Zinner syndrome: a radiological journey through a little known condition.

Zinner syndrome is a rare congenital urological entity, secondary to an alteration in embryogenesis between 4th and 13th weeks of gestation, specifically because of abnormalities in the development of the distal mesonephric duct. It is characterized by the triad of unilateral renal agenesis, cystic dilatation of the ipsilateral seminal vesicle and ipsilateral ejaculatory duct obstruction. The aim of this article is to provide the reader with all the necessary information to be able to suspect the presence of this syndrome, reviewing its physiopathology, clinical manifestations and the imaging techniques that enable its diagnosis, emphasizing those radiological findings by MRI that should lead us to think about it. This work is illustrated with representative radiological images of cases belonging to our institution, including patients with different variants of Zinner syndrome. We also include an overview of the embryology of the male urogenital system, to remember the role of the mesonephric duct and the ureteral bud in the formation of the different urogenital structures, as well as a differential diagnosis that allows us to differentiate seminal vesicle cysts from other pelvic cystic lesions.

Ecotoxicology Evaluation of a Fenton-Type Process Catalyzed with Lamellar Structures Impregnated with Fe or Cu for the Removal of Amoxicillin and Glyphosate.

Antibiotics and pesticides, as well as various emerging contaminants that are present in surface waters, raise significant environmental concerns. Advanced oxidation processes, which are employed to eliminate these substances, have demonstrated remarkable effectiveness. However, during the degradation process, by-products that are not completely mineralized are generated, posing a substantial risk to aquatic ecosystem organisms; therefore, it is crucial to assess effluent ecotoxicity following treatment. This study aimed to assess the toxicity of effluents produced during the removal of amoxicillin and glyphosate with a Fenton-type process using a laminar structure catalyzed with iron (Fe) and copper (Cu). The evaluation included the use of Daphnia magna, Selenastrum capricornutum, and Lactuca sativa, and mutagenicity testing was performed using strains TA98 and TA100 of Salmonella typhimurium. Both treated and untreated effluents exhibited inhibitory effects on root growth in L. sativa, even at low concentrations ranging from 1% to 10% v/v. Similarly, negative impacts on the growth of algal cells of S. capricornutum were observed at concentrations as low as 0.025% v/v, particularly in cases involving amoxicillin-copper (Cu) and glyphosate with copper (Cu) and iron (Fe). Notably, in the case of D. magna, mortality was noticeable even at concentrations of 10% v/v. Additionally, the treatment of amoxicillin with double-layer hydroxides of Fe and Cu resulted in mutagenicity (IM ≥ 2.0), highlighting the necessity to treat the effluent further from the advanced oxidation process to reduce ecological risks.

Basaloid squamous cell carcinoma with prominent shadow (ghost) cell differentiation. An unreported neoplasm of the parotid gland.

Basaloid squamous cell carcinoma (BSCC) is an aggressive type of squamous cell carcinoma (SCC) predominant in the upper aerodigestive tract. To our knowledge, only one case of that tumor has been previously described in the parotid gland. Shadow (ghost) cell differentiation (SCD) is a specialized form of keratinization characteristic of pilomatricoma, and other skin tumors with follicular differentiation. SCD has also been described infrequently in some visceral carcinomas and rarely in the minor salivary glands. Recently, an SCC with prominent SCD has been reported in the parotid. We report for the first time the case of parotid BSCC with prominent SCD in an 87-year-old man. He was admitted due to the appearance in the last few months of a mass, painful on palpation, in the left parotid region. Imaging studies and tru-cut biopsies indicated the need for surgical removal. A left superficial parotidectomy, including the branch of the cervicofacial nerve, was performed. The BSCC showed predominance (62%) of SCD. Immunohistochemically, the basaloid cells were positive for ß-catenin, pan-cytokeratin (pan-CK) AE1∕AE3, CK19, high-molecular-weight CK (HMWCK), p63, p40, and cluster of differentiation 10 (CD10) in a diffuse pattern. No signs of recurrence or metastasis were observed four months after surgery. The main differential diagnoses include nuclear protein in testis (NUT) carcinoma, adamantinoma-like Ewing sarcoma, embryonal carcinoma, and basal cell adenocarcinoma of the solid type. SCD in BSCC of the parotid should be recognized to avoid misdiagnosis, especially in small samples. Although rare, BSCC with SCD should be added to the list of tumors that may originate in the parotid gland.

LDPE Transformation by Exposure to Sequential Low-Pressure Plasma and TiO2/UV Photocatalysis.

