, heterotopic ossification or revision. CONCLUSION: This procedure has shown good functional results in the medium term with 100% osseointegration, despite cases of severe bone resorption of the graft that does not compromise the stability of the prosthesis.

[Diffuse pulmonary calcification in a patient with renal insufficiency]. / Calcinosis pulmonar difusa en paciente con insuficiencia renal.

We report the case of a 37-year-old man with chronic renal insufficiency, on hemodialysis, with no respiratory symptoms but whose chest radiograph showed parenchymal consolidation in the middle and upper lung fields. High resolution computed tomography showed a high-attenuating diffuse alveolar pattern that indicated calcium deposits. Bronchoscopy revealed metastatic calcification on the interalveolar septa and bronchiolar and arteriolar. The present report, based on radiologic and bronchoscopic findings, describes the pathogenesis and anatomical distribution of the patient's diffuse pulmonary calcification.

Calcinosis pulmonar difusa en paciente con insuficiencia renal / Diffuse pulmonary calcification in a patient with renal insufficiency

Se describe el caso de un varón de 37 años de edad con insuficiencia renal crónica en hemodiálisis y asintomático desde el punto de vista respiratorio, que presentó una radiografía de tórax con consolidaciones parenquimatosas en campos pulmonares medios y superiores. Los hallazgos de la tomografía computarizada de alta resolución mostraron un patrón alveolar difuso de alta atenuación, indicativo de depósito de calcio. La broncoscopia demostró calcificaciones metastásicas en septos alveolares y paredes de bronquiolos y arteriolas. Este artículo describe la patogenia y distribución anatómica de las calcificaciones pulmonares difusas basándose en los hallazgos radiológicos y broncoscópicos

We report the case of a 37-year-old man with chronic renal insufficiency, on hemodialysis, with no respiratory symptoms but whose chest radiograph showed parenchymal consolidation in the middle and upper lung fields. High resolution computed tomography showed a high-attenuating diffuse alveolar pattern that indicated calcium deposits. Bronchoscopy revealed metastatic calcification on the interalveolar septa and bronchiolar and arteriolar. The present report, based on radiologic and bronchoscopic findings, describes the pathogenesis and anatomical distribution of the patient´s diffuse pulmonary calcification

Atlas de gammagrafía de receptores de somatostatina en tumores neuroendocrinos de páncreas y tumores carcinoides / Scintigraphy atlas of somatostatin receptors in neuroendocrine tumors of the pancreas and carcinoid tumors

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[Bronchial carcinoid tumor and scintigraphy of somatostatin receptors: detection of bone metastasis]. / Tumor carcinoide bronquial y gammagrafía de receptores de somatostatina: detección de metástasis óseas.

UNLABELLED: Surgery is the treatment of choice for bronchial carcinoid tumor (BCT), whenever the staging is adequate. There is little information about the capability of the somatostatin receptor scintigraphy (SRS) to detect bone metastases in the carcinoid tumor. AIM: This work has aimed to evaluate retrospectively the diagnostic accuracy of the SRS in the detection of bone metastases in BCT. MATERIALS AND METHODS: Based on their clinical indication, the patients were classified into two different groups: Group A (n = 4), staging of a known BCT; and Group B (n = 6), treatment control. The SRS results could be correlated with the CT results in all 4 patients from the group A, and in one patient from the group B, and the SRS results were compared with the clinical follow up during at least one year in the other 5 patients. RESULTS: The SRS scan detected the 4 BCT from the group A; in 2 of them the patient staging was superior when the SRS was used than with the CT, whereas the scan overestimated the tumor stage (BCT + sarcoidosis) in another patient. During the clinical course, one of these patients developed bone and liver metastases. The SRS was normal in 5 asymptomatic patients from group B, whereas the scan showed disseminated metastatic disease (liver, bone, spleen and lymph nodes) in another patient. In the 2 patients with bone metastases, the total number of bone metastases detected by the bone scan was 12, and by the SRS 8. The four lesions that were not detected by SRS were located in the ribs (n = 3) and 12-D (n = 1). CONCLUSIONS: The capability of the SRS to detect bone metastases makes it more useful in BCT staging. Over the next few years, the role of the bone scan and SRS in the detection of bone metastases in carcinoid tumors needs to be established.

