Peliosis hepatis associated with follicular lymphoma with a rise in vascular endothelial growth factor and anaemia of inflammation.

Follicular lymphoma does not usually present with associated paraneoplastic syndromes. We describe the case of a patient diagnosed with follicular lymphoma when investigating anaemia of chronic disease/inflammation and who, during her clinical course, developed peliosis hepatis. We have been able to confirm the similarity between the symptoms, the tumour's biology, the anaemia and peliosis, with the behaviour of endothelial growth factor, interleukins and iron metabolism disorders, which were normalised with treatment. To date, we have found no cases where peliosis has been described in this type of lymphoma.

Eructos supragástricos. Una entidad a conocer / Supragastric belches. An entity to know

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Importance of the polarity of the glycosaminoglycan chain on the interaction with FGF-1.

Heparin-like saccharides play an essential role in binding to the fibroblast growth factor (FGF)-1 and to their membrane receptors fibroblast growth factor receptor forming a ternary complex that is responsible of the internalization of the signal, via the dimerization of the intracellular regions of the receptor. In this study, we report the binding affinities between five synthetic hexasaccharides with human FGF-1 obtained by surface plasmon resonance experiments, and compare with the induced mitogenic activity previously obtained. These five oligosaccharides differ in sulfation pattern and in sequence. We have previously demonstrated that all the five hexasaccharides have similar 3D structure of the backbone. Consequently, the differences in binding affinity should have their origin in the substitution pattern. Subsequently, the different capacity for induction of mitogenic activity can be, at least partially, explained from these binding affinities. Interestingly, one of the oligosaccharides lacking axially symmetry ( 3: ) was biologically inactive, whereas the other ( 2: ) was the most active. The difference between both compounds is the order of the FGF-binding motifs along the chain relative to the carbohydrate polarity. We can conclude that the directionality of the GAG chain is essential for the binding and subsequent activation. The relative biological activity of the compounds with regular substitution pattern can be inferred from their values of IC50. Remarkably, the sulfate in position 6 of d-glucosamine was essential for the mitogenic activity but not for the interaction with FGF-1.

Cellular characterization of wound exudate as a predictor of wound healing phases.

UNLABELLED: This study was designed to characterize the cell populations present in wound exudate, to examine the validity of these populations in identifying the wound phase to find possible predictors of healing, and to anticipate events in favor of a more rapid recovery. METHODS: Fourteen patients who presented with postsurgical wounds with negative pressure therapy were included in the study. The authors collected samples from 51 wounds in the inflammatory phase and 29 in the proliferative phase. RESULTS: The number of neutrophils and platelets in the exudate collected from wounds in the inflammatory phase was significantly higher (P < 0.05), while the number of lymphocytes, eosinophils, and basophils was significantly higher in exudate from wounds in the proliferative phase. The receiver operating characteristic analysis gives an area under curve of 0.815 for neutrophils (P < 0.001, CI: 0.698-0.933) and 0.760 for platelets (P < 0.001, CI: 0.647-0.873). The results showed 45.8% of neutrophils have a sensitivity of 84.4% and a specificity of 66.7% for detecting the inflammatory phase. For platelets, a level of 135.000 has a sensitivity of 71.1% and a specificity of 61.1%. The percentage of neutrophils and the platelet levels remained significant predictors of the inflammatory phase. CONCLUSION: The study results suggest that platelets and neutrophils in wound exudate might be useful prognostic indicators of the inflammatory or proliferative phase of wound healing.

The role of postmortem study in the diagnosis of the cause of death in a young man: a rare case of Ehlers-Danlos syndrome type IV.

Diagnosis of the cause of death in young people is a challenge to both the clinician and the pathologist. Ehlers-Danlos syndrome (EDS) type IV is an inherited connective tissue disorder. It is characterised by thin translucent skin, abnormal fragility of blood vessels, and a typical facial appearance. The cause of death is usually due to large arterial rupture. We describe an unusual case of a 23-year-old man clinically diagnosed with myocarditis, who suffered from recurrent pulmonary haemorrhage and died of massive myocardial haemorrhage and ischaemia without coronary artery disease. Diagnosis of EDS type IV was made by autopsy. To our knowledge, this is the first such report in the literature. Delay in diagnosing this syndrome is common even when clinical features are typical, and the condition often goes unrecognised until necropsy. The diagnosis of EDS should be considered in young people who seek medical attention because of arterial rupture.

Synchronous bilateral breast carcinoma in a patient with cowden syndrome: a case report with morphologic, immunohistochemical and genetic analysis.