Low-density polyethylene (LDPE) sheets (3.0 ± 0.1 cm) received sequential treatment, first by the action of direct-current low-pressure plasma (DC-LPP) with a 100% oxygen partial pressure, 3.0 × 10-2 mbar pressure, 600 V DC tension, 5.6 cm distance, 6-min treatment. Then, sheets were submitted to TiO2 photocatalysis at UV radiation at 254 nm (TiO2/UV) with a pH value of 4.5 ± 0.2 and a TiO2 concentration of 1 gL-1. We achieved a complementary effect on the transformation of LDPE films. With the first treatment, ablation was generated, which increased hydrophilicity. With the second treatment, the cavities appeared. The changes in the LDPE sheets' hydrophobicity were measured using the static contact angle (SCA) technique. The photocatalytic degradation curve at 400 h revealed that the DC-LPP photocatalysis sequential process decreased SCA by 82°. This was achieved by the incorporation of polar groups, which increased hydrophilicity, roughness, and rigidity by 12 and 38%, respectively. These sequential processes could be employed for LDPE and other material biodegradation pretreatment.

Recomendaciones de diagnóstico y tratamiento del ataque cerebrovascular isquémico agudo durante la contingencia por covid-19 / Recommendations for diagnosis and treatment of the acute ischemic stroke during COVID-19 contingency

RESUMEN INTRODUCCIÓN. El tiempo es un factor importante en el tratamiento del ACV agudo, con la pandemia de covid-19 se puede ver afectada la adherencia a las guías. Se han reportado tasas de ACV en presencia de covid-19 alrededor del 5%, además un aumento en el tiempo de consulta de los pacientes en otras regiones del mundo y una mayor ocupación de camas de UCI para patologías respiratorias que usualmente se destinan a pacientes con ACV. Este documento recoge las recomendaciones del comité de Enfermedad Cerebrovascular de la Asociación Colombiana de Neurología basados en la literatura y votadas por consenso. OBJETIVOS. Proporcionar una guía rápida adaptada a los diferentes escenarios de atención de ACV en Colombia, divididos en centro listo, primario y avanzado incluyendo una ruta de atención para paciente con sospecha de covid-19 denominada Código ACV protegido, que incluye el uso de elementos de protección personal para pacientes y personal de salud. PUNTOS PRINCIPALES. Dentro de las recomendaciones principales está el cuestionario de tamizaje al ingreso a urgencias, uso de tapabocas para el paciente, considerar todo Código ACV sospechoso de covid-19, toma de PCR para covid-19 en todos los ACV y llevar a zona buffer. En sospecha de oclusión proximal incluir tomo-grafía de tórax a la evaluación de imágenes. CONCLUSIONES. Establecer pautas de atención durante la pandemia covid-19 permite optimizar protección para pacientes y personal de salud, disminuir retrasos y tratar de evitar que pacientes no reciban el tratamiento adecuado en los diferentes niveles de atención del sistema de salud.

SUMMARY INTRODUCTION. Time is an important factor in the treatment of acute stroke, with the COVID-19 pandemic adherence to guidelines can be affected. Stroke rates in the presence of COVID-19 have been reported around 5%, in addition to an increase in the consultation time of patients in other regions of the world and a greater occupation of ICU beds for respiratory pathologies that are usually intended for patients with stroke. This document contains the recommendations of the Cerebrovascular Disease Committee of the Colombian Neurology Association based on the literature and voted by consensus. OBJECTIVES. Provide a quick guide adapted to the different stroke care scenarios in Colombia, divided into ready, primary and advanced centers, including a care route for a patient with suspected COVID-19 called the protected stroke code, which includes the use of protection elements for the patient and the healthcare team. MAIN FACTS. Among the main recommendations are the screening questionnaire on admission to the emergency department, the use of face masks for the patient, considering all suspected stroke code as COVID-19, taking the PCR for COVID-19 in all strokes and taking them to the buffer zone. In suspected large vessel occlusion, include chest tomography to image evaluation. CONCLUSIONS. Establishing guidelines of care during the COVID-19 pandemic allows optimizing protection for patients and health care personnel, reducing delays and trying to avoid patients not receiving adequate treatment at different levels of attention in the health system.

Low-cost media statistical design for laccase rPOXA 1B production in P. pastoris.

