Upper Eyelid Reconstruction With a Horizontal V-Y Myotarsocutaneous Advancement Flap

Upper eyelid tumours, particularly basal cell carcinomas, are relatively frequent. Surgical ablation of these lesions creates defects of variable complexity. Although several options are available for lower eyelid reconstruction, fewer surgical alternatives exist for upper eyelid reconstruction. Large defects of this region are usually reconstructed with two-step procedures. In 1997, Okada et al. described a horizontal V-Y myotarsocutaneous advancement flap for reconstruction of a large upper eyelid defect in a single operative time. However, no further studies were published regarding the use of this particular flap in upper eyelid reconstruction. In addition, this flap is not described in most plastic surgery textbooks. The authors report here their experience of 16 cases of horizontal V-Y myotarsocutaneous advancement flaps used to reconstruct full-thickness defects of the upper eyelid after tumour excision. The tumour histological types were as follows: 12 basal cell carcinomas, 2 cases of squamous cell carcinomas, 1 case of sebaceous cell carcinoma and 1 of malignant melanoma. This technique allowed closure of defects of up to 60% of the eyelid width. None of the flaps suffered necrosis. The mean operative time was 30 min. No additional procedures were necessary as good functional and cosmetic results were achieved in all cases. No recurrences were noted. In this series, the horizontal V-Y myotarsocutaneous advancement flap proved to be a technically simple, reliable and expeditious option for reconstruction of full-thickness upper eyelid defects (as wide as 60% of the eyelid width) in a single operative procedure. In the future this technique may become the preferential option for such defects.

Caracterización y determinación del proceso para la producción de cal comercial a partir de la piedra caliza

La cal es un material producido a partir de la calcinación de la roca caliza y tiene diversas utilidades en el mundo de la industria como la siderúrgica, papelera, alimentaria, en la construcción, entre otras. Es fundamental conocer todas las características de la caliza para poder determinar su grado de calcinación. Con el presente trabajo se pretende estudiar las propriedades de la caliza para su posterior calcinación y el dimensionamento de una planta de producción de cal desde que el mineral llega de la explotación hasta que sale al mercado.Para determinar los equipos se calularon sus dimensiones para una producción de 600 t/h de cal, sabiendo que la planta principal de machaquero solo trabajará 5 días de la semana en jornadas de 8 horas, mientras que a partir del horno de calcinación estará en funcionamento los 7 dias de la semana, 24 horas al día. A partir de esas consideraciones se obtienen las dimensiones de todos los equipos y se realiza un estudio para la elección de un horno, o un horno de eje vertical y un horno rotativo, así como el combustible empleado, ya que es una parte fundamental para determinar los costes para la producción de cal.Tmbién fue objeto de este trabajo, el estudio ambiental de la instalación de la planta, en función de la mezcla de combustible empleada y del impacto en el entorno de la lisma, así como un estudio de viabilidad de la planta, estimando unos costes de la misma y un precio de mercado "ex Works".

La lista de Angel piedras. Memória de la guerra civil y subalternidad

Ángel Piedras naciô en Nava dei Rey província de Valladolid (Espana), en 1910. Hijo de una família de jomaleros, tambiên él ti"abajó en ei campo hasta los veintiséis afios. Fue detenido y encarcelado en los dias de Ia terrible represión que sucedíó ai alzamíento franquista. Trás 101 dias de condena a muerte, su pena fue conmutada por Ia de cárcel. Salíó indultado en 1944. Ángel Piedras era hermano de mi abuelo, fusílado en Cáceres en enero de 1938. Su testímonio tiene que ver decisivamente con mi ínterés y mi dedicación a Ia historia. Este pequefío ensayo, primera piedra de un trabajo más amplio, es ante todo una prueba de mi admíración y mi agradecimiento hacia él. Guando Ángel Piedras muere en 1997, deja en casa de su hija Petra, persona clave en nuestro trabajo, una caja con materíales muy diversos, entre los que se encontraban vários cuademos, varias listas de represaliados y diversos manuscritos más, principalmente con ripios y poemas memorizados y transcritos por él.

One Anastomosis Gastric Bypass versus Roux en Y Gastric Bypass as Salvage Technique after Failed Gastric Band: a Retrospective Analysis of 80 Cases

The classical “Roux en Y Gastric Bypass” (RYGBP) is still the standard technique between all the ones being used nowadays. The “One anastomosis gastric bypass” (OAGBP), is an evolution of the “Minigastic bypass” described by Robert Rutledge in 2001, is a well known and progressively frequent but still controversial technique. In our group, after an experience of 10 years using the RYGBP as a salvage surgery after failed gastric banding, in 132 cases, we decided to adopt the OAGBP as our preferential bariatric technique also in this situation. The theoretical main reasons for that shift are related to the increased safety, maximized weight loss, long term weight loss maintenance and reversibility of the operation. Method: Retrospectively we evaluated data of the surgical management of revisional cases for conversion, after failed or complicated gastric bands to gastric bypass. We selected the last 40 cases of each technique since May 2010. Results: All cases were performed by laparoscopy without any conversion. In both groups the conversion has been performed in one single step (17 cases, 42,5%). Data showed lower morbidity with OAGBP (2,5% against 7,5%) and better weight loss in theOAGBP cohort after a median follow up of 16months (67%against 55%) in patients revised after gastric band failure or complications. None had statistic significance (p>0,1) by the chi-square contingency table analysis.Conclusion: It seems to there is a difference in favour of OAGBP for conversion of complicated gastric bands. In this study we didn’t found statistic significance probably because of the short numbers. Prospective and more powerful studies are necessary to evaluate the benefit of the studied procedure.

The avirulence of the cultivated Y strain of Trypanosoma cruzi: IV. The effect of immunosuppressive agents in mice

Drogas imunossupressoras (Azathioprina e Methotrexato) que se mostraram capazes de agravar infecções experimentais por Trypanosoma cruzi virulento (cepa Y), em camundongos, não conseguiram favorecer o aparecimento de qualquer sinal de infecção em animais vacinados com a cepa avirulenta PF do mesmo tripanosoma. Vinblastine, quando dado 3 dias antes da vacina, não favoreceu parasitemias positivas nem mortalidade significativamente aumentada, mas induziu o aparecimento de hemoculturas positivas. Os tripanosomas dessas culturas foram incapazes de infectar camundongos jovens. Quando o Vinblastine foi usado 15 dias após a vacinação dos animais, todos os testes foram negativos, inclusive as hemoculturas

Variant Rett Syndrome in a Girl with a Pericentric X-Chromosome Inversion Leading to Epigenetic Changes and Overexpression of the MECP2 Gene

Rett syndrome is a neurodevelopmental disorder caused by mutations in the MECP2 gene. We investigated the genetic basis of disease in a female patient with a Rett-like clinical. Karyotype analysis revealed a pericentric inversion in the X chromosome -46,X,inv(X)(p22.1q28), with breakpoints in the cytobands where the MECP2 and CDKL5 genes are located. FISH analysis revealed that the MECP2 gene is not dislocated by the inversion. However, and in spite of a balanced pattern of X inactivation, this patient displayed hypomethylation and an overexpression of the MECP2 gene at the mRNA level in the lymphocytes (mean fold change: 2.55±0.38) in comparison to a group of control individuals; the expression of the CDKL5 gene was similar to that of controls (mean fold change: 0.98±0.10). No gains or losses were detected in the breakpoint regions encompassing known or suspected transcription regulatory elements. We propose that the de-regulation of MECP2 expression in this patient may be due to alterations in long-range genomic interactions caused by the inversion and hypothesize that this type of epigenetic de-regulation of the MECP2 may be present in other RTT-like patients.

Infecção experimental de macacos Cebus apella sp pelo Trypanosoma cruzi (cepa "y") I - curva da parasitemia na fase aguda da doença de Chagas

Sete macacos (Cebus apella sp) foram inoculados por via subcutânea peto Trypanosoma cruzi com um número de formas tripomastigotas que variou de 25 x 103 a 5 x 1O6. Um outro primata, também da mesma espécie, foi inoculado por via palpebral com fezes de Triatoma infestans contendo formas de T. cruzi provenientes da mesma cepa "Y". A presença do T. cruzi foi assinalada na maioria dos animais, pela primeira vez, no 8º dia após a infecção. Os picos máximos da parasitemia foram observados entre o 9º e o 12º dia da infecção. O número de tripanosomas caiu acentuadamente do 19º ao 25º dia. Todos os animais infectados sobreviveram. Estudos estão sendo conduzidos com o intuito de se observar o comportamento destes animais na fase crônica da doença.