Leiomioma vascular uterino con foco epiteliode: caso clínico / Uterine leiomyoma with a focus epithelioid vascular: clinical case

Los leiomiomas son los tumores mas frecuentes en la mujer y en términos coloquiales se les conoce como "Fibroides" (1). En las variantes infrecuentes de presentación están los leiomiomas vasculares uterinos que son tumores benignos compuestos por células musculares lisas miometriales y vasos sanguíneos de paredes gruesas (2). Presentamos el caso de una femenina hispana de 36 años de edad con tumoración abdominal, trastornos mestruales y dolor pélvico de tres meses de evolución. Se le realizó ecosonograma pélvico y transvaginal que reportó tumor de ovario derecho ecomixto, fue llevada a quirófano teniendo como hallazgo incidental un útero aumentado de tamaño sin alteración de los anexos, tomándose la decisión de concluir el acto operatorio hasta clarificar el diagnóstico. En un segundo tiempo quirúrgico y posterior a estudios complementarios se le realizó histerectomía. En cuanto a los hallazgos histológicos y por estudios de inmunohistoquímica se diagnósticó un leiomioma vascular uterino intramural, con áreas celulares y foco epiteliode.

SMEDWI-2 is a PIWI-like protein that regulates planarian stem cells.

We have identified two genes, smedwi-1 and smedwi-2, expressed in the dividing adult stem cells (neoblasts) of the planarian Schmidtea mediterranea. Both genes encode proteins that belong to the Argonaute/PIWI protein family and that share highest homology with those proteins defined by Drosophila PIWI. RNA interference (RNAi) of smedwi-2 blocks regeneration, even though neoblasts are present, irradiation-sensitive, and capable of proliferating in response to wounding; smedwi-2(RNAi) neoblast progeny migrate to sites of cell turnover but, unlike normal cells, fail at replacing aged tissue. We suggest that SMEDWI-2 functions within dividing neoblasts to support the generation of cells that promote regeneration and homeostasis.

Identification of genes needed for regeneration, stem cell function, and tissue homeostasis by systematic gene perturbation in planaria.

Planarians have been a classic model system for the study of regeneration, tissue homeostasis, and stem cell biology for over a century, but they have not historically been accessible to extensive genetic manipulation. Here we utilize RNA-mediated genetic interference (RNAi) to introduce large-scale gene inhibition studies to the classic planarian system. 1065 genes were screened. Phenotypes associated with the RNAi of 240 genes identify many specific defects in the process of regeneration and define the major categories of defects planarians display following gene perturbations. We assessed the effects of inhibiting genes with RNAi on tissue homeostasis in intact animals and stem cell (neoblast) proliferation in amputated animals identifying candidate stem cell, regeneration, and homeostasis regulators. Our study demonstrates the great potential of RNAi for the systematic exploration of gene function in understudied organisms and establishes planarians as a powerful model for the molecular genetic study of stem cells, regeneration, and tissue homeostasis.

[Gonadal, hormonal and spermatic function in patients treated for cryptorchidism]. / Función gonadal hormonal y espermática en pacientes tratados por criptorquidia.

This paper studies the gonadal-hormonal and spermatic function of 48 adults (over 18 years old) who were treated in childhood for cryptorchidism by medical, surgical or both treatments. We measure plasmatic levels of FSH, LH, testosterone and prolactin of 34 patients and sperm samples of 31 patients. The testicular hormonal function was not disturbed except in four patients with high levels of prolactin (> 20 ng/ml) without symptoms. The spermatic function was disturbed in bilateral cryptorchidism mainly. The better sperm quality and testicular volume were at patients treated with hormonal treatment before surgical treatment.

Gastroparesis of digestible and indigestible solids in patients with insulin-dependent diabetes mellitus or functional dyspepsia.

