Heat shock proteins (HSPs) 27, 72 and 73 in normal and pre-ulcerative mucosa of the gastric pars oesophagea in swine.

Heat shock proteins (HSPs), known to play a key role in cellular homeostasis, may also play a role in the defensive mechanisms of gastric mucosa. By means of appropriate immunohistochemical and immunobiochemical techniques, the expression of HSP27, HSP72 and HSP73 within the epithelium of normal and pre-ulcerative (hyperkeratinized) mucosa of the pars oesophagea of abattoir pigs was assessed. In normal mucosa, HSP72 and HSP73 expression was mainly limited to the basal epithelial cell layer, whereas HSP27 expression was consistently detected within the superficial epithelial cell layers. In hyperkeratinized mucosa, HSP72 and HSP73 immunoreactivity appeared to be more widespread, becoming very intense within epithelial cells affected by hydropic degeneration. Hyperkeratinized mucosa also showed HSP27 immunoreactivity, which was particularly intense in epithelial areas affected by hydropic degeneration. Western blot analysis confirmed HSP27, HSP72 and HSP73 expression in normal and in pre-ulcerative mucosa of the pars oesophagea. Semi-quantitative analysis showed that for all three HSPs the immunoreactivity was more intense in pre-ulcerative mucosa than in normal mucosa. The different expression patterns observed may have functional significance; further studies are needed, however, to define the role of HSPs in swine oesophagogastric lesions, the aetiology and pathogenesis of which are largely unknown.

Diagnóstico ultrasonográfico, tratamiento y evolución en abscesos hepáticos: experiencia en nuestro medio / Hepatic abscess: US diagnosis, percutaneous drainage and clinical evolution

A fin de evaluar las características ecográficas y su correlación con la etiología, el rendimiento diagnóstico y terapéutico de la punción dirigida y otros hallazgos orientadores de la patogenia, se evaluaron 43 pacientes con abscesos hepáticos diagnosticados mediante US entre enero de 1990 y junio de 1998. Observamos que en nuestra población los abscesos múltiples se correlacionaron en el 69 por ciento de los casos con patogenia biliar o portal, siendo los criptogenéticos en su mayoría únicos (12/14). El rédito diagnóstico obtenido por punción percutánea (81 por ciento) fue significativamente mayor al obtenido por hemocultivo (31 por ciento). La terapéutica con drenaje percutáneo fue eficaz en el 78 por ciento de los casos aplicados. La mortalidad global (7 por ciento) es levemente inferior a la descripta en la literatura; destacamos que en nuestra población la asociación con pileflebitis se observó en 2 de los 3 casos

Diagnóstico ultrasonográfico, tratamiento y evolución en abscesos hepáticos: experiencia en nuestro medio / Hepatic abscess: US diagnosis, percutaneous drainage and clinical evolution

A fin de evaluar las características ecográficas y su correlación con la etiología, el rendimiento diagnóstico y terapéutico de la punción dirigida y otros hallazgos orientadores de la patogenia, se evaluaron 43 pacientes con abscesos hepáticos diagnosticados mediante US entre enero de 1990 y junio de 1998. Observamos que en nuestra población los abscesos múltiples se correlacionaron en el 69 por ciento de los casos con patogenia biliar o portal, siendo los criptogenéticos en su mayoría únicos (12/14). El rédito diagnóstico obtenido por punción percutánea (81 por ciento) fue significativamente mayor al obtenido por hemocultivo (31 por ciento). La terapéutica con drenaje percutáneo fue eficaz en el 78 por ciento de los casos aplicados. La mortalidad global (7 por ciento) es levemente inferior a la descripta en la literatura; destacamos que en nuestra población la asociación con pileflebitis se observó en 2 de los 3 casos (AU)

Scleredema adultorum: case report and demonstration of abnormal expression of extracellular matrix genes in skin fibroblasts in vivo and in vitro.

To elucidate the mechanisms involved in the development of cutaneous fibrosis in scleredema adultorum, we studied a patient with long-standing scleredema who had no history of diabetes mellitus or preceding febrile illness. Histological examination of a biopsy specimen from involved forearm skin demonstrated marked thickening of the dermis and accumulation of mucin between collagen bundles. Increased levels of type I collagen mRNA, as evidenced by positive in situ hybridization signals with an alpha 1(I) procollagen cDNA were found in numerous fibroblasts throughout the dermis. The expression of several genes coding for proteins involved in the maintenance of connective tissue was examined by determining in vitro protein production and mRNA levels in fibroblasts from the affected skin. Total protein production, glucosamine incorporation and collagen synthesis, were elevated by 44-97% in scleredema fibroblasts, compared with fibroblasts from two healthy individuals. Levels of mRNAs for alpha 1(I) and alpha 1(III) procollagens and fibronectin were elevated in scleredema fibroblasts, whereas mRNA levels for the tissue inhibitor of metalloproteinase were unaltered compared with control cultures. The results suggest that fibroblasts from the involved skin in non-diabetic patients with scleredema may exhibit a biosynthetically activated phenotype, which persists for several years. These alterations are likely to be involved in the development of the cutaneous induration and thickening which is characteristic of this disease.

Methazolamide-induced skin eruptions.

To our knowledge, this is the first histopathologic report of skin eruptions due to oral methazolamide. From the four cases studied, we conclude that there are at least two histopathologic types: one is characterized by perivascular lymphocytic infiltrate with a vacuolar alteration at the dermoepidermal junction, the other by perivascular eosinophils, lymphocytes, and scattered mast cells. There also seem to be at least two patterns of skin eruptions: one maculopapular and the other urticarial. The type of skin eruption and the histopathologic type appear to be related.

Papular mucinosis (scleromyxoedema) complicating diffuse systemic sclerosis: clinical features and electron microscope observations.

Papular mucinosis (scleromyxoedema) is an uncommon disorder characterized by generalized papular eruption and cutaneous induration, which may be associated with a variety of extracutaneous manifestations. Although scleroderma and papular mucinosis share many features, they are clinically and histologically distinct entities. We report here a patient with diffuse scleroderma who developed superimposed papular mucinosis. Degranulating mast cells were a prominent ultrastructural finding in the involved skin. The occurrence of scleroderma and papular mucinosis, two uncommon cutaneous indurative diseases, in the same patient has not been described previously.