Bisphosphonate-related osteonecrosis. Application of adipose-derived stem cells in an experimental murine model.

BACKGROUND: Bisphosphonate-related osteonecrosis of the jaw is a pathological condition without effective established treatment and preventive strategies. The aim of this study was to analyse the effect of adipose-derived stem cells (ASC) in an experimental murine model of osteonecrosis. MATERIAL AND METHODS: 38 Wistar rats were injected intraperitoneally with zoledronic acid. After treatment, upper jaw molars were extracted. The animals were randomly assigned to one of two groups. In the control group, saline solution was applied over the alveolar sockets after the tooth extractions. In the treatment group, ASCs were applied instead of saline solution. The control and treatment groups were subdivided based on the time of euthanasia. A clinical and histological analysis was performed. RESULTS: The presence of osteonecrosis in alveolar bone was observed in a similar distribution in both groups. In the ASC-treated group, new bone formation was greater than in controls. CONCLUSION: In this study, application of ASCs showed greater new bone formation in an osteonecrosis-like murine model. Previous inhibited post-extraction bone remodelling could be reactivated, and these findings appeared to be secondary to implantation of ASCs.

Beckwith-Wiedemann Syndrome: Open bite evolution after tongue reduction.

BACKGROUND: Macroglossia causes functional deficits such as airway obstruction, drooling, phonation difficulties, and leads to protrusion of dentoalveolar structures resulting in an anterior open bite and a prognathic mandibular appearance. Macroglossia is present in the majority of patients with Beckwith-Wiedemann syndrome (BWS) and surgical treatment may be indicated. MATERIAL AND METHODS: A retrospective review was conducted including BWS patients who underwent surgical tongue reduction between 2000 and 2015 at the Hospital Universitario La Paz, Madrid. RESULTS: Out of 16 patients with BWS, surgery was performed in 11 cases. Tongue protrusion with open bite was the main indication for surgical treatment. Reduction glossectomy was performed using the keyhole technique. We analysed the relationship between age at surgery and evolution of open bite. Complications were minimal and satisfactory outcomes were observed with a decrease in anterior open bite. CONCLUSIONS: In this study we have observed that surgical treatment in patients with BWS and open bite accompanied by macroglossia seems to provide positive results with a satisfactory outcome in dentoskeletal alterations.

Factores relacionados con la cirugía secundaria en la reconstrucción mamaria autóloga con tejido libre abdominal / Secondary surgery related factors in autologous breast reconstruction using abdominal free tissue

La reconstrucción mamaria con colgajo libre abdominal se ha convertido en la opción terapéutica de elección en nuestro centro hospitalario cuando se necesita abundante cantidad de tejido. La culminación de este tipo de reconstrucción requiere un número variable de procedimientos auxiliares de retoque. Revisamos las historias de las pacientes sometidas en nuestro centro a reconstrucción mamaria con colgajo libre abdominal entre enero de 2010 y diciembre de 2013. El criterio de inclusión fue la reconstrucción del pezón como última cirugía. Las pacientes fueron estratificadas atendiendo a factores relacionados con la reconstrucción microquirúrgica y la existencia de radioterapia adyuvante. Analizamos el número y tipo de procedimientos y cirugías de retoque, así como el tiempo transcurrido hasta completar el proceso de reconstrucción. En total, recogimos 68 pacientes reconstruidas con colgajo libre abdominal. De ellas, 31 (45,6%) completaron la reconstrucción mamaria. La media de procedimientos fue de 3,2 por paciente, con una media de 2,4 tiempos quirúrgicos y un tiempo medio de 15,5 meses hasta la reconstrucción del pezón. El momento de la reconstrucción, la bilateralidad, el tratamiento con radioterapia y la presencia de complicaciones tempranas del colgajono se relacionaron con diferencias estadísticamente significativas en la tasa de cirugía secundaria. Los colgajos libres abdominales necesitan frecuentemente cirugías secundarias para mejorar el resultado y terminar la reconstrucción. Remarcamos la necesidad de planificar la reconstrucción desde el primer tiempo quirúrgico para disminuirla necesidad de cirugías de retoque y el tiempo hasta completarla reconstrucción mamaria (AU)