Gastric emptying of a solid meal and of 10 indigestible radiopaque solids was measured with scintigraphic and radiological techniques in 50 healthy volunteers (controls), 41 patients with insulin-dependent diabetes mellitus, and 50 patients with functional dyspepsia. Gastroparesis was found in 51% of our diabetic patients and 74% of our patients with dyspepsia. The values of Tlag, T1/2 and the percentage of isotope remaining in the stomach at 105 min were 14.9 min, 59.4 min and 25.3% in control subjects; 21.4 min, 88.1 min, and 46.9% in diabetic patients (P < 0.05 vs the control group); and 23.2 min, 114.6 min, and 58.7% in dyspeptic patients (P < 0.05 vs the control group). Whereas all healthy volunteers emptied all 10 indigestible solids in less than 4 hr, only 51% and 32% of diabetics and dyspeptics, respectively, achieved this emptying time (P < 0.01). Their respective values of T1/2 were 81 min, 212 min, and 203 min (P < 0.01 for diabetics and dyspeptics vs controls). We found no correlation between the findings for gastric emptying of digestible and indigestible solids. We conclude that gastroparesis affecting digestive and interdigestive motility is present in a high percentage of diabetics and functional dyspeptics and that conscientious evaluation of gastroparesis in both groups requires studies designed specifically to characterize each type of motility.

[Pituitary apoplexy in 2 hypophyseal tumors]. / Apoplejía hipofisaria en dos tumores hipofisarios.

Hypophyseal apoplexy is not always easy to confirm morphologically or analytically. We present a patient with Cushing's syndrome due to hypophyseal apoplexy and optochiasmic pachyarachnoiditis which produced serious visual alterations. The adenoma necrotized behind an area of hypophyseal apoplexy which cured the patient's Cushing's disease. The second case was admitted with hypophyseal apoplexy, presenting hypophyseal tumoration with signs of hemorrhage and subsequent panhypopituitarism.

[Suprarenal carcinoma of an unusual size]. / Carcinoma suprarrenal de tamaño inusual.

Suprarenal carcinoma is an unusual entity, rarely surpassing 4,000 gr. In general, tumors of such big size are not functional. We present a case of a 31-years-old woman with a suprarenal carcinoma weighting 5,200 gr, in which hormonal production was clinically and biochemically demonstrated.

[Parathyroid insufficiency syndrome. Two new cases: type Ia pseudohypoparathyroidism and pseudo-idiopathic hypoparathyroidism]. / Síndrome de insuficiencia paratiroidea. Dos nuevos casos: pseudohipoparatiroidismo tipo Ia e hipoparatiroidismo pseudoidiopático.

Two new cases with parathyroid insufficiency syndrome are described. The first one is a seven year and 6 months old male with Pseudohypoparathyroidism Type Ia, who has presented: hypocalcemia, hyperphoforemia, increased PTH and TSH, prolactin decreased and Albright hereditary osteodystrophy phenotype. The second one in a six year and four months old female with Pseudo-idiopathic hypoparathyroidism who has presented: hypocalcemia, hyperphosforemia, increased PTH, without any hormonal disturbances nor dysmorphias. Ellsworth-Howard test with 50 micrograms of 1-34 hPTH is made in both, remarking the different renal response about phosphaturia and plasmatic, urinary and nephrogenic cyclic AMP. The treatment is performed in both with calcitriol and oral calcium (L-Thyroxine is associated for the first patient). Biochemical disturbances are normalized. Other parathyroid insufficiency syndrome are revised.

[Current evaluation of the classical Werner test and its correlation with current in vitro E.T.R. technics]. / Valoración actual de la clásica prueba de captación y test de Werner y su correlación con nuevas técnicas in vitro. E.T.R

The authors evaluated the current standing of the classical 131I uptake test, together with its subsidiary stimulation and suppression tests, and its correlation to clinical diagnosis and the in vitro ETR (Effective Thyroxine Ratio) technique. In the 349 cases studied, a good correlation was found between the previous diagnosis--made by means of 131I uptake test--and the clinics and symptomatology, and very particularly, the in vitro ETR test. The authors conclude that the combination of both tests is sufficiently reliable for the diagnosis of thyroid dysfunction.