Synchronous bilateral breast carcinoma (SBBC) and early onset are important characteristics of hereditary cases. The lifetime risk for breast carcinoma in Cowden syndrome (CS) is estimated to be 25-50%. We reported a 44-year-old woman presenting SBBC and characteristic mucocutaneous lesions of CS, confirmed by PTEN gene mutation analysis. Bilateral modified mastectomy and axillary dissection were performed. Histopathologic examination revealed a moderate-differentiated invasive ductal carcinoma with mixed features of luminal A immunophenotype (Estrogen and/or Progesterone Receptors >50% and/or Ki67 < 30% of positive cells). The skin lesions showed the characteristic findings of tricholemmoma. Lack of PTEN expression was observed in all specimens. Sequencing analysis confirmed the presence of PTEN splice-acceptor site mutation in intron 8 (c.1027-2A>G), a germline mutation which had not been previously reported in CS. The patient received adjuvant chemotherapy and tamoxifen for 5 years. After 5 years of follow-up, she persists recurrence-free. SBBC with early onset suggests a hereditary predisposition. Thus, analysis of PTEN expression abnormality, easily assessed by immunohistochemistry, may be of clinical value to screen those patients with CS.

Interleucina-8 en el lavado broncoalveolar del donante y su impacto en la disfunción primaria del injerto en el trasplante bipulmonar / Interleukin 8 Concentrations in Donor Bronchoalveolar Lavage: Impact on Primary Graft Failure in Double Lung Transplant

La disfunción primaria del injerto pulmonar (DPIP) contin¨²a siendo la principal causa de mortalidad perioperatoria y precoz en los receptores de un trasplante pulmonar (TP)1. La DPIP es una lesi¨®n pulmonar aguda, que acontece en el per ...(AU)

Background and Objective The purpose of this study was to determine concentrations of interleukin 8 (IL-8) in the bronchoalveolar lavage (BAL) fluid from donor lungs and assess the role of IL-8 levels in the development of primary graft failure.Patients and MethodTwenty patients who received a double lung transplant were studied. A series of data, including BAL fluid concentrations of IL-8, were collected for the donors. Data collected for the recipients included arterial blood gases after 6, 24, and 48hours, and intubation time. Patients with a ratio of PaO2 to the fraction of inspired oxygen (FiO2) of less than 300 during the first 48hours were diagnosed with primary graft failure. IL-8 levels were determined by enzyme-linked immunosorbent assay. Associations between the donor variables and IL-8 concentrations were evaluated using the Spearman rank correlation coefficient (¦Ñ) and the Mann-Whitney test for categorical and continuous variables, respectively. Logistic regression was used for multivariate analysis(AU)

Results Fifteen of the 20 donors were men. The cause of brain death was trauma in 9 donors, 7 were smokers, 13 required inotropic support, and pathogens were isolated in the BAL fluid of 18. The median age was 35 years (interquartile range [IQR], 23.5¨C51.25y), the median ventilation time was 1 day (IQR, 1¨C2d), the median PaO2/FiO2 was 459.5 (IQR, 427¨C510.25), and the median IL-8 concentration in BAL fluid was 49.01ng/L (IQR, 7.86¨C94.05ng/mL).Ten of the recipients were men and the median age was 48.43 years (IQR, 25.4¨C56.81y). The median ischemic time was 210minutes (IQR, 176.25¨C228.75min) for the first lung and 300minutes (IQR, 273.75¨C333.73min) for the second lung. The median PaO2/FiO2 ratio for the implant at 6, 14, and 48hours was 329 (IQR, 190.25¨C435), 363.5 (IQR, 249¨C434.75), and 370.5 (IQR, 243.25¨C418.25), respectively. The median intubation time was 39.5hours (IQR, 19.25¨C68.5h) and the correlation with IL-8 values was positive: higher IL-8 concentrations in BAL fluid correlated with longer ventilation times (Spearman rank correlation, P=.007; ¦Ñ=0.583). Five patients developed primary graft failure; IL-8 concentrations were significantly higher in these patients than in those whose grafts did not fail (Mann-Whitney test, P=.003).ConclusionHigh IL-8 concentrations in donor BAL fluid lead to longer ventilation time in the recipients and favor the development of primary graft failure after lung transplant(AU)

Role of mutation Y6F on the binding properties of Schistosoma japonicum glutathione S-transferase.

