ABSTRACT
Paciente femenina de 35 años, raza mestiza, saludable, vista por Consulta Externa de Cirugía en Honduras en mayo de 2010, quien refería cuadros de dolor abdominal localizado en epigastrio y mesogastrio acompañado de trastornos digestivos, vómitos ocasionales de siete meses de evolución asociado a melena en los últimos tres meses. El examen físico mostró una tumoración abdominal de diez centímetros, móvil, no dolorosa y sin signos de reacción peritoneal. Se realizó ultrasonido abdominal y exámenes de sangre; no se pudo acceder a otros estudios diagnósticos por las condiciones del lugar. Se ingresó y decidió tratamiento quirúrgico electivo con laparotomía exploradora: se encontró gran tumoración que afectaba más del tercio de la curvatura mayor del antro y cuerpo gástrico, sin adenopatías visibles, ni palpables. Se realizó gastrectomía subtotal distal con gastroyeyunostomía técnica de Billroth II, antecólica, Polya. La biopsia arribó al diagnóstico de tumor estromal gastrointestinal de localización gástrica. La paciente se egresó satisfactoriamente a los siete días.
A 35-year-old female patient without previous medical history, evaluated by surgical department in Honduras La Ceiba in May 2010 was presented in this paper. The patient referred occasionally abdominal pain located in epigastrium, mesogastrium since seven months ago, associated to digestive disorders and vomiting referred one episode of melena three months before. On physical examination a large 10 cm abdominal tumor was found, easy to move, painless on palpation without any signs of peritoneal reaction, abdominal ultrasound, blood test were performed, no other diagnostic studies could not be achieved because the condition of the country. Exploratory laparotomy was done and a large tumor that occupied more than a third part of the greater gastric curvature of the antrum and body of the stomach without palpable lymphadenopathy. Distal subtotal gastrectomy with Billroth II gastrojejunostomy antecolic, Polya technique was performed. The histopathology report confirmed the diagnosis of GIST. The patient was discharged with satisfactory evolution.
ABSTRACT
AIM: To determine the expression of c-kit mRNA and protein in the bladders in guinea pigs with diabetic cystopathy (DCP) and to explore the correlation and mechanisms between c-kit expression and DCP. METHODS: Sixty guinea pigs were divided randomly into control group (n=20) and experimental group (n=40). The guinea pigs in experimental group were injected with streptozotocin (STZ) to induce diabetes mellitus. After fed for 10 weeks, the animals in both groups were tested with urodynamics, and the guinea pigs in experimental group were divided into the subgroups of DCP and the diabetic no-cystopathy (NDCP) group according to the results of urodynamics. mRNA expression of c-kit was detected by reverse transcription polymerase chain reaction (RT-PCR) and protein expression of c-kit was tested and analyzed by laser scanning confocal microscope. RESULTS: Decreased expression of c-kit mRNA was observed in DCP group compared to control and the NDCP group. The ratio of c-kit mRNA and GAPDH was 5.66±0.54 in controls (P<0.05), 5.54±1.28 in NDCP group (P<0.05) and 4.65 ±0.47 in DCP group. c-kit protein expression significantly declined in DCP group. The mean value of fluorescence intensity was 856.52± 53.03 in control group, 844.67± 59.24 in NDCP group and 548.69± 48.51 in DCP (P<0.01).CONCLUSION: The declined expression of c-kit) gene at transcription and translation levels destroys the SCF/c-kit signal pathway, leading to the dysfunction of Cajal-like) cells in DCP guinea pig, so the abnormal expression of c-kit gene is involved in the pathogenesis of DCP.
ABSTRACT
The objective of this work was identify the presence of interstitial cells of Cajal, muscle cells, nerves and androgen receptor positive cells in adult human testicle, using immunohistochemical detection for c-kit/CD-117, actin smooth muscle specific (ASMS), neurofilament (N) and androgen receptor (AR), respectively. The samples were obtained from patients (n= 10) with diagnosis of prostate cancer, with surgery of orchiectomy. Subsequently were processed by histology and for immunohistochemistry using specific antibodies. It showed the presence of cells c-kit/CD-117, with diverse degrees of positivity, distributed mainly in the interstitial peritubular area of the human testicle. The peritubular myoides cells were positive to the presence of the actin smooth muscle and androgen receptor. The neurofilaments elements (+) only were observed in the vascular tunic. The specific immunohistochemistry describe the presence of the interstitial cells of Cajal in human testicular interstitium, opening a new perspective for the functional interpretation of the testicular cellularity and tubular motility. Possibly associated functionally to peribubulars cells of smooth muscle to regulate the mobility of the seminiferous tabules, whose integration and function would be androgen dependent. The cells that express the c-kit receptor, were found exclusively in the interstitial compartment. This cellular type in addition of the muscular cells of peritubules and the absence of nervous fibers to the interior of the testicle, could be responsible for the regulation of tubular mobility, as it happens in the gastrointestinal apparatus.
El objetivo de este trabajo fue identificar la presencia de células interticiales de Cajal, células musculares lisas, células nerviosas y células que expresan receptores de andrógeno en el testículo de humano adulto, usando inmunohistoquímica específica para: c-kit/CD-117, músculo liso actina específico (ASMS), neurofilamentos (N) y para receptores de andrógenos (AR). Las muestras fueron obtenidas de pacientes (n=10) con diagnóstico de cáncer prostático sometidos a cirugía de orquiectomía. Las biopsias se procesaron para histología e inmunohistoquímica usando anticuerpos específicos. Se muestra la presencia de células c-kit/CD-117, con diversos grados de positividad y distribuidas en el compartimento interticial del testículo. Las células peritubulares mioides fueron positivas para la presencia de músculo liso actina específico y para receptor de andrógenos. La marcación de neurofilamentos positivos, sólo fueron observados en la túnica vascular. Conclusiones: La inmunohistoquímica específica describe la presencia de células interticiales de Cajal en los interticios testiculares humanos, abriendo una nueva visión en la interpretación funcional de la celularidad testicular y la motilidad tubular. Lo anterior asociado a la funcionalidad de las células peritubulares (músculo liso) regularían la motilidad de los túbulos seminíferos. Este proceso posiblemente es andrógeno dependiente. Las células que expresan receptores c-kit se encuentran exclusivamente en los compartimentos interticiales, estas células en conjunto con las células musculares peritubulares agregado a la ausencia de fibras nerviosas al interior del testículo, podrían ser los responsables de la regulación de la motilidad tubular, similar a como se informa para el tracto gastrointestinal.