[Osteosynthesis with 2-octylcyanoacrylate and sodium bicarbonate in zygomatic arch fractures: animal model results]. / 2-octilcianoacrilato y bicarbonato de sodio para osteosíntesis de arco cigomático. Un modelo animal.

BACKGROUND: 2-octylcyanoacrylate (2OCA) is a liquid monomer that polymerizes on contact with a surface by an exothermic reaction creating a strong and flexible film. The addition of sodium bicarbonate accelerates the polymerization. The aim was to use the combination of 2OCA and sodium bicarbonate in the treatment of zygomatic arch fractures in an animal model and to evaluate the biocompatibility and bone healing. METHODS: twenty animals were subjected to bilateral zygomatic arch fracture under surgical sedation, and using 2OCA fixation and sodium bicarbonate for the experimental side and without fixation for the control side. Observation was over a period from two to four weeks, assessing biocompatibility, stability and consolidation. RESULTS: at the end of two and four weeks the twenty animals showed the presence of osseous callus and continuity of marrow channel measured by macroscopic and radiography examinations. CONCLUSIONS: the use of 2-octylcyanoacrylate and sodium bicarbonate led to the stabilization and reduction of bilateral zygomatic arch fractures in an animal model without adverse reactions.

[Küttner's tumour (chronic sclerosing sialadenitis). Clinical, pathological, and immunohistochemical study in 8 cases of a little-known entity]. / Tumor de Küttner (sialoadenitis crónica esclerosante). Estudio clinicopatológico e inmunohistoquímico de 8 casos de una entidad poco reconocida.

OBJECTIVE: To present the clinical-pathological characteristics of Küttner's tumour (KT) or chronic sclerosing sialadenitis. MATERIAL AND METHOD: We studied 8 cases of KT that were graduated histologically according to the Seifert grading system. An immunohistochemistry panel including CD20, CD3, and keratin AE1-3 was performed. RESULTS: All cases involved the sub-maxillary gland. Microscopically the cases were in stages 2, 3, and 4. There was a chronic inflammatory infiltrate, marked fibrosis, variable degrees of parenchymal atrophy, PAS+ intraluminal material, and microliths. The infiltrate was polymorphic and polyclonal, without lymphoepithelial lesions. CONCLUSIONS: Although it has a typical clinical and pathological presentation and was described more than a century ago, KT remains under-diagnosed and often reported as non-specific inflammatory infiltrate or as "low grade lymphoma". In this latter diagnosis lies the greatest importance for recognizing KT, as confusion with lymphoma would result in a different therapeutic approach.

[Appendiceal mucocele and gangrenous cholecystitis]. / Mucocele apendicular y colecistitis aguda gangrenada.

OBJECTIVE: We present a case report of appendiceal mucocele and gangrenous cholecystitis. SETTING: Hospital de Especialidades, Centro Médico Nacional Siglo XXI, México, D.F. CLINICAL CASE: An 80-year-old man was admitted to the hospital with diagnosis of acute cholecystitis and abdominal tumor under study, with complaints of abdominal pain for 10 days located in the right upper quadrant, without fever or significant weight loss. Laboratory analyses revealed moderate leucocytosis. CT of the abdomen revealed thickening of the gallbladder wall and acute local inflammation, as well as the presence of abdominal tumor in the right lower quadrant. The patient was surgically explored with the following findings: gangrenous cholecystitis and appendiceal tumor of 20 cm length. Cholecystectomy and appendectomy was performed. The postoperative period was normal. The final histological report was appendiceal mucocele and the patient was discharged after 5 days. The patient is currently without complaints at 5 months postoperatively.

Mucocele apendicular y colecistitis aguda gangrenada / Appendiceal mucocele and gangrenous cholecystitis

Objetivo: descripción de un caso de mucocele apendicular y colecistitis aguda gangrenada, atendido en el Hospital de Especialidades, Centro Médico Nacional Siglo XXI, IMSS. Caso clínico: hombre de 80 años de edad que ingresó al hospital con diagnóstico de colecistitis aguda y tumor abdominal de etiología desconocida, dolor abdominal de 10 días de evolución localizado en hipocondrio derecho, sin fiebre ni pérdida importante de peso. Los exámenes de laboratorio mostraron únicamente leucocitosis moderada. La tomografía computarizada abdominal mostró vesícula biliar con paredes engrosadas y datos de agudización, así como tumor abdominal en fosa iliaca derecha. Se exploró quirúrgicamente con los siguientes hallazgos: colecistitis aguda supurada y tumoración apendicular de 20 cm de longitud, sin datos de malignidad. Se realizó colecistectomía y apendicectomía. El periodo posoperatorio transcurrió sin incidentes. El diagnóstico histopatológico fue de mucocele apendicular no roto. El paciente fue dado de alta a los cinco días. Pasados cinco meses de la intervención, se encontraba asintomático.

OBJECTIVE: We present a case report of appendiceal mucocele and gangrenous cholecystitis. SETTING: Hospital de Especialidades, Centro Médico Nacional Siglo XXI, México, D.F. CLINICAL CASE: An 80-year-old man was admitted to the hospital with diagnosis of acute cholecystitis and abdominal tumor under study, with complaints of abdominal pain for 10 days located in the right upper quadrant, without fever or significant weight loss. Laboratory analyses revealed moderate leucocytosis. CT of the abdomen revealed thickening of the gallbladder wall and acute local inflammation, as well as the presence of abdominal tumor in the right lower quadrant. The patient was surgically explored with the following findings: gangrenous cholecystitis and appendiceal tumor of 20 cm length. Cholecystectomy and appendectomy was performed. The postoperative period was normal. The final histological report was appendiceal mucocele and the patient was discharged after 5 days. The patient is currently without complaints at 5 months postoperatively.

Tumor de Küttner (sialoadenitis crónica esclerosante). Estudio clinicopatológico e inmunohistoquímico de 8 casos de una entidad poco reconocida / Küttner's Tumour (Chronic Sclerosing Sialadenitis). Clinical, pathological, and immunohistochemical study in 8 cases of a little-known entity

Objetivo: Presentar las características clinicopatológicas del tumor de Küttner (TK) o sialoadenitis crónica esclerosante. Material y método: Se estudiaron 8 casos de TK. Se graduaron los casos histológicamente de acuerdo con la clasificación de Seifert. Se realizó una batería de anticuerpos contra CD20, CD3 y queratina AE1-3. Resultados: Todos los casos afectaron a la glándula submaxilar. Microscópicamente se encontraban en estadios 2, 3 y 4. Había inflamación crónica folicular y fibrosis acentuada, con atrofia parenquimatosa variable, material PAS+ intraluminal y microcalcificaciones. El infiltrado inflamatorio fue polimorfo, policlonal y sin lesiones linfoepiteliales. Conclusiones: A pesar de su descripción hace más de un siglo y su presentación clínica e histopatológica característica, el TK es poco diagnosticado y a menudo se informa como proceso inflamatorio inespecífico o como linfoma de bajo grado. En este último diagnóstico radica la mayor importancia del reconocimiento del TK, ya que resultaría en un manejo terapéutico diferente

Objective: To present the clinical-pathological characteristics of Küttner's tumour (KT) or chronic sclerosing sialadenitis. Material and method: We studied 8 cases of KT that were graduated histologically according to the Seifert grading system. An immunohistochemistry panel including CD20, CD3, and keratin AE1-3 was performed. Results: All cases involved the sub-maxillary gland. Microscopically the cases were in stages 2, 3, and 4. There was a chronic inflammatory infiltrate, marked fibrosis, variable degrees of parenchymal atrophy, PAS+ intraluminal material, and microliths. The infiltrate was polymorphic and polyclonal, without lymphoepithelial lesions. Conclusions: Although it has a typical clinical and pathological presentation and was described more than a century ago, KT remains under-diagnosed and often reported as non-specific inflammatory infiltrate or as "low grade lymphoma". In this latter diagnosis lies the greatest importance for recognizing KT, as confusion with lymphoma would result in a different therapeutic approach

Pancreatoduodenectomía en hemorragia de tubo digestivo. Reporte de un caso / Pancreaticoduodenectomy in digestive tract hemorrhage. Report of a case

Objetivo: describir la presentación clínica y el tratamiento de un paciente con neoplasia pancreática neuroendocrina y hemorragia de tubo digestivo. Antecedentes: los tumores neuroendocrinos del páncreas son neoplasias relativamente raras; cuando no son funcionantes el cuadro clínico es inespecífico y se manifiestan hasta que la neoplasia ha adquirido grandes dimensiones. La hemorragia masiva de tubo digestivo alto es una manifestación clínica poco frecuente de este tipo de tumores. Método: se presenta un caso en el cual se requiere tratar una hemorragia masiva de tubo digestivo alto con pancreatoduodenectomía de urgencia por una neoplasia ulcerada de la cabeza del páncreas. Conclusión: la pancreatoduodenectomía es sin duda el procedimiento de elección para control de la hemorragia masiva duodenal en presencia de una neoplasia neuroendocrina del páncreas ulcerada.