Atrapamiento de cabeza fetal en útero septo

Septate uterus, which occurs in approximately 1% of fertile women, is considered the most common uterine anomaly but is associated with the poorest reproductive results. Uterine anomalies are especially associated with difficulty in maintaining a pregnancy to full term, often leading to late miscarriage or preterm delivery. We present a case of fetal microcephaly in a woman with septate uterus as a consequence of trapping of the fetal head between the septum and one of the uterine walls.     

Histiocytic sarcoma that mimicks benign histiocytosis

A 28-year-old man presented with a histiocytic sarcoma of a very uncommon origin, as it had developed for several years like a benign cutaneous histiocytosis resembling generalized eruptive histiocytoma before becoming acute, with nodal and massive pulmonary involvement. Despite various chemotherapies, the patient died within 8 months. Skin biopsies showed histiocytic proliferation in the dermis and node biopsies showed histiocytic proliferation with a sinusoidal pattern. Immunohistochemical analysis, performed on paraffin-embedded sections, demonstrated strong labeling of tumoral cells for CD68 and moderate labeling for CDS and CD4. CD30 labeling was negative. S-100 protein was positive on a Langerhans' cell reactive subpopulation. Electron microscopy confirmed the histiocytic nature of malignant cells and showed cytoplasmic inclusions such as regularly laminated bodies, dense bodies and pleomorphic inclusions. No Birbeck granules were seen. A gene rearrangement study of T-cell receptor γ and immunoglobulin heavy chain genes showed a germline configuration. Histiocytic sarcoma is an extremely rare true histiocytic malignancy, the existence of which has been recently debated since it has often been mistaken in the past for large cell lymphomas. Such a deceptive onset as benign cutaneous histiocytosis has not been described in the literature to our knowledge.     

Sterile wounding is a minimal and sufficient trigger for a cellular immune response in Drosophila melanogaster

An attack and oviposition by parasitic wasp Leptopilina boulardi induces a vigorous cellular immune response in Drosophila melanogaster larvae. This response is manifested by the appearance of a specialized subset of blood cells, the lamellocytes, which are the key players in the encapsulation and killing of the parasite. The formation of lamellocytes involves the activation of the Toll, the Jun kinase and the JAK/STAT pathways however the minimal requirement for initiation of lamellocyte development in the course of the cellular immune response has not been defined yet. In this study, we tested whether or not the mechanical injury itself, caused by oviposition, could provide a sufficient signal for lamellocyte development. We found that sterile wounding, comparable to that occurring during oviposition, induces normal lamellocyte development. We propose therefore that mechanical damage of the cuticle and subsequent disruption of the basal lamina is a minimal and sufficient single signal for normal lamellocyte development in the course of the cellular immune response of Drosophila.     

A possible prognosis score in corticosteroid-resistant nephrotic syndrome

Chronic glomerular nephropathies in children are marked by an often unfavourable evolution, so that the establishing of a prognosis at the time of the diagnosis is both a professional and a moral duty for the pediatric nephrologists. The estimation of the current practice renal survival prognosis in children with chronic glomerular nephropathies, by using clinical and laboratory elements in different histological forms of primitive chronic glomerulonephritis (CGN), with a minimum period of observation of one year. We analyzed parameters that may intervene in the duration of renal survival: type of CGN, age at the debut of the illness, histological scores of activity and chronicity, the presence of tubular atrophy lesions and that of interstitial fibrosis, renal failure (RF) installment time, in cases with normal renal function at the beginning, the time until the initiation of dialysis in cases with ESRF, respectively. The statistic analysis of data has been carried out with Epi soft (Fischer test). The results have been as follows: unfavourable evolution has been taken into consideration in the cases which have presented fixed nitric retention or which required the initiation of dialysis. The initiation of dialysis was necessary in 19 cases (76%), out of which 11 (44%) having associated between 4 and 6 of the considered risk factors. If the histological type (SFGS, DGS, MPGN) is added to the obtained score, the accuracy of the estimation increases to 89%. In conclusion, the usage of prognosis scores composed of current elements of diagnosis that have proven to have statistical significance, as far as the renal survival prognosis is concerned, may allow the invoking of a medium-term prognosis in the evolution of children with CGN.     

