La cirugía ocular en el Corpus hippocraticum / Ocular surgery in Hippocratic corpus

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Sarcoidosis: a Critical Review of History and Milestones.

Sarcoidosis is a chronic systemic disease of unknown origin and uncertain prognosis that most commonly affects young adults, and frequently presents with bilateral hilar lymphadenopathy, pulmonary infiltrates and ocular and skin lesions. The diagnosis is established when characteristic clinical-radiological features are supported by compatible histopathology of epithelioid cell granulomas, following exclusion of known causes of granulomatous inflammation. Indeed, sarcoidosis belongs to a large family of disorders that share granuloma formation as common denominator. Since its first description by Jonathan Hutchinson in 1869, sarcoidosis has generated enormous interest and considerable controversy. In Hutchinson's day, it was considered a dermatological condition, which gradually evolved into a multisystem disorder associated in the majority of cases with respiratory abnormalities. With time, it has also become clear that sarcoidosis occurs throughout the world, affecting individuals of both genders and all races, although its prevalence varies widely across ethnic and racial groups. In recent years, advances in different disciplines, particularly biochemistry, genetics, immunology and molecular biology, have improved dramatically our understanding of the disease. Yet, the critical questions regarding who gets sarcoidosis and whether it has an infectious origin remain unanswered. Sarcoidosis has a distinguished medical history that covers the last 150 years. Right from the time of seminal contributions by Hutchinson, Besnier and Boeck medical discussion on sarcoidosis has always been animated and to a certain extent emotional. Such discussions will inevitable continue until the true cause of the disease has been found, hopefully in the near future.

Dermatofitosis atípica en un paciente con SIDA / Atypical dermatophytosis in a patient with AIDS

Presentamos el caso de un varón de 37 años VIH positivo, con nódulos subcutáneos faciales, sin historia previa de infección micótica superficial. El estudio histológico mostraba granulomas en dermis centrados por estructuras fúngicas. En cultivos repetidos se identificó Microsporum canis (AU)

Estudio hispatológico de granuloma apical / Apical granuloma, histopathological study

Teniendo en cuenta la frecuencia con que aparece las lesiones periapicales crónicas en pacientes odontológicos, su distribución por edad, sexo y tipo de lesión. Para tal fín se recolectaran un total de nueve muestras procesadas y teñidas con hematoxilina-eosina. Dos de las muestras fueron observadas con microscopía-electrónica. De las muestras obtenidas seis correspondieron a granuloma periapical; un quiste periapical, un granuloma periapical abscedado; un fragmentos óseos necrozados. Histológicamente hubo predominio de tejidos fibroconectivo, infiltrado inflamatorio linfoplasmocitario, neutrofilos, cuerpos de Russell, histiacitos espumosos. En cuanto a edad y sexo, se encontraron: 1 lesión en el grupo de 0-14 años (11,11 por ciento); dos en el grupo de 15-29 años (22,22 por ciento); y 6 en el grupo de 30-44 años (55,55 por ciento). De las muestras obtenidas de mayores (66,66 por ciento), y tres de hombres (33,33 por ciento). En conclusión, de las lesiones estudiadas, algunas presentaron evolución a quiste, mientras que otras manifestaron reacciones inflamatorias o cuerpos extraños que trataron de ser identificadas por medio de fluorescencia y polarización. Además encontramos que en las lesiones con diagnóstico de Granuloma Periapical, se encontraron cuerpos Rossell e histiocitos espumosos, células que no se hallaron en las lesiones con diagnósticos diferentes

A new morphological concept and classification of granulomatous inflammation: the polar granulomas.

An historical analysis of granulomas and a new morphological concept and classification of granulomatous inflammation, the polar-granulomas, are presented. The historical analysis of the concept of granulomas reveals that the still proclaimed confusion concerning the process was due more to Virchow's comparison of granulomas to ordinary granulation tissue than to tumors and to objections of pathologists to Metchnikoff's theory of phagocytosis. And it is strange to verify that differences between granulomas and granulation tissue, although already established in the end of the 19th Century, were overlooked by the majority of pathologists. In this Century , the knowledge of granulomatous inflammation was greatly improved by Aschoff 's concept of reticulum endothelial system, Mitsuda test for types of leprosy, Jadassohn- Lewandowsky law, South American classification of leprosy into polar forms, and Forbus contribution to histogenesis and morphological classification of granulomas. The best model for the study of granulomatous inflammation is leprosy, because this disease is characterized by two different clinical polar forms, each one having particular types of phagocytosis (complete or incomplete) and of granulomas (tuberculoid or non tuberculoid). Based on the phenomenon of phagocytosis, polar forms of leprosy, Jadassohn- Lewandowsky law, metamorphosis of macrophages and nature of the etiologic agent, granulomas can be defined as a reactional hyperplasia of macrophages towards inanimate agents and towards animate agents of low virulence. Also based in the same data, a morphological classification of granulomas into polar types, tuberculoid and non tuberculoid, is proposed. The polar tuberculoid type follows the Jadassohn- Lewandowsky law, its etiologic agent is absent or scarce (complete phagocytosis) - and comprise two sub-types: tubercle-like and sarcoid-like. The polar non tuberculoid type does not follow the Jadassohn- Lewandowsky law, its etiologic agent is always present or copious (incomplete phagocytosis) and comprises two sub-types: giant cell and persistent macrophage. In the latter case, macrophages behave as a culture medium cell or as a storage cell. When both polar tuberculoid and non tuberculoid structures are found together in the same disease, granuloma can be called interpolar . If both types occur simultaneously in the same disease, granuloma would be bipolar. It seems that the proposed definition of granulomas combines morphology with functional activity of macrophages, easily observed in routine histopathological examination by optical microscopy. This morphological classification into polar granulomas (ABSTRACT TRUNCATED AT 250 WORDS)