Breast reconstruction using abdominal free flaps has become the therapeutic choice at our center when a lot of tissueis needed, The completion of this reconstructive technique requires a variable number of ancillary procedures. Patients who underwent breast reconstruction with abdominal free flap at our center between January 2010 and December2013 were reviewed. The inclusion criterion was completion to nipple reconstruction. The patients were stratified attending to microsurgical reconstruction related factors and adjuvant radiotherapy. Number and sort of procedures and surgeries, and total elapsed time to complete the reconstruction were analyzed. Sixty-eight patients underwent reconstruction using abdominal free flap; 31 (45.6%) completed breast reconstruction. The average of procedures, surgical steps and elapsed time was3.2, 2.4 and 15.5 months respectively. Surgical time and bilateral procedures, treatment with radiotherapy and early flap complications were not related to statistically significant differences in secondary surgery rates. Abdominal free flaps often need secondary surgeries to improve the result and finish the reconstruction. We remark the necessity of planning the reconstruction since first surgical time to diminish the secondary surgeries and the elapsed time until completion of breast reconstruction (AU)

Diagnóstico histológico del tumor fibromixoide osificante: 2 casos en los últimos 20 años / Histologic diagnosis of ossifying fibromyxoid tumor: 2 cases in the past 20 Years

No disponible

Polyetheretherketone custom-made implants for craniofacial defects: Report of 14 cases and review of the literature.

BACKGROUND: Craniofacial defects tend to carry functional and esthetic consequences for the patient. The complex shapes in this region make such reconstructions a challenging procedure and the most suitable material to be used remains controversial. METHODS: We report a series of 14 patients whose craniofacial defects were reconstructed using a computer designed PEEK-PSI (Polyetheretherketone- Patient Specific Implant). We analyzed the complications and outcomes of PEEK custom-made implants and compared our results with those of other case series reported in the current literature. RESULTS: Fourteen patients underwent craniofacial reconstruction using a PEEK-PSI. Three cases involved a one-step primary reconstruction and the rest of cases underwent a delayed reconstruction. Two cases (14.3 %) presented infection and only in one case was the implant definitively removed. Esthetic results were considered to be highly satisfactory. CONCLUSION: With CAD-CAM techniques, it is possible to prefabricate an individual implant. The ideal material for reconstructing maxillofacial defects does not exist, but PEEK has demonstrated good outcomes. When autologous bone is not available or, in selected cases with large or complex defects in the maxillofacial area, PEEK is one of the best options to reconstruct these defects. However, further studies are needed to determine the long-term results.

Opciones quirúrgicas actuales en el tratamiento del linfedema crónico / Current surgical options in the treatment of chronic lymphedema

El linfedema, con independencia de su origen, continúa suponiendo un reto terapéutico, en especial aquellos casos resistentes a las medidas conservadoras. En los últimos 60 años se han desarrollado multitud de técnicas que pretenden dar una solución quirúrgica a esta compleja afección, con resultados dispares. El presente trabajo tiene por objeto ofrecer una visión global de estas técnicas, las indicaciones con las que se han aplicado, los resultados esperables y las potenciales complicaciones (AU)

Lymphedema, regardless of its origin, is a challenge in terms of treatment, particularly those refractory to conservative measures. During the last 60 years a multitude of techniques have been developed in an attempt to provide a surgical solution to this disease, with mixed results being obtained. This work tries to offer an overview of these techniques, the indications when they are applied, the results, and complications (AU)

The effect of in vitro ã-irradiation on mitogenic responsiveness of murine lymphocytes

The objective of this study was to analyze the proliferative response of BALB/cmice lymphocytes after in vitro irradiation (0.05 to 6 Gy). The capability of irradiatedlymphocytes for proliferating without any stimulation and after activation withspecific T and B cell mitogens has been evaluated. The results show that ionizingradiation significantly inhibits spontaneous cellular proliferation and that induced bymitogens and that variations in the degree of inhibition are found depending on theinducing proliferation mitogens and the dosage applied. The conclusion drawn is thatdifferent lymphocyte populations have different radiosensitivities, being B cells moresensitive to ionizing irradiation than T cells. Besides, the effects of gamma-irradiationvary according to the different subpopulations of T cells or, alternatively, to differentT-dependent activation mechanisms (AU)

No disponible

The effect of in vitro gamma-irradiation on mitogenic responsiveness of murine lymphocytes.

