Incidental benign metastasizing leiomyoma in a patient with bone sarcoma: a case report.

Background. The benign metastasizing leiomyoma is an exceptionally rare entity; it presents with ectopic leiomyoma nodules with a benign pattern. Symptoms vary according to the anatomic location. The diagnosis is histopathological, usually in patients with history of hysterectomy. Case Presentation. A 36-year-old female with 2-month history of left knee pain was diagnosed with bone fibrosarcoma. A CT scan showed pulmonary nodules. The patient started neoadjuvant chemotherapy. Conservative surgery of pelvic limb was achieved. A new CT scan reported pulmonary nodules that remained in relation to the previous CT. A nodule resection by thoracotomy and TOB (transoperative biopsy) was performed. The final pathology report described benign proliferative lesions consistent with benign metastatic leiomyoma. Conclusions. Benign metastatic leiomyoma is a rare condition presenting with uterine and extrauterine nodules most commonly in the lung. The diagnosis is histopathological. The surgical procedure must be reserved for selected patients.

Evaluation of a surgical simulator as used by students with different experience levels.

BACKGROUND: Historically, the operating room has been the training setting for both surgeons and students. Nowadays, an alternative is represented by surgical simulators. In the same way a not-very-well-built mirror cannot reflect trustworthy images (distortion), a not well-built, calibrated or programmed simulator will be unable to reflect the training level of the operator. Our aim is to indirectly evaluate the Surgical SIM® simulator. METHODS: Twelve surgical residents were classified according to novices, intermediates and experts, and 15 tasks were applied with three dimensions of evaluation in each using the Surgical SIM® simulator. Pearson's correlation test was used to establish validity. RESULTS: In general, from the three dimensions evaluated, results showed a statistically significant difference for time (p = 0.001), trajectory (p = 0.01) and errors (p = 0.001). CONCLUSIONS: Effectiveness of Surgical SIM® was indirectly demonstrated.

[Twelve years of liver transplant at the San José-Tec De Monterrey Hospital]. / Doce años de trasplante hepáitico continuo en el Hospital San José-Tec de Monterrey.

BACKGROUND: Liver transplantation is the only curative alternative for patients with end stage liver disease or acute liver failure. AIM: To report the experience of a single transplant center in Mexico. MATERIAL AND METHODS: Fifty-five transplants in 54 adult patients were analyzed between 1999 and 2011 in a single private institution. All grafts were obtained from deceased donor. Surgical technique, donor and recipient demographics, complications, causes of death and overall survival are described. Results were expressed as range and percentages. A Kaplan-Meier survival curve was done to analyze patient and graft survival. RESULTS: Main cause of cirrhosis was hepatitis C virus infection followed by alcohol intake. A 16% of patients developed biliary complications without graft loss, and vascular complications were observed in 15%. Patient survival at one and five years was 83% and 76%, respectively. CONCLUSIONS: Complication rates and survival in our center are comparable to those in the United States and Europe.