Laccases (E.C. 1.10.3.2) are multicopper oxidases of great importance in the industry due to their non-specificity and high oxidative potential. Laccases are useful to bleach synthetic dyes, oxidize phenolic compounds and degrade pesticides, among others. Hence, the objective of this work was to optimize low cost culture media for recombinant (rPOXA 1B) laccase production from Pleurotus ostreatus in Pichia pastoris. To this end, low cost nitrogen sources were studied, such as malt extract, isolated soy protein and milk serum. Following, two central composite designs (CCD) were performed. In CCD-1 different concentrations of glucose USP (0-13.35 gL-1), protein isolated soy protein (5-25 gL-1), malt extract (3.5-17.5 gL-1) and (NH4)2SO4 (1.3-6.5 gL-1) were evaluated. In CCD-2 only different concentrations of glucose USP (7.9-22 gL-1) and isolated soy protein (15.9-44.9 gL-1) were evaluated. CCD-2 results led to a One Factor Experimental design (OFED) to evaluate higher isolated soy protein (20-80 gL-1) concentrations. In all designs, (CCD-1, CCD-2 and OFED) CuSO4 (0.16 gL-1) and chloramphenicol (0.1 gL-1) concentrations remained unchanged. For the OFED after sequential statistical optimization, an enzyme activity of 12,877.3 ± 481.2 UL-1 at 168 h was observed. rPOXA 1B activity increased 30.54 % in comparison with CCD-2 results. Final composition of optimized media was: 20 gL-1 glucose USP, 50 gL-1 isolated soy protein 90 % (w/w), 11.74 gL-1 malt extract, and 4.91 gL-1 (NH4)2SO4. With this culture media, it was possible to reduce culture media costs by 89.84 % in comparison with improved culture media previously described by our group.

Tertiary treatment (Chlorella sp.) of a mixed effluent from two secondary treatments (immobilized recombinant P. pastori and rPOXA 1B concentrate) of coloured laboratory wastewater (CLWW).

Industrial development has increased wastewater (WW) volume; generating contamination and disturbing ecosystems, because of breeching disposal parameters. In this work, Coloured Laboratory Wastewater (CLWW), (1500.00 colour units, CU) was separately submitted to two secondary treatments. For the first one CLWW was treated for three cycles C1, C2 and C3 with P. pastoris X33/pGAPZαA-LaccPost-Stop producing rPOXA 1B laccase, immobilized in calcium alginate beads. For the second-one, rPOXA 1B enzyme concentrate was used (three processes: P1, P2, and P3). Both treatments were carried out in a 15 L reactor with 10 L effective work volume (EWV) with 72 h hydraulic retention time. C1, C2, and C3 effluents were flocculated and filtered through quartzite sand, while P1, P2, and P3 effluents were only filtered through quartzite sand. The mixture of secondary effluents was submitted to a tertiary treatment with Chlorella sp. For C1, C2, C3, P1, P2, and P3, CU removal was of 99.16, 99.58, 99.53, 96.72, 97.05 and 96.47%, respectively. Discharge parameters, total organic carbon (TOC), inorganic carbon (IC), chemical oxygen demand (COD) and biological oxygen demand (BOD5) decreased, although they reached different final values. After the tertiary treatment (144 h) effluent discharge parameters were reduced to 34 ± 4 CU, TOC to 6.6 ± 0.9 mg L-1 and COD to 155 ± 4 mg L-1. It was demonstrated that secondary treatments (immobilized recombined cells or recombinant enzyme concentrate) combined with Chlorella sp., (tertiary treatment) attained a considerable removal of discharge parameters, demonstrating a promissory alternative for CLWW sequential treatment.

Neoplasias de la unión esofagogástrica: presentación de tres casos / Three Case Reports of Neoplasms of the Esophagogastric Junction

Los patrones de incidencia de las neoplasias de esófago vienen presentando cambios en las últimas décadas. Es así como en hombres, el adenocarcinoma de esófago es ahora más frecuente que el carcinoma epidermoide. Hay evidencia en las diferencias del comportamiento biológico de los adenocarcinomas y dentro de los mismos carcinomas de células escamosas de acuerdo con su localización. Muchas discrepancias existen en la literatura respecto a la etiología, clasificación y tratamiento quirúrgico para estos tumores. Los adenocarcinomas de la unión gastroesofágica incluyen a los tumores originados en el esófago distal con invasión de la unión gastroesofágica, a los cardiales y a los originados en el estómago proximal. Generalmente se utiliza la clasificación topográfica propuesta por Siewert y Stein, que divide a los tumores en tipo I, cuando hay compromiso proximal a la unión gastroesofágica, tipo II, encontrados directamente en el cardias, y tipo III, encontrados en el estómago proximal. Hacemos la presentación de tres casos. Se lleva a cabo una revisión del enfoque diagnóstico y del manejo de estas lesiones.

Patterns of esophageal tumor incidence have changed in recent decades, now esophageal adenocarcinomas have become more common than squamous cell carcinoma among men. There is evidence of biological differences in behavior among adenocarcinomas and squamous cell carcinomas according to their locations. Many discrepancies exist in the literature regarding the etiology, classification and surgical treatment for these tumors. Adenocarcinomas of the gastroesophageal junction include tumors that arise in the distal esophagus as a result of invasion from the proximal stomach through the gastroesophageal junction and the cardiac glands. The usual topographic classification is that proposed by Siewert and Stein. It divides tumors into Type 1, which is used when the compromise is proximal to the gastroesophageal junction, Type 2 when the tumor is found directly in the cardia, and Type 3 when the tumor is in the proximal stomach. Here we present three cases and a review of the diagnostic approach to, and management of, these lesions.

Incidental bladder lipoma: a case report and review of the literature.

Conventional lipoma is the most common benign mesenchymal neoplasm in adults. However, bladder lipoma is a rare tumor. We report an incidental 0.5-cm, mucosal, bladder lipoma in a 75-year-old man, successfully treated with endoscopic excision. The tumor was found during the extension study of a high-grade urothelial carcinoma of the renal pelvis. A review of the published cases, including the present report, yielded a total of 16. Conclusions on this review are presented. The case is being reported because its rarity and to highlight the importance of complete workup to clarify associated disorders that may suggest extension of a malignant process.

Bladder endometriosis and endocervicosis: presentation of 2 cases with endoscopic management and review of literature.

Urinary tract endometriosis and endocervicosis are an uncommon pathologic finding, with a common embryological origin. We present 2 cases of female patients with bladder mass. The first one was a finding of a nodular formation in the bladder during study of a nonviable foetus and the second was an incidental finding of a neoformation in the fundus of the bladder during the realization of an ultrasound. In both cases, we performed a surgical management with transurethral resection. Histopathological examination revealed a bladder endometrioma in the first case and endocervicosis with associated endometriosis in the second.

Bilateral xanthogranulomatous orchitis in a tetraplegic patient.

Xanthogranulomatous orchitis (XGO) is a rare chronic inflammatory process characterized by destruction of tissue that is replaced by an outstanding cellular infiltrate of lipid-laden macrophages. To date, 20 cases of this process have been reported previously. We present herein the case of a 55-year-old man who had sustained complete tetraplegia at C-6 level and neuropathic bladder for 21 years. After repeated episodes of urinary tract infection, the patient developed a bilateral XGO and a right xanthogranulomatous epididymitis (XGE) that were treated with bilateral orchiepididymectomy. To our knowledge, a bilateral XGO has not yet been reported. Repeated episodes of high-pressure urinary reflux along the vas deferens during dyssynergic voiding possibly led to retrograde extension from the urinary tract by common urinary pathogens and development of bilateral XGO and right XGE. Since tissue destruction is a feature of this process, curative treatment required antibiotic therapy followed by bilateral excision of testes and epididymes.

CT protocol for acute stroke: tips and tricks for general radiologists.

Acute stroke services have been installed in most hospitals in the industrialized world, and dealing with hyperacute stroke has become one of the most frequently performed tasks of the on-call radiologist. Imaging plays a key role in current guidelines for thrombolysis, and knowledge of classic early ischemic signs or depiction of hemorrhage at nonenhanced computed tomography (CT) is necessary (although not sufficient) for a satisfactory imaging study. A modern CT examination must also include perfusion CT and CT angiography. Perfusion CT delineates the ischemic tissue (penumbra) by showing increased mean transit time with decreased cerebral blood flow (CBF) and normal or increased cerebral blood volume (CBV), whereas infarcted tissue manifests with markedly decreased CBF and decreased CBV. CT angiography can depict the occlusion site, help grade collateral blood flow, and help characterize carotid atherosclerotic disease. A complete CT study (nonenhanced CT, perfusion CT, and CT angiography) may be performed and analyzed rapidly and easily by general radiologists using a simple standardized protocol and may even facilitate diagnosis by less experienced radiologists in affected patients.

Radiological aid to clinical diagnosis of Schnitzler's syndrome: multimodality imaging approach.

Schnitzler's syndrome is a rare combination of chronic urticaria, fever of unknown origin, disabling bone pain, and monoclonal gammopathy. We report a case with an unusual radiological manifestation as a solitary sclerotic lesion of the right iliac bone. Its main features on conventional radiography, computed tomography, and magnetic resonance imaging are described, and the main radiological differential diagnoses are discussed to help with the characterization of this syndrome, which requires a combination of clinical, laboratory, and radiological data. On the other hand, although our patient had an excellent clinical response to anakinra, the sclerotic lesion remained unchanged on follow-up X-ray examinations.