Salinity-dependent expression of calcium-sensing receptors in Atlantic salmon (Salmo salar) tissues.

Multiple reports suggest that calcium-sensing receptors (CaSRs) are involved in calcium homeostasis, osmoregulation, and/or salinity sensing in fish (Loretz 2008, Herberger and Loretz 2013). We have isolated three unique full-length CaSR cDNAs from Atlantic salmon (Salmo salar) kidney that share many features with other reported CaSRs. Using anti-CaSR antibodies and PCR primers specific for individual salmon CaSR transcripts we show expression in osmoregulatory, neuroendocrine and sensory tissues. Furthermore, CaSRs are expressed in different patterns in salmon tissues where mRNA and protein expression are modified by freshwater or seawater acclimation. For example, in seawater, CaSR mRNA and protein expression is increased significantly in kidney as compared to freshwater. Electrophysiological recordings of olfactory responses produced upon exposure of salmon olfactory epithelium to CaSR agonists suggest a role for CaSRs in chemoreception in this species consistent with other freshwater, anadromous, and marine species where similar olfactory responses to divalent and polyvalent cations have been reported. These data provide further support for a role of CaSR proteins in osmoregulatory and sensory functions in Atlantic salmon, an anadromous species that experiences a broad range of environmental salinities in its life history.

Enfermedad de Mondor y mamoplastías / Mondor's disease and mammoplasty

Resumen Objetivo: Revisar la incidencia de esta enfermedad en pacientes sometidos a mamoplastías en una clínicaprivada en el período de 11 años, con el fin de describir sus síntomas y signos, diagnóstico, tratamiento y evolución. Materiales y Método: Se estudiaron 355 mujeres que se sometieron a mamoplastías estéticas. Se excluyó aquellas cirugías reconstructivas secundarias a cáncer de mama y aquellas con otros antecedentes oncológicos previos. La información fue recolectada de las fichas clínicas. Resultado: Se analizan 710 mamas operadas en el período 2008-2018, de las cuales seis mamas (6/710) evolucionaron con enfermedad de Mondor (0,8%). El diagnóstico se realizó clínicamente. Todos los casos recibieron terapia antiinflamatoria oral y local, respondiendo favorablemente. Discusión: Existe poca literatura publicada al respecto. Casos bilaterales son menos reportados. Pareciera asociarse con cirugías del surco submamario y no está claro que requiera curación terapéutica. Conclusiones: La enfermedad de Mondor es infrecuente, puede presentarse secundario a mamoplastías, es de diagnóstico clínico y sólo tratamiento sintomático con evolución satisfactoria sin secuelas.

Aim: Review the disease incidence in patients who had mammoplasties in a private clinic on a 11 year-period. The purpose is to describe their symptoms and signs, diagnosis, treatment and evolution. Materials and Method: 355 women who underwent cosmetic mammoplasties were studied. Those reconstructive surgeries secondary to breast cancer and those with other previous oncological history were excluded. The information was collected from clinical files. Results: 710 breasts operated between 2008-2018 are analyzed, six of them (6/710) evolved Mondor disease (0.8%). The diagnosis was made clinically. All cases received oral and local antiinflammatory therapy, responding favorably. Discussion: There is a few published literature about it. Bilateral cases are less reported. It appears to be associated with surgeries of the submammary sulcus and it is not clear that it requires therapeutic cure. Conclusions: Mondor's disease is infrequent, can occur secondary to mammoplasty, diagnosis is clinical, treatment is symptomatic, all cases had satisfactory evolution without sequelae.

Caracterización de los pacientes con tinnitus y hallazgos audiométricos

Resumen Introducción: El tinnitus se define como la percepción consciente de un sonido, en ausencia de un estímulo acústico externo correspondiente. Se ha relacionado a múltiples comorbilidades como hipertensión arterial (HTA), diabetes mellitus (DM) e hipoacusia, sin evidencia sólida en la actualidad. Hay diversas formas de experimentar el tinnitus, ya sea de comienzo unilateral o bilateral, intermitente o persistente, con deterioro de la calidad de vida, leve hasta formas invalidantes. El conocer las diversas patologías presentes en el tinnitus, en especial la hipoacusia, toma relevancia al momento de enfrentar a pacientes con dicha patología. Objetivo: Caracterizar el tinnitus y sus principales hallazgos audiométricos en pacientes atendidos en el Servicio de Otorrinolaringología del Hospital Clínico Herminda Martín de Chillán, Chile. Material y Método: Estudio retrospectivo. Se incluyeron pacientes mayores de 18 años con diagnóstico de tinnitus entre los años 2015-2017. Se obtuvo información epidemiológica, comorbilidades, presentación clínica del tinnitus en función de lateralidad y frecuencia, hipoacusia asociada y hallazgos audiométricos. Resultados: Se incluyeron en el estudio a 249 pacientes, la mayoría mujeres (70%) con una edad promedio de inicio de su tinnitus entre 60-79 años (52%). Entre las principales comorbilidades se encuentran la hipertensión arterial, diabetes mellitus y patologías autoinmunes; los síntomas otorrinolaringológicos acompañantes estuvieron en menos del 10% de los casos. En relación a la caracterización del tinnitus, el 52% fue de inicio unilateral y el 66% de forma continua. La hipoacusia objetivada en el audiograma estuvo presente en el 43% de los pacientes con tinnitus. Conclusión: El tinnitus es una patología compleja y multifactorial, en este sentido, la presencia de hipoacusia objetiva en la audiometría estuvo presente en un 43% de los pacientes, siendo una de las principales causas a descartar por el médico en el primer enfrentamiento del paciente.