The objective of this study was to analyze the proliferative response of BALB/c mice lymphocytes after in vitro irradiation (0.05 to 6 Gy). The capability of irradiated lymphocytes for proliferating without any stimulation and after activation with specific T and B cell mitogens has been evaluated. The results show that ionizing radiation significantly inhibits spontaneous cellular proliferation and that induced by mitogens and that variations in the degree of inhibition are found depending on the inducing proliferation mitogens and the dosage applied. The conclusion drawn is that different lymphocyte populations have different radiosensitivities, being B cells more sensitive to ionizing irradiation than T cells. Besides, the effects of gamma-irradiation vary according to the different subpopulations of T cells or, alternatively, to different T-dependent activation mechanisms.

[Pleomorphic adenoma of the nasal cavity. A case report]. / Adenoma pleomorfo de la cavidad nasal. Presentación de un caso.

We present an extremely rare case of pleomorphic adenoma of the nasal cavity in a 31-year old woman who when to consultation because of right nasal obstruction. The radiologic discoveries by computerized tomography showed a tumor of the right nasal cavity with septal lysis. Incisional biopsy was done, with a histopathological report of pleomorphic adenoma. Later, surgical exeresis of the neoplasm was perform with the facial degloving technique and the histology revealed pleomorphic adenoma of the nasal cavity.

Effects of nordihydroguaiaretic acid on murine antibody-dependent cellular cytotoxicity.

The purpose of this study was to analyze the effects of nordihydroguaiaretic acid, an inhibitor of the lipoxygenase pathway of arachidonic acid, on antibody-dependent cellular cytotoxicity. Antibody-dependent cellular cytotoxicity mediated by murine spleen cells was significantly inhibited by concentrations of nordihydroguaiaretic acid from 10(-5) to 10(-4) M (1C50 = 2 x 10(-5) M). The inhibitory effect of nordihydroguaiaretic acid was also observed on antibody-dependent cellular cytotoxicity mediated by macrophage-depleted spleen cells as well as isolated macrophages. Nordihydroguaiaretic acid was highly effective when added at the beginning of the assay and was always present throughout the assay, but failed to inhibit the binding of effector and target cells. The inhibition produced by nordihydroguaiaretic acid could not be reversed by leukotriene B4, a 5-lipoxygenase product. These results suggest that arachidonic acid metabolites other than leukotriene B4 are released by different populations of spleen cells to positively regulate important events in the postbinding phase of murine antibody-dependent cellular cytotoxicity.

Seasonal variation in proliferative response and subpopulations of lymphocytes from mice housed in a constant environment.

A seasonal variation in the proliferative response to mitogens and in the proportion of splenic lymphocyte subpopulations was found in mice housed in a constant environment. The lymphoproliferative responses to T-cell and B-cell mitogens reached maximum values in autumn and summer. Identification of lymphocyte subpopulations by flow cytometry demonstrated that the proportion of T cytotoxic-suppressor (Tcs) lymphocytes was significantly higher in autumn and summer than in spring and winter. However, the proportion of B lymphocytes was significantly lower in spring than in the other three seasons, whereas the proportions of T and T helper (Th) cells did not show any seasonal variation. On the other hand, we observed a significant correlation between the level of mitogenic responsiveness and the proportion of Tcs cells, but not between the former and the proportions of B, T or Th cells. These data suggest that the seasonal variation in murine lymphoproliferative responses may depend on the cyclic changes in the proportion of Tcs lymphocytes; these changes, in turn, may be predetermined by the inherent internal biological rhythms of the animal.

Changes in total serum IgE concentrations after splenectomy.

