Mesotelioma en paciente colombiano con sobrevida mayor a tres años: presentación de caso / Mesothelioma in a Colombian Patient over three years: Case Presentation / Mesotelioma em paciente colombiano com sobrevivência superior a três anos: apresentação de caso

Resumen Introducción: el mesotelioma epitelioide es un tumor que se desarrolla en las capas embrionarias mesoteliales; es de etiología desconocida, pero se relaciona con la exposición al asbesto, con una presentación clínica inespecífica y con un pronóstico de sobrevida corto después del diagnóstico. Presentación del caso: hombre de profesión mecánico automotor, con tos sin expectoración, disnea, hipertermia y emaciación posterior a la extracción quirúrgica de lipomas que afectaban el tórax, quien posteriormente fue diagnosticado con mesotelioma epitelioide maligno con ubicación en la pleura del hemitórax derecho y fue tratado con toracotomía, quimioterapia con los medicamentos pemetrexed y cisplatino y sesiones de radioterapia, que mostraron un aumento en la sobrevida 3 tres años. Conclusión: este caso permitió identificar que el uso de la pleurodesis química con quimioterapia como tratamiento podría ser responsable del aumento de la esperanza de vida y la calidad de esta en los pacientes que padecen este tipo de tumor.

Abstract Introduction: Epithelioid mesothelioma is a tumor that develops in the mesothelial embryonic layers; it is of an unknown etiology, but it is related to asbestos exposure with a nonspecific clinical presentation and a short survival prognosis after diagnosis. Case presentation: An automotive mechanic patient presents with cough without expectoration, dyspnea, hyperthermia, and emaciation following surgical removal of lipomas. This affected the chest and the patient was subsequently diagnosed with malignant epithelioid mesothelioma located in the pleura of the right hemithorax. The patient was treated with thoracotomy, chemotherapy with the drugs pemetrexed and cisplatin, and radiation therapy sessions which resulted in an increased survival rate at 4 years. Conclusion: This case report identifies the use of chemical pleurodesis in combination with chemotherapy as an effective treatment for increasing the life expectancy and quality of life in patients suffering from this type of tumor.

Resumo Introdução: o mesotelioma epitelióide é um tumor que se desenvolve nas camadas embrionárias mesote-liais; é de causa desconhecida, mas está relacionado com a exposição ao amianto e possui uma manifestação clínica inespecífica e com prognóstico de sobrevivência curto após o diagnóstico. Apresentação do caso: o paciente é um mecânico automotivo, que apresentou tosse seca, dispneia, hipertermia e emagrecimento posterior a extração cirúrgica de lipomas que afetavam o tórax sendo posteriormente diagnosticado com mesotelioma epitelióide maligno localizado na pleura do hemitórax direito e foi tratado com toracotomia, quimioterapia com os medicamentos pemetrexed e cisplatino além de sessões de radioterapia, mostrando um aumento de expectativa de vida para 4 anos. Conclusão: este estudo de caso permite identificar que o uso da pleurodese química com quimioterapia como tratamento poderia ser a responsável pelo aumento da expectativa e qualidade de vida em pacientes acometidos por este tipo de tumor.

Análises macroscópica e histopatológica do alotransplante parcial de vesícula urinária com células-tronco mesenquimais alogênicas derivadas do tecido adiposo em coelhos / Macroscopic and histopathological analysis of partial urinary bladder allograft using allogenic adipose tissue derived mesenchymal stem cells in rabbits

O número de transplantes de órgãos e tecidos em humanos e animais tem crescido significativamente nos últimos anos, principalmente após o advento de técnicas modernas e mais seguras indutoras de imunossupressão. Objetiva-se com o presente estudo avaliar macro e microscopicamente o alotransplante parcial de bexiga a fresco em coelhos, utilizando como agente imunomodulador células-tronco mesenquimais derivadas do tecido adiposo (ADSC) alogênicas. Foram utilizados 25 coelhos, sendo um deles macho e doador das ADSCs, e os outros 24 eram fêmeas, submetidas a alotransplante parcial de bexiga, tratadas com ciclosporina (GCi) ou células-tronco mesenquimais (GCe). Conclui-se que o GCe teve melhor aceitação histológica do implante em relação ao GCi aos 30 dias de avaliação.(AU)

The number of organ and tissue transplantation in humans and animals has grown significantly recently, especially after the advent of modern and safer techniques of immunosuppression. The objective of this study was to evaluate macro and microscopically partial urinary bladder fresh allograft in rabbits, using as immunomodulatory agent cyclosporine or allogenic adipose tissue derived mesenchymal stem cells (ADSCs). For this purpose, 25 rabbits were used. One male was the donor of ADSCs; 24 females received a partial urinary bladder allograft and were treated with cyclosporine (GCi) or mesenchymal stem cells (GCe). We conclude that the GCe group had better histological acceptance of the implant than GCi group at 30 days evaluation.(AU)

Aspectos da E-caderina na invasão óssea do carcinoma epidermóide da mucosa oral / E-cadherin expression in oral squamous cells carcinoma with boné invasion

O carcinoma epidermóide da mucosa oral (CEMO) é uma neoplasia maligna comum; no Brasil, são estimados, para 2016, 15.490 novos casos. A invasão óssea ocorre em casos avançados.; esta é classificada em erosiva e infiltrativa. Aparentemente, o processo de transição epitélio-mesenquimal, com o envolvimento da E-caderina, é implicado. Foi investigada a expressão de E-caderina, por meio da imunoistoquímica em 15 casos avançados de CEMO e avaliada sua correlação com as características clínicas e histológicas da invasão óssea. A imunoexpressão da E-caderina foi estudada nos 15 casos de CEMO com evidência histológica de invasão óssea. A maioria dos pacientes eram homens (10 pacientes) e apresentavam invasão em mandíbula (9 casos). A expressão de E-caderina foi negativa em CEMOs com invasão erosiva e positiva nos casos que apresentavam infiltração óssea. A expressão de E-caderina na invasão óssea sugere que a participação do fenômeno de transição epitélio-mesenquimal é um fator diretamente envolvido com o tipo de invasão óssea.

Oral squamous cell carcinoma (OSCC) is a common malignancy; in Brazil it is estimated, in 2016,15.490 new cases. Bone invasion occurs in advanced cases; it is classified in