Diagnosis of elephantiasis nostras verrucosa as a clinical mani-festation of Kaposi's sarcoma / Diagnóstico de elefantiasis nostras verrucosa como mani-festación clínica del Sarcoma de Kaposi

Elephantiasis nostras verrucosa, a rare manifestation of Kaposi's sarcoma, is a progressive cutaneous hypertrophy caused by chronic non-filarial lymphedema secondary to obstruction of the lymphatic system that can lead to severe disfigurement of parts of the body that have gravity-dependent blood flow, due to edema, fibrosis, and hyperkeratosis, especially lower extremities. Among the various conditions that can induce chronic lymphedema are tumors, trauma, radiotherapy, obesity, hypothyroidism, chronic venous stasis, and AIDS-related Kaposi's sarcoma. Kaposi's sarcoma is a vascular tumor associated with the presence of human gammaherpesvirus 8 that is predominantly cutaneous, locally aggressive, with metastasis, and is associated with the production of factors that favor inflammation, lymphatic obstruction, and lymphedema.

Reporte de caso de granuloma facial, una vasculitis cutánea infrecuente / A case report of granuloma faciale, an uncommon cutaneous vasculitis

El granuloma facial es una dermatosis benigna poco frecuente de etiología desconocida, generalmente asintomática, caracterizada por inflamación crónica y localizada habitualmente en zonas fotoexpuestas de la cara, con un patrón histológico característico. Si bien la respuesta al tratamiento es variable, existen múltiples opciones terapéuticas que han reportado ser efectivas en algunos pacientes. Entre estas alternativas se incluyen tratamientos sistémicos con corticoides y dapsona o tratamientos intralesionales con corticoides, crioterapia e inhibidores de calcineurina tópicos. Describimos el caso de un paciente adulto con una placa eritemato violácea asintomática en mejilla derecha, de crecimiento lentamente progresivo de dos años de evolución, clínica e histopatológicamente compatible con granuloma facial y respuesta favorable a corticoides intralesionales.

Granuloma faciale is an uncommon benign dermatosis, with unknown etiology, usually asymptomatic, characterized by chronic inflammation localized in sun-exposed areas of the face with a characteristic histological pattern. Although response to treatment is variable, there are multiple therapeutic alternatives that have been reported to be effective in some patients, including systemic treatments with steroids and dapsone or also topical treatments like intralesional corticosteroid, cryotherapy and calcineurin inhibitors, such as tacrolimus. We present the case of an adult patient with an asymptomatic erythematous-violet plaque on the right cheek, with progressive slow growth over two years, clinically and histologically and pathologically compatible with a facial granuloma. The patient responded well to intralesional corticosteroids.

Sonography in pathologies of scalp and hair.

Disorders of the scalp often result in severe cosmetic interference with quality of life, creating the need for optimal medical surveillance. We tested the latest generation of ultrasound machines in patients with scalp pathology and prepared a cross-sectional library encompassing a wide assortment of conditions. Normative data on the sonographic anatomy of scalp and human hair, and important methodological considerations, are also included.

Hiperplasia nodular focal hepática / Liver focal nodular hyperplasia

Se presenta la experiencia en el manejo de 4 casos de hiperplasia nodular focal hepática, 2 de ellos de pequeños tamaño resecados en forma incidental durante la realización de otros procedimientos quirúrgicos. El tercer y cuarto caso son pacientes que consultaron con sensación de pesadez en el hipocondrio derecho en los cuales el estudio realizado con ECO, TAC, RNM y cintigrafía hepática plantearon el diagnóstico de hiperplasia nodular. En la lesión de mayor tamaño se realizó biopsia incisional que confirmó el diagnóstico. Se destaca que son lesiones poco frecuentes, generalmente asistomáticas y con escasa o nula tendencia a producir complicaciones, por lo cual su manejo es conservador, salvo en lesiones muy sintomáticas o de fácil resolución quirúrgica durante hallazgo incidental

[Radical resective surgery for the management of rectosigmoidal endometriosis. Clinical case]. / Cirugía resectiva radical en el manejo de la endometriosis rectosigmoidea. Caso clínico.

We report a 35 years old female with a profound rectosigmoidal endometriosis, who had been subjected to multiple laparoscopic procedures and open surgery due to infertility in the last five years. Main presenting symptoms were cyclic hematochezia during the menstrual periods associated to pelvic pain. Colonoscopy was inconclusive, barium enema showed a marked stenosis of the zone, appearing as an extrinsic compression. CAT scan showed a homogeneous, solid parauterine mass. During surgery, an inflammatory mass with multiple endometriotic foci was found. A low anterior resection with mechanical anastomosis was done, preserving the uterus and left adnexa. Two months later, the patient became pregnant and an elective cesarean section was done at 38 weeks of gestation, giving birth to a healthy newborn. Radical resective surgery for rectosigmoidal endometriosis is indicated in patients with intense and recurrent symptoms in whom hormonal treatment has failed and when a tumor cannot be discarded. The fertility rate, when adnexa and uterus are preserved, is 40% and symptomatic improvement is achieved in 85% of patients.

Neuropeptide gene transfer into neuronal and glial cell lines.

Procorticotrophin-releasing hormone (ProCRH) is the precursor to the hypothalamic neuropeptide CRH(1-41) which mediates the neuroendocrine response to stress. In neuroendocrine cells and neurones, peptide hormones and neuropeptides are targeted to the dense-core vesicles of the regulated secretory pathway. These vesicles are transported to the ends of the cellular processes where they are stored until they are released upon an external stimulus. In order to study the post-translational processing and intracellular trafficking of neuropeptides in neuronal cells we have established stably transfected Neuro2A cells and NG115-401L cells expressing proCRH. The expression vector used contains glutamine synthetase (GS) coding sequences which are used as a dominant selectable marker in cells already containing GS genes. The various clonal cell lines isolated express different levels of CRH as assessed using a specific radioimmunoassay (RIA) thus indicating that the level of expression of the exogenous gene must depend upon the site of chromosome integration. Using immunofluorescence labelling, we have demonstrated that in Neuro2A and NG115-401L cells proCRH is packaged in vesicles which accumulate at the tips of cellular processes.