The role of the hydroxyl group of tyrosine 6 in the binding of Schistosoma japonicum glutathione S-transferase has been investigated by isothermal titration calorimetry (ITC). A site-specific replacement of this residue with phenylalanine produces the Y6F mutant, which shows negative cooperativity for the binding of reduced glutathione (GSH). Calorimetric measurements indicated that the binding of GSH to Y6F dimer is enthalpically driven over the temperature range investigated. A concomitant net uptake of protons upon binding of GSH to Y6F mutant was detected carrying out calorimetric experiments in various buffer systems with different heats of ionization. The entropy change is favorable at temperatures below 26 degrees C for the first site, being entropically favorable at all temperatures studied for the second site. The enthalpy change of binding is strongly temperature-dependent, arising from a large negative DeltaC(o) (p1)=-3.45+/-0.62kJK(-1)mol(-1) for the first site, whereas a small DeltaC(o) (p2)=-0.33+/-0.05kJK(-1)mol(-1) for the second site was obtained. This large heat capacity change is indicative of conformational changes during the binding of substrate.

Salt influence on glutathione--Schistosoma japonicum glutathione S-transferase binding.

There has been some speculation about the salt independence of Schistosoma japonicum glutathione S-transferase (Sj26GST, EC. 2.5.1.18), but this aspect has not been carefully studied before. To establish the basis for a further development of this dependence, we have performed a methodical study of the influence of some important ions and their concentration on the binding properties of glutathione to Sj26GST by means of isothermal calorimetry and fluorescence quenching. Salts like NaCl, Na(2)SO(4) and MgSO(4) do not change practically the affinity of the protein for its substrate, whilst MgCl(2) has the effect of decreasing the affinity as its concentration rises. However, the enthalpy change is not affected by all the salts studied, and so, the entropy change is the causal factor in dropping the affinity. We also looked at the conformational stability of the protein under different conditions to check the structural changes they provide, and found that the unfolding parameters are practically not affected by the salt concentration. We discuss the results in terms of the chaotropic nature of the ions implied.

Dislipoproteinemias y cardiopatía isquémica prematura : hallazgos en 130 casos / Dislipoproteinemias and premature ischemic cardiopathy : findings in 130 cases

La ateroesclerosis coronaria es una enfermedad multifactorial y responsables de la mayoria de los casos de cardiopatia isquemica. En este informe se presenta 29 hombres con cardiopatias esquemica (edad: 51.2+-1.5 años peso: 73.9+-1.9kg) y se comparan con 15 sujetos control (edad: 50.0+-1.4 años; peso:70.8+-2.1kg). Los factores de riesgo coronario encontrados en los pacientes fueron las dislipoproteinemias, y hipertension arterial, el fumado y la obesidad comparado con los controles, los pacientes tenian concentraciones mas bajas de colesteriol en las lipoproteinas de alta densidad (31.4+-2.6vs.46.1+-4.2mg/dl,p<(0.01);concentraciones de triglicéridos mayores (255.5+-62.3vs94.7+-20.4,p<(0.05) y no habia diferencias en la concetracion de colesterol total. La relacion LDL/HDL fue mayor en los pacientes que en los controles (4.99+-0.5vs2.9+-0.5,respectivamente (p<0.01). Diez pacientes diabeticos no insulino dependientes tenian anormalidades lipidicas aun mas severas que los no diabeticos. Doce pacientes participaron en un programa de intervencion dietetica durante 3 meses. Al final de los 3 meses se observo una mejoria en las concentraciones de lipidos; sin embargo, no se logro normalizar el perfil de lipidos y lipoproteinas. En conclusion, los pacientes con cardiopatia isquemica presentan variadas alteraciones en el perfil de lipidos y lipoproteinas, especialmente los diabeticos, que persisten a pesar de atencion nutricional adecuada

Descripción de tres casos con hiperlipoproteinemias tipo III / A description of three cases with hyperlipoproteinemia type III

Hiperlipoproteinemia tipo III es una enfermedad genetica caracterizada por hipertrigliceridemia, hipercolesterolemia y por presencia en el plasma de lipoproteinas de muy baja densidad, enriquecidas en colesterol. Los pacientes con este padecimiento desarrollan xantomas tuberosos y ateroesclerosis prematura. En este informe se presenta tres casos de pacientes con hiperlipoproteinemias tipo III. En dos de ellos la hiperlipoproteinemia se manifesto en la infancia. El perfil de los lipidos y lipoproteinas y la electroforesis del plasma que mostro una banda ancha con movilidad prebeta fueron caracteristicos de la hiperlipoproteinemia tipo III. El fenotipo de la apolipoproteina E (APO E), por medio de enfoque isolectrico, fue APO E2/2 en dos casos y APO E3/2 en el otro. Se revisan las anormalidades metabolicas asociadas a esta enfermedad asi con el efecto de la intervencion nutricional y farmacologica de los pacientes con esta enfermedad genetica

