ABSTRACT
In Chronic hepatitis B (CHB) infection, virus and immune response interplay is thought to be responsible for pathogenesis. Yet, the impact of each immune cell population and viral protein expression in liver damage is still unknown. Our aim was to study the interplay between intrahepatic immune response and viral activity in relation to CHB liver damage. Immunostaining was performed in 29 liver biopsies from untreated CHB patients to characterize liver infiltrate [Th (CD4+), CTL (CD8+), Treg (FoxP3+), Th17 (IL-17A+) and Th1 (T-bet+)] and viral antigen expression (HBsAg and HBcAg). Inflammatory activity and fibrosis were assessed using the HAI and METAVIR scoring system. All studied populations were identified in the portal-periportal (P-P) areas with a CD4+ lymphocyte predominance, while only CD8+ and FoxP3+ cells were observed in the intralobular area. Both P-P CD4+ and intralobular CD8+ cell frequencies were increased among severe hepatitis cases. Concerning HBsAg and HBcAg expression, a mutually exclusive pattern was observed. HBcAg was mainly detected among HBeAg-positive patients and was associated with hepatitis severity and higher frequency of P-P FoxP3+, intralobular CD8+ and FoxP3+ cells. HBsAg was identified among HBeAg-negative cases with less severe hepatitis grade and lower frequency of P-P CD4+ and intralobular FoxP3+ lymphocytes. In conclusion, the HBV antigen profile expression seen during CHB infection may be reflecting different stages of viral replication which impacts the host immune response and liver damage process. While HBcAg might be an inducer of a regulatory microenvironment, the intralobular CTL population seemed to have a key role in hepatitis severity.
Subject(s)
Antigens, Viral/immunology , Hepatitis B, Chronic/immunology , Liver/immunology , Liver/pathology , Lymphocyte Subsets/immunology , Adult , Aged , Antigens, Viral/genetics , Biopsy , CD4-Positive T-Lymphocytes/immunology , CD8-Positive T-Lymphocytes/immunology , Female , Hepatitis B Core Antigens/genetics , Hepatitis B Core Antigens/immunology , Hepatitis B e Antigens/genetics , Hepatitis B e Antigens/immunology , Hepatitis B virus , Humans , Immunohistochemistry , Inflammation , Liver/cytology , Male , Middle Aged , Retrospective Studies , T-Lymphocytes, Regulatory/immunology , Young AdultABSTRACT
Colonic lipomas are a rare entity, even lessfrequent colonic lipomatosis (lipohyperplasia) of which we only found very few reports in literature (five cases). We report a case of colonic lipomatosis in a young adult that manifested as acute diverticulitis with perforation and rectalpolyposis requiring surgical resolution.
Subject(s)
Colonic Diseases/diagnosis , Colonic Diseases/surgery , Lipomatosis/diagnosis , Adult , Diverticulitis, Colonic/diagnosis , Diverticulitis, Colonic/etiology , Humans , Lipomatosis/surgery , MaleABSTRACT
Colonic metastasis of breast cancer are extremely infrequent, being ductal subtype the most rarely affects the digestive tract, compared to lobular subtype. We present a case report of a colonic metastasis of ductal breast cancer; found in the context of a screening colonoscopy. Besides we perform an article research about digestive tract metastasis of primary breast cancer, finding very few published cases among the literature about this ductal subtype behavior.
Subject(s)
Breast Neoplasms/pathology , Carcinoma, Ductal, Breast/secondary , Colonic Neoplasms/secondary , Aged , Colonic Neoplasms/diagnosis , Colonoscopy , Female , HumansABSTRACT
Contenido: La crisis de la salud pública mundial en Latinoamérica y la Argentina. Todos los países se verán afectados, aunque no por igual. Objetivos de desarrollo del Milenio en Caribe y América Latina. Tendencias del hambre y la desnutrición en la región. Objetivo del desarrollo del Milenio relacionado con la salud: reducción de la mortalidad infantil. La lucha contra la pobreza en América Latina. Argentina: crisis socio- sanitaria del 2001 en adelante. La problemática de los medicamentos. Los fideicomisos cuestionados. Un problema de salud, de independencia y de defensa nacional. Remediar. Quién atiende los argentinos hoy.
Subject(s)
Public HealthABSTRACT
Fueron estudiados 989 pacientes con linfoma. Tuvieron infiltración linfomatosa craneocerebral 53 casos (5.3%). Los principales factores de riesgo para esta complicación fueron: a. estado avanzado del linfoma (III o IV); b. las forma difusas histiocíticas, difusa pobremente diferenciada o celularidad mixta: c. el compromiso de la medula osea y de la quimioterapia sistémica previa. En el 32% de los casos la infiltración meníngea linfomatosa fué asintomática y representó hallazgos de autopsia. La tomografía cerebral fué de utilidad para detectar infiltraciones parenquimatosas focales, no así para las infiltraciones meníngeas. El tiempo medio de sobrevida en pacientes con infiltración meníngea linfomatosa fué de 4.3 meses, siguientes al uso combinado de terapia radiante a craneo total, quimioterápia sistémica y/o intratecal con methotrexate. Dos casos con linfoma cerebral primario no estuvieron asociados con inmunodeficiencia. Hemorragias intracraniales se observaron en 20 pacientes (2%), en relación con alteraciones plaquetarias. En 15 casos hubo infección del SNC (1.5%), causada por bacterias comunes o por agentes oportunistas. En 7 de esos casos el diagnóstico se hizo por autopsia. En 8 de 36 casos autopsiados (22%) se observaron desmielinización, microcalcificaciones, necrosis coagulativa o gliosis, sugestivas de complicaciones por los tratamientos efectuados
