Tumor testicular de saco vitelino con metástasis a pleura: primer caso reportado en la literatura

ResumenEl cáncer testicular es el tumor urológico maligno más común en hombres jóvenes. Más del 90% corresponden a tumores de células germinales. El objetivo del estudio es el reporte del primer caso de cáncer testicular de tumores de células germinales con metástasis a pleura.Paciente masculino de 21 años, inicia su padecimiento con dolor en hemitórax derecho; la radiografía de tórax presenta una radioopacidad en lóbulo medio de pulmón derecho y la tomografía de tórax detecta una masa intratorácica y extrapulmonar. La biopsia torácica guiada por ultrasonido muestra una masa sólida adosada a la pared torácica, con efecto de desplazamiento sobre la pleura, conocido como «efecto en cola de cometa». La biopsia fue positiva para lesión neoplásica maligna poco diferenciada de la pleura. A la exploración encontramos testículo derecho con tumoración en polo inferior el cual se corrobora por ultrasonido. Los marcadores tumorales solo con elevación de alfa-fetoproteína 295.87ng/dL y deshidrogenasa láctica en 2,380UI/L. En la tomografía de abdomen se identificó actividad ganglionar interaortocava. Realizamos orquiectomía radical derecha. Reporte patológico: tumor testicular de saco vitelino, pT1N2M1S2.En este caso se pudo comprobar que las metástasis fueron a nivel pleural, que lo ubica como una forma de diseminación excepcional.AbstractTesticular cancer is the most common malignant urologic tumor in young men. More than 90% are germ cell tumors. The aim of this study was to report the first case of germ cell tumor testicular cancer with metastasis to the pleura.A 21-year-old man had disease onset with pain in the right hemithorax. The chest x-ray showed radio-opacity in the middle lobe of the right lung. A chest tomography scan detected an intrathoracic and extrapulmonary mass. Ultrasound-guided thoracic biopsy revealed a solid mass attached to the thoracic wall, displaced over the pleura, known as the “comet tail effect”. The biopsy was positive for a poorly differentiated malignant neoplastic lesion of the pleura. Upon physical examination we encountered a right testis with a tumor at the lower pole; this was corroborated through ultrasound. In relation to tumor markers, only alpha-fetoprotein was elevated at 295.87ng/dl and lactate dehydrogenase at 2,380 IU/l. An abdominal tomography scan identified interaortocaval lymph node activity. We performed a right radical orchiectomy and the pathology report was testicular yolk sac tumor, pT1N2M1S2.In our patient, metastasis at the level of the pleura was confirmed, making this a case with an exceptional form of spread

Management of freezing rate and trehalose concentration to improve frozen dough properties and bread quality

Abstract Bread is one of the most consumed foods in the world, and alternatives have been sought to extend its shell life, and freezing is one of the most popular methods. The purpose of this study was to evaluate the effect of freezing rate and trehalose concentration on the fermentative and viscoelastic properties of dough and bread quality. Dough was prepared and trehalose was added at three concentrations (0, 400, 800 ppm); dough was pre fermented and frozen at two freezing rates then stored for 42 days. Frozen dough samples were thawed every two weeks. CO2 production and elastic and viscous modulus were determined. In addition, bread was elaborated and specific volume and firmness were evaluated. High trehalose concentrations (400 and 800 ppm) produced dough with the best viscoelastic and fermentative properties. Greater bread volume and less firmness were observed when a slow freezing rate (-.14 °C/min) was employed

Management of freezing rate and trehalose concentration to improve frozen dough properties and bread quality

Abstract Bread is one of the most consumed foods in the world, and alternatives have been sought to extend its shell life, and freezing is one of the most popular methods. The purpose of this study was to evaluate the effect of freezing rate and trehalose concentration on the fermentative and viscoelastic properties of dough and bread quality. Dough was prepared and trehalose was added at three concentrations (0, 400, 800 ppm); dough was pre fermented and frozen at two freezing rates then stored for 42 days. Frozen dough samples were thawed every two weeks. CO2 production and elastic and viscous modulus were determined. In addition, bread was elaborated and specific volume and firmness were evaluated. High trehalose concentrations (400 and 800 ppm) produced dough with the best viscoelastic and fermentative properties. Greater bread volume and less firmness were observed when a slow freezing rate (-.14 °C/min) was employed

Nefrectomía bilateral laparoscópica pretrasplante. Presentación de 2 casos

ResumenLa laparoscopia se ha convertido en una alternativa práctica y aceptable para el tratamiento de las enfermedades urológicas quirúrgicas complejas. El trasplante renal es el tratamiento de elección en el paciente con insuficiencia renal terminal. Las indicaciones de nefrectomía pretrasplante son: enfermedad renal poliquística autosómica dominante, hipertensión refractaria, infecciones renales crónicas, diagnóstico o sospecha de cáncer renal o urotelial, urolitiasis, niveles persistentes de anticuerpos antimembrana basal glomerular, proteinuria significativa no controlada e hidronefrosis grados 4 o 5.Se presentan 2 casos de pacientes con enfermedad renal terminal con manejo en hemodiálisis, los cuales requieren nefrectomía bilateral previo al trasplante. En un caso se extrajeron las piezas ampliando la herida umbilical y en el otro caso, a través de herida Pfannestiel con tiempo quirúrgico: 280 y 235min, respectivamente; sangrado transoperatorio: 250ml y 155ml, respectivamente; sin complicaciones. Estancia intrahospitalaria: 6 y 5 días, respectivamente.La nefrectomía pretrasplante es un procedimiento habitual en los servicios de trasplante renal, y la resolución de la misma con procedimientos mínimos invasivos, es la técnica ideal. Tratándose ambos casos de nefrectomía bilateral hace de gran relevancia las ventajas del procedimiento laparoscópico.AbstractLaparoscopy has become a practical and acceptable alternative for the treatment of urologic diseases that are surgically complex. Kidney transplantation is the treatment of choice in the patient with end-stage kidney disease. The pre-transplantation indications for nephrectomy are: autosomal dominant polycystic kidney disease, refractory hypertension, chronic renal infections, diagnosis or suspicion of renal or urothelial cancer, urolithiasis, persistent levels of anti-glomerular basement membrane antibodies, significant uncontrolled proteinuria, and grade 4 or 5 hydronephrosis.The cases are presented herein of 2 patients with end-stage kidney disease undergoing hemodialysis that required bilateral nephrectomy prior to the transplantation. In one case the specimens were extracted through the widening of the umbilical incision and in the other case through the Pfannenstiel incision. Surgery duration was 280 and 235min, intraoperative blood loss was 250 and 155ml, and hospital stay was 6 and 5 days, respectively. There were no complications.Pre-transplantation nephrectomy is a common procedure in the kidney transplantation services and the ideal technique for its resolution is with minimally invasive procedures. The advantages of the laparoscopic procedure were particularly relevant in the present cases of bilateral nephrectomy