Abstract Introduction: tinnitus is defined as the conscious perception of a sound, in the absence of a corresponding external acoustic stimulus. It has been related to multiple comorbidities such as high blood pressure, diabetes mellitus, hearing loss, with no solid evidence at present. There are various ways to experience tinnitus, whether it is unilateral or bilateral, intermittent or persistent onset, from mild quality of life deterioration to disabling forms. Knowing the various pathologies present in tinnitus, especially hearing loss, becomes relevant when confronting patients with this pathology. Aim: To characterize tinnitus and its main audiometric findings in patients treated at the Otorhinolaryngology Service of the Herminda Martin of Chillán Clinical Hospital in Chile. Material and Method: Retrospective study. Patients older than 18 years with a diagnosis of tinnitus between the years 2015-2017 were included. Epidemiological information, comorbidities, clinical presentation of tinnitus according to laterality and frequency, associated hearing loss and audiometric findings were obtained. Results: 249 patients were included. Most were women (70%), with an onset average age of tinnitus between 60 to 79 years (52%). The accompanying otorhinolaryngological symptoms were in less than 10% of the cases. The main comorbidities were high blood pressure, diabetes mellitus and autoimmune pathologies. 52% of tinnitus was unilateral presentation and in 66% it was continuous. 43% had hypoacusis objectified on the audiogram, regardless of whether they had the sensation of hearing loss. Conclusion: Tinnitus is a complex and multifactorial pathology, in this sense, the presence of objective hearing loss in audiometry was present in 43% of patients, being one of the main causes to be ruled out by the doctor in the patient's first confrontation.

Colgajo giratorio retroauricular / Retroauricular flip-flop flap

Resumen El colgajo retroauricular en isla (flip-flop flap) fue descrito por Masson en 1972 y consiste en tejido dermoepidérmico irrigado por un pedículo de patrón aleatorio subcutáneo de ramas de la arteria auricular posterior. Proviene de la región mastoidea y retroauricular y aporta buena cobertura para la región anteromedial del pabellón auricular. Se describen dos casos, en que se realizó cobertura inmediata secundario a un defecto de la concha auricular posterior a resección neoplásica, obteniendo resultados satisfactorios y sin complicaciones.

Abstract The retroauricular island flap (flip-flop flap), was described by Masson in 1972 and consists on dermoepidermal tissue irrigated by a random subcutaneous pedicle of branches of the posterior auricular artery. It comes from the mastoid and retroauricular region and provides a good coverage for the anteromedial region of the pinna. Two cases are described, in which immediate coverage was performed secondary to a defect in the auricular concha after a neoplastic resection, obtaining satisfactory results without complications.

Colgajo C-V y tatuaje: una alternativa para reconstrucción aréola pezón / Nipple areola reconstruction with c-v flap and tatoo: experience in 18 patients

Introducción : La reconstrucción del complejo aréola pezón es el complemento final de la reconstrucción mamaria. Su objetivo es dar naturalidad a la nueva mama reconstruida y simetría con la mama opuesta. Para ello se han descrito numerosas técnicas que combinan colgajos locales, injertos y tatuajes no existiendo en la literatura actual, claras ventajas a favor de algunas de ellas. Material y Métodos: Ensayo clínico controlado de una serie de 16 mujeres a las cuales se les reconstruyó 18 complejos aréolas pezón, con técnica asociada de colgajo C-V para pezón y tatuaje intradérmico areolar, en el Hospital Clínico Regional de Concepción, entre los años 2003 y 2004. El promedio fue de seguimiento de 17 meses. Se analiza la proyección del pezón y diámetro areolar reconstruido, comparándolos con el opuesto. Se mide además el grado de satisfacción de la paciente a través de encuesta y se registran las complicaciones. Resultados: La proyección promedio del pezón reconstruido fue de 5,5 mm comparado con el contralateral de 6,1 mm. No hubo diferencias estadísticas significativas entre ellos (p= 0,39). La aréola tatuada midió promedio 21,58 mm² comparada con la cotralateral de 20,06 mm². Tampoco hubo diferencias estadísticas significativas entre ellas (p=0,21). Hubo sólo una complicación menor en un areola (5,5 por ciento). La satisfacción global fue registrada como adecuada en 87,5 por ciento de las pacientes. Conclusión: La técnica del colgajo C-V y tatuaje intradérmico es una alternativa adecuada para la reconstrucción de aréola pezón, ya que logra adecuada simetría con el complejo opuesto, aceptable mantención de proyección y volúmenes en el tiempo, escasas complicaciones y alto grado de satisfacción de las pacientes.