Colesterol y triglicéridos en la población costarricense: interpretación de los resultados obtenidos en la Encuesta Nacional de Nutrición de 1982 / Cholesterol and triglycerides in the Costa Rican population: interpretation of the 1982 National Nutrition Suvey

En la Encuesta de Nutrición de Costa Rica de 1982 se determinó la concentración de colesterol y triglicéridos séricos en una muestra de la población adulta costarricense. En este informe se presenta y analiza estos resultados. La muestra fue constituida por 928 hombres y 1091 mujeres con edades comprendidas entre 20 y 59 años y fue represntativa de la población costarricense para ese año. La concentración de colestero (XñSD) fue de 198.8ñ49.2 mg/dl y de 208.0ñ49.2 mg/dl en hombres y mujeres, respectivamente. La concentración de triglicéridos fue mayor en hombres que en mujeres, 140.2ñ126 mg/dl vs 18.2ñ58.2 mg/dl (p - 0.05), respectivamente. Se determinó el porcentaje de personas con cifras de colesterol consideradas como riesgo coronario según los criterios establecidos por el Instituto Nacional de Salud de Estados Unidos. Mediante este análisis, se encontró que el 20 por ciento de colesterol consideradas como de riesgo moderado a alto para el desarrollo de enfermedad coronaria. Este estudio muestra la prevalencia de la concentración de colesterol y triglicéridos séricos en una muestra de la población adulta costarricense en 1982

Efecto de la distribución del tejido adiposo sobre la concentración de lípidos y lipoproteínas en mujeres delgadas / Effect of adipose tissue distribution on lipid and lipoprotein concentrations in slim women

El predominio del tejido adiposo en la región abedominal constituye un factor de riesgo cardiovascular y predice el desarrollo de diabetes mellitus. Con el fin de identificar factores de riesgo coronario en personas sanas, se estudió cincuenta y una mujeres, premenopáusicas, no obesas (indice de Quetelet, Kg/m2 = 22.0 ñ 0.25) con edades comprendidas entre 20 y 49 años pertenecientes a una población entre 20 y 49 años, pertenecientes a una población trabajadora y libre de enfermedades crónicas. De acuerdo a la distribución del tejido adiposo, medida por la razón entre la circunferencia abdominal (CA) y la circunferencia de la cadera (CC) y expresada como CA/CC, se obtuvieron dos grupos. Uno con CA/CC de 0.74 ñ 0.009, incluyó a mujeres con predominio de la adiposidad en la región femoral y glútea (adiposidad tipo I), mientras que aquellas con CA/CC de 0.81 ñ 0.003, conformaron el grupo de mujeres con adiposidad predominantemente abdominal (adiposidad tipo II). La concentración de colesterol total y triglicéridos estaba dentro de límites normales y no se observaron diferencias en estas variables entre ambos grupos. Sin embargo, la concentración del colesterol en las lipoproteínas de alta densidad fue significativamente menor en las mujeres pertenecientes al grupo con adiposidad tipo II. Los resultados obtenidos en esta inestigación muestran que en mujeres no obesas, la distribuición abdominal del tejido adiposo se asocia a concentraciones más bajas de colesterol en las lipoproteínas de alta densidad comparada con aquellas con distribuición femoral y glútea de la grasa corporal. Estos datos sugieren que entre mujeres sanas y sin sobrepeso, la adiposidad abdominal podría representar un factor de mayor riesgo cardiovascular a través de concentraciones reducidas de colesterol HDL, comparado con aquellas que tienen predominio de la grasa corporal en la región femoral y glútea

Intervencion nutricional en pacientes con hiperlipoproteinemias / Nutritional intervention in hiperlypidemic patients

La intervencion nutricional juega un papel central en el manejo de las lipoproteinemías. Se diseño un modelo de intervencion nutricional para reducir las concentraciones elevadas de lipidos y lipoproteinas en los pacientes con hiperlipoproteinemias primarias y secundarias. Este modelo emplea un aborde educativo, a traves del cual los pacientes aprenden los conceptos basicos de nutricion y el efecto potencial de los nutrientes sobre la concentracion sanguinea de lipidos y lipoproteinas. Se plantea que el mejor conocimiento que los pacientes tengan acerca de su problema metabolico los estimulara a continuar adheriendose a la dieta.