In addition to allergic diseases, there are other disorders that can be accompanied by increased levels of total serum IgE. It has been demonstrated that splenectomy can alter the serum concentrations of other immunoglobulins. The aim of this study was to examine the concentrations of total IgE in the serum of patients splenectomized as a result of abdominal trauma but with no associated disease. Our results show that the average concentrations in the serum of patients were significantly higher that in the control group. Furthermore, in a large number of patients, the concentrations were above the normal limit set for the nonatopic Spanish population. These results suggest that splenectomy can alter the regulation of IgE concentrations. Since total IgE is usually determined for diagnostic purposes, it is useful to be aware of this anomaly when dealing with splenectomized patients in order to interpret correctly the laboratory analyses.

Differential effects of the calcium ionophore A23187 and the phorbol ester PMA on lymphocyte proliferation.

The effects of the phorbol ester, phorbol-12-myristate-13-acetate (PMA), and of the calcium ionophore A23187 on DNA synthesis in murine quiescent and mitogen-stimulated lymphocytes have been examined. Neither PMA nor A23187 had any mitogen effect on their own on quiescent lymphocytes. However, stimulation of cells sequentially with A23187 and then PMA resulted in a proliferative response in proportion to the duration of the exposure to A23187, and the sustained simultaneous presence of both agents was necessary for maximum proliferation. On the other hand, while short incubations with A23187 potentiated mitogen-induced DNA synthesis, prolonged exposure inhibited it. Furthermore, on lymphocytes stimulated with two T cell mitogens, the effects of A23187 and PMA depended on the proliferation-inducing mitogens and the responsiveness level induced by them. Therefore, while PMA and short pretreatments with A23187 had no effect on high intensity mitogenic responses, low intensity responses were significantly enhanced. These results demonstrate differential effects of A23187 and PMA on DNA synthesis that should be useful in studies on the mechanisms of activation of lymphocyte proliferation.

Autoantibodies in splenectomized patients as a consequence of abdominal trauma.

The presence of autoantibodies was examined in 100 adult patients splenectomized because of abdominal trauma and without systemic disease, and the results were compared with those observed in a healthy control group. Thirty-seven percent of the patients studied presented some type of autoantibody. Those observed were antinuclear, anti-smooth muscle and, in 1 case, anti-reticulin. Patients with antinuclear antibodies have no antibodies against native DNA, but in 5 cases, anti-Ro (SS-A) and anti-La (SS-B) antibodies were observed. Rheumatoid factors were also found, but their incidence was similar in patients and controls. The incidence of autoantibodies proved not to be related to either the period of time since splenectomy or to age of the patient; they were observed in patients many years after splenectomy and in individuals of both sexes and all ages. Although the presence of autoantibodies seemed to have no effect on our patients, all of whom were asymptomatic, it is important to be aware of this phenomenon when evaluating the laboratory results obtained from splenectomized patients.

Effects of lipoxygenase and cyclooxygenase inhibitors on murine antibody-dependent cellular cytotoxicity (ADCC).

The purpose of this study was to determine the effects that specific inhibition of arachidonic acid (AA) metabolism has on the antibody-dependent cellular cytotoxicity (ADCC) of murine spleen cells. The action of three inhibitors of the lipoxygenase (LO) pathway--nordihydroguaiaretic acid (NDGA), esculetin (Es), and phenanthroline (Phe)--was compared with that of three inhibitors of the cyclooxygenase (CO) pathway--indomethacin (INDO), acetyl salicylic acid (ASA), and imidazole (IMI). All the LO inhibitors suppressed ADCC function in a dose-dependent manner, but NDGA was the most potent inhibitor of this cytolytic activity. In fact, NDGA inhibited the ADCC function with 97% inhibition at 100 microM, while Phe and Es, at the same concentration, inhibited ADCC by 21% and 19%, respectively. However, CO inhibitors did not markedly affect ADCC function and only some doses of them had a slight, but significant, depressing effect (8-11% inhibition at 0.01-0.1 microM of INDO, 7% inhibition at 400 microM of ASA, and 13% inhibition at 800-1000 microM of IMI). These results suggest the LO pathway of the arachidonic acid metabolism plays an important role in regulating ADCC activity of murine spleen cells and the products of the CO pathway have little effect on ADCC lysis.