Presentación mamográfica y compromiso axilar en cáncer de mama específico / Comparison of mammographic presentation of mucinous and medullary cancer with infiltrating ductal cancer

Introducción: El cáncer de mama Mucinoso puro y Medular típico, corresponden a carcinomas específicos que presentan características diferentes al cáncer ductal invasor STE (sin ningún tipo especial). Pueden presentarse como nódulos mamográficos de aspectos benigno y asociarse con baja frecuencia a invasión axilar. Material y Método: Estudio de corte transversal con grupo testigo que analiza 718 pacientes con cáncer de mama atendidos en la Unidad Patología Mamaria del Hospital Clínico Regional de Concepción, entre los años 1996-2004, seleccionando un grupo de 15 pacientes con cáncer específico (2,1 por ciento), compuesto por 12 pacientes con carcinoma Mucinoso puro y 3 con carcinoma Medular típico comparándolo con otro grupo de 15 pacientes con cáncer ductal invasor STE. El objetivo de este trabajo es analizar los resultados de ambos grupos y establecer si existen diferencias significativas en la presentación mamográfica, a través de la clasificación de birads y el grado de compromiso axilar. Resultados: De los pacientes con carcinoma Mucinoso puro y Medular típico hubo un 31 por ciento de presentación mamográfica considerada birads 2 ó 3, comparado con los carcinomas STE en que no hubo presentación mamográfica de aspecto benigno, sin embargo, esta diferencia no fue estadísticamente significativa. En la axila, para los carcinomas específicos hubo un 7,6 por ciento con invasión comprado con el 66 por ciento para los STE, siendo esta diferencia estadísticamente significativa. Conclusión: Los carcinomas Mucinosos puros y Medulares típicos de mama, a diferencia de carcinomas ductales invasores STE, pueden presentarse como nódulos mamográficos de aspecto benigno e invaden con menos frecuencia la axila, siendo esta última diferencia estadísticamente significativa.

Detection of salinity by the lobster, Homarus americanus.

Changes in the heart rates of lobsters (Homarus americanus) were used as an indicator that the animals were capable of sensing a reduction in the salinity of the ambient seawater. The typical response to a gradual (1 to 2 ppt/min) reduction in salinity consisted of a rapid increase in heart rate at a mean threshold of 26.6 +/- 0.7 ppt, followed by a reduction in heart rate when the salinity reached 22.1 +/- 0.5 ppt. Animals with lesioned cardioregulatory nerves did not exhibit a cardiac response to changes in salinity. A cardiac response was elicited from lobsters exposed to isotonic chloride-free salines but not to isotonic sodium-, magnesium- or calcium-free salines. There was little change in the blood osmolarity of lobsters when bradycardia occurred, suggesting that the receptors involved are external. Furthermore, lobsters without antennae, antennules, or legs showed typical cardiac responses to low salinity, indicating the receptors are not located in these areas. Lobsters exposed to reductions in the salinity of the ambient seawater while both branchial chambers were perfused with full-strength seawater did not display a cardiac response until the external salinity reached 21.6 +/- 1.8 ppt. In contrast, when their branchial chambers were exposed to reductions in salinity while the external salinity was maintained at normal levels, changes in heart rate were rapidly elicited in response to very small reductions in salinity (down to 29.5 +/- 0.9 ppt in the branchial chamber and 31.5 +/- 0.3 ppt externally). We conclude that the primary receptors responsible for detecting reductions in salinity in H. americanus are located within or near the branchial chambers and are primarily sensitive to chloride ions.

Thermosensitivity of the lobster, Homarus americanus, as determined by cardiac assay.

It is generally accepted that crustaceans detect, and respond to, changes in water temperature, yet few studies have directly addressed their thermosensitivity. In this investigation a cardiac assay was used as an indicator that lobsters (Homarus americanus) sensed a change in temperature. The typical cardiac response of lobsters to a 1-min application of a thermal stimulus, either warmer (n = 19) or colder (n = 17) than the holding temperature of 15 degrees C, consisted of a short bradycardia (39.5 +/- 8.0 s) followed by a prolonged tachycardia (188.2 +/- 10.7 s). Lobsters exposed to a range of rates of temperature change (0.7, 1.4, 2.6, 5.0 degrees C/min) responded in a dose-dependent manner, with fewer lobsters responding at slower rates of temperature change. The location of temperature receptors could not be determined, but lesioning of the cardioregulatory nerves eliminated the cardiac response. Although the absolute detection threshold is not known, it is conservatively estimated that lobsters can detect temperature changes of greater than 1 degree C, and probably as small as 0.15 degrees C. A comparison of winter and summer lobsters, both held at 15 degrees C for more than 4 weeks, revealed that although their responses to temperature changes were similar, winter lobsters (n = 18) had a significantly lower baseline heart rate (34.8 +/- 4.4 bpm) and a shorter duration cardiac response (174 s) than summer lobsters (n = 18; 49.9 +/- 5.0 bpm, and 320 s respectively). This suggests that some temperature-independent seasonal modulation of cardiac activity may be occurring.

Biogeographic patterns in Mediterranean and Macaronesian species of Saxifraga (Saxifragaceae) inferred from phylogenetic analyses of ITS sequences.

A biogeographic study of Saxifraga section Saxifraga was performed based on phylogenetic analyses of ITS (internal transcribed spacer) sequences of nuclear ribosomal DNA. ITS sequences from 21 species and 31 populations were examined to identify colonization patterns for the two species of Saxifraga occurring in Macaronesia and for S. globulifera in the west Mediterranean basin. Phylogenetic analysis of the sequence data yield a single most parsimonious tree with many of the major clades well supported by bootstrap and decay values. The ITS tree provided resolution at specific and populational levels that points to two biogeographic patterns within the genus. In contrast to the molecular evidence provided by other authors for a Mediterranean origin of several Macaronesian genera of angiosperms, our results indicate that the Madeiran archipelago was colonized a single time by a species of Saxifraga originating from the Eurosiberian region. On the other hand, the molecular evidence also suggests that populations of S. globulifera from North Africa have been isolated for a long time from populations occurring in the Iberian Peninsula, and that the endemic S. reuteriana has evolved from the Iberian populations of S. globulifera. The Mediterranean Sea has probably been an effective isolating barrier for some plant groups that occur in Europe and North Africa.

Behavioral thermoregulation in the American lobster Homarus americanus.

It is generally accepted that water temperature has a strong influence on the behavior of the American lobster Homarus americanus. However, there is surprisingly little behavioral evidence to support this view. To characterize the behavioral responses of lobsters to thermal gradients, three different experiments were conducted. In the first, 40 lobsters acclimated to summer water temperatures (summer-acclimated, 15.5±0.2 °C, mean ± s.e.m.) were placed individually in an experimental shelter, and the temperature in the shelter was gradually raised until the lobster moved out. Lobsters avoided water warmer than 23.5±0.4 °C, which was an increase of 8.0±0.4 °C from ambient summer temperatures. When this experiment was repeated with lobsters acclimated to winter temperatures (winter-acclimated, 4.3±0.1 °C), the lobsters (N=30) did not find temperature increases of the same magnitude (T=8.0±0.4 °C) aversive. The second experiment was designed to allow individual summer-acclimated lobsters (N=22) to select one of five shelters, ranging in temperature from 8.5 to 25.5 °C. After 24 h, 68 % of the lobsters occupied the 12.5 °C shelter, which was slightly above the ambient temperature (approximately 11 °C). In a similar experiment, winter-acclimated lobsters (N=30) were given a choice between two shelters, one at ambient temperature (4.6±0.2 °C) and one at a higher temperature (9.7±0.3 °C). Winter-acclimated lobsters showed a strong preference (90 %) for the heated shelter. In the final experiment, summer-acclimated lobsters (N=9) were allowed to move freely in a tank having a thermal gradient of approximately 10 °C from one end to the other. Lobsters preferred a thermal niche of 16.5±0.4 °C and avoided water that was warmer than 19 °C or colder than 13 °C. When standardized for acclimation temperature, lobsters preferred water 1.2±0.4 °C above their previous ambient temperature. Collectively, the results of these studies indicate that lobsters are capable of sensing water temperature and use this information to thermoregulate behaviorally. The implications of these findings for lobster behavior and distribution in their natural habitat are discussed.

Prevention of severe mucosecretory ear disease and its complications in patients with cleft lip and palate malformations.

Morphological and functional alterations in patients with cleft lip and palate act as predisposing factors in eustachian tube dysfunctions and as a result thereof in the occurrence of mucosecretory ear disease (MSED) and its complications. Development of MSED is the result of tube dysfunction and it consists of: (a) fluctuating conductive hearing loss, (b) swallowing alterations and (c) respiratory functional disorders. Once this syndrome is confirmed in children with clefts, action must be taken through a coordinated multidisciplinary approach with plastic surgery, odontology, and speech therapy to achieve morphological and functional reconstruction, thus allowing early middle ear ventilation.