[Appendicular invagination]. / Invaginación apendicular.

Two cases of intussusception of the appendix are reported. The first case stands out for its rarity, corresponding exclusively to intussusception of appendicular mucosa. The second case was due to cystoadenoma of the appendix. Both cases were treated by right hemicolectomy due to the difficulty of diagnosing the condition.

[Necrotizing myelopathy associated with neoplasia. A clinico-pathological study of 2 cases and a review of the literature]. / Mielopatía necrosante asociada a neoplasia. Estudio clínico-patológico de dos casos y revisión de la literatura.

Two cases of necrotic myelopathy are presented. This is a very rare paraneoplasic syndrome. One patient had clear cell renal carcinoma and other had lymphatic metastasis of malignant melanoma without filiation of the primary tumor. The complete spinal study (MNR, CT, myelography) proved normal. Diagnosis is possible when all other causes of spinal disease have been discarded. Nowadays, it is possible to diagnose this disease premortem. The international literature reviewed showed 31 cases published since 1903, associated mainly to malignant diseases such as lymphomas, lung cancer, renal carcinoma, breast cancer, leukemias, etc. The differential diagnosis appears in the comments, as well as the presentation and evolution of the cases described up until now.

Skeletal muscle changes in chronic alcoholic patients. A conventional, histochemical, ultrastructural and morphometric study.

Muscle biopsies of 20 alcoholic patients (15 males and 5 females), most of whom had liver disease and with no clinical or analytical evidence of neuromyopathy, were studied. 10 abstemious patients with no neuromuscular disease were selected as controls. Conventional histology failed to show significant skeletal muscle changes. A characteristic histochemical picture of tubular aggregates was found in one patient. An enlargement of the intermyofibrillar space with increase in glycogen deposition and fat droplets were detected ultrastructurally while 2 of the patients showed tubular aggregates. The mitochondriae of the alcoholic patients had a smaller perimeter and area than those of the control group (P less than 0.004 and P less than 0.008, respectively). These results suggest that the prolonged ingestion of alcohol can cause a mitochondrial alteration only evidenced by morphometry, with poor clinical, biochemical, electrophysiological and histological expression of myopathy. These findings can represent an early stage of alcoholic skeletal muscle injury.

Tubular aggregates in skeletal muscle of chronic alcoholic patients.

The presence of tubular aggregates (TA) in type II muscle fibers in two of 20 alcoholic patients with chronic liver disease, and with no apparent neuromuscular disorder, is reported. The localization, histochemical reactions, and ultrastructural features of the TA are similar to those previously described in other conditions. In one of the two cases TA were demonstrated by E/M observations only and not by histochemistry. No correlations were found between the biochemical changes and the presence of tubular aggregates. We believe that TA are long-standing structures since the muscle biopsies were performed 12 and 13 days after the ingestion of alcohol had been discontinued. They may represent a non-specific response of the sarcoplasmic reticulum to compensate for the deficient calcium uptake reported in alcoholic patients.