Corneal thickness after overnight wear of an intraocular pressure fluctuation contact lens sensor

Purpose: To assess the effect of overnight wear of a contact lens‐based sensor (CLS) for monitoring of 24‐hr intraocular pressure (IOP) fluctuations on central corneal thickness (CCT). Materials and Methods: Changes in the CCT, mid‐peripheral corneal thickness and central corneal radius (CCR) during overnight CLS wear in 20 eligible patients with ocular hypertension or established glaucoma were prospectively studied using ultrasound pachymetry and topography. Corneal thickness and CCR changes were evaluated from pre‐to‐postsleep, with the fellow eye as control. Paired t‐test or Wilcoxon signed‐rank test was used as appropriate and with α = 0.05. Relationship between the IOP profile recorded by the CLS and the pre‐to‐postsleep corneal thickness differences was assessed using the Spearman correlation coefficient. Results: After CLS wear, mean CCT had changed from 523 to 537 μm (p = 0.015) in the study eye and from 518 to 522 (p = 0.206) in the fellow eye (n = 15). There was no difference in CCT change between eyes (p = 0.075). There were no statistically significant changes in horizontal or vertical CCR in either eye (p > 0.05 for all). No correlation was found between the pre‐to‐postsleep differences in the CLS signal and the pre‐to‐postsleep differences in ultrasound CCT measurements (p = 0.974). Conclusion: The continuous IOP monitoring does not appear to be affected by differences in corneal thickness that occur during overnight CLS wear, although the CLS did induce some corneal swelling. This effect was not statistically significantly different from the control eye and does not seem to influence the CLS IOP profile.     

Clinical, histopathological and therapeutic considerations in non-neoplastic abnormal uterine bleeding in menopause transition

With the decline of ovarian hormonal function, from the fifth decade of life, women enter the menopause transition, during which bleeding becomes irregular in duration and time of occurrence. Secondary to ovarian dysfunction, developmental and maturation endometrial anomalies occur, which are clinically translated by abnormal uterine bleeding, which in many cases at this age can be caused by organic lesions (fibroma, polyps, endometritis, endometrial hyperplasia, adenomyosis, etc.). The retrospective study included a total of 256 patients with abnormal uterine bleeding in menopause transition. Statistics showed that the incidence of these types of bleeding increases with age (64.5%) and parity (30.5%), with symptoms consisting mostly in different clinical forms of abnormal uterine bleeding (62.1%), and leiomyomas prevailing at histopathological examination (49.6%). Progesterone replacement therapy was the first therapeutic choice for correcting these types of bleeding. Progesterone therapy is useful not only for therapeutic purposes to amend the bleeding, but also as a precaution against the development of endometrial carcinoma. Progestogens cancel the proliferative and mitogenic effect of estrogens, even when administered in sequential regimen 10-12 days per month.     

In vitro evaluation of the effects of intraluminal thrombus on abdominal aortic aneurysm wall dynamics

The optimum time to treat abdominal aortic aneurysms (AAAs) still remains an uncertain issue. The decision to intervene does not take in account the effects that wall curvature, intraluminal thrombus (ILT) properties and thickness have on rupture. The role of ILT in aneurysm dynamics and rupture has been controversial. In vitro testing of four silicone AAA models incorporating the ILT and aortic bifurcation was studied under physiological conditions. Pressures (P) and diameters (D) were analysed for models with and without ILT at different locations. The diametral strain, compliance and P/D curves were influenced by the presence, elastic stiffness and thickness of the ILT. In this case, the inclusion of ILT reduced the lumen area by 77% that resulted in a 0.5–81% reduction in compliance depending on ILT properties. With an increase in ILT stiffness from 0.05 to 0.2 MPa, the compliance was reduced by 81%. In the region of maximum diameter, there was a reduction of diametral strain and compliance except for the softer ILT which was more compliant throughout the proximal region. The shifting of the maximum diametral strain and compliance to the proximal neck was pronounced by an increase in ILT stiffness, thus creating a possible rupture site.