Tumor carcinoide bronquial y gammagrafía de receptores de somatostatina: detección de metástasis óseas / Bronchial carcinoid tumor and scintigraphy of somatostatin receptors: detection of bone metastasis

El tratamiento de elección del tumor carcinoide bronquial (TCB) es quirúrgico siempre que la estadificación lo permita. Existe escasa información sobre la capacidad de la gammagrafía de receptores de somatostatina (GRS) para detectar metástasis óseas en el tumor carcinoide. Objetivo: Valorar de forma retrospectiva la utilidad diagnóstica de la GRS en la detección de metástasis óseas del TCB. Material y método: Hemos clasificado a los pacientes en dos grupos según los motivos por los que el clínico solicitó la GRS: Grupo A (n = 4) Estadificar un TCB conocido y Grupo B (n = 6) Controlar la eficacia del tratamiento. En 4 pacientes del grupo A y en uno del grupo B hemos podido correlacionar los resultados de la GRS con los de la TC y en los 5 restantes con el seguimiento clínico durante al menos 1 año. Resultados: La GRS detectó los 4 TCB del grupo A; en 2 de ellos la estadificación del tumor fue superior con la GRS que con la TC, y en otro la sobrestimó (TCB + sarcoidosis).Uno de estos pacientes desarrolló metástasis óseas sincrónicas con metástasis hepáticas. En 5 pacientes del grupo B, asintomáticos, la GRS fue normal, mientras que en el paciente restante demostró enfermedad metastásica diseminada (hígado, bazo, hueso y linfoganglionar). Entre los dos pacientes con metástasis óseas el número de lesiones detectadas, mediante la gammagrafía ósea, fue de 12 y 8 con la GRS. Los cuatro falsos negativos de la GRS correspondieron a metástasis localizadas, 3 en parrilla costal y una en D-12. Conclusiones: La capacidad de diagnosticar metástasis óseas de la GRS refuerza su valor para estadificar un TCB. En los próximos años habrá que establecer el valor respectivo de la gammagrafía ósea y de la GRS en la detección de metástasis óseas en los tumores carcinoide (AU)

[Gammagraphy of somatostatin receptors in an ACTH secreting thymic carcinoid]. / Gammagrafía de receptores de somatostatina en un carcinoide tímico secretor de ACTH.

Ectopic ACTH secretion represent 10 to 15% in the causes of Cushing's syndrome. Carcinoid tumor of the thymus is a rare neoplasm and is currently believed to arise from population of thymic cells of neural crest origin. We present the case of a 43-year-old man with a corticotropin hormone (ACTH) secreting thymus carcinoid. 111In-octreotide scintigraphy demonstrated an intense uptaken on the lesion. The surgical specimen measured 17 x 18 x 18 cm and weighed 1. 25 kg. Postoperatively the patient was treated by chemotherapy and radiotherapy. A follow-up 111In-octreotide scintigraphy was normal. Very few scintigraphic images of these lesions have been published in the literature. Somatostatin receptor scintigraphy can be successful in the detection and follow-up of ACTH-secreting neuroendocrine tumors.

[Thoracic SPECT using (111 In-DTPA-D-Phe1)-octreotide in bronchial carcinoid syndrome]. / SPECT torácico mediante (111In-DTPA-D-Phe1)-octreótido en el carcinoide bronquial]

We describe two cases of bronchial carcinoid tumour detected by (111In-DTPA-D-Phe1)-octreotide scintigraphy. The SPECT of the thoratic region provided a better images of the primary tumour than the planar images. In one of the patients, the bronchial carcinoid tumour was associated with sarcoidosis, which led to an erroneous evaluation of the extension of the tumour.

[Favorable response to cisapride in acute colonic pseudo-obstruction (Ogilvie's syndrome)]. / Favorable respuesta a la cisaprida en la pseudobstrucción aguda del colon (Síndrome de Ogilvie).

Acute pseudobstruction of the colon (Ogilvie's syndrome) has been treated by different surgical, endoscopic and radiological procedures, but a high proportion of recurrences has been reported. Here, we report two cases that showed a fast and favorable response to oral cisapride, a prokinetic agent that may become the treatment of choice for these patients.

[Deficiency polyneuropathy secondary to immunoproliferative disease of the small intestine]. / Polineuropatía carencial secundaria a enfermedad inmunoproliferativa de intestino delgado.

We report a new case of immunoproliferative small intestinal disease with neurological involvement expressed as deficiency polyneuropathy. In spite of non identifiable plasmatic paraprotein, the use of immunohistochemical techniques showed the characteristic proliferation in the intestinal mucosa of plasma cells with a prevalence of IgA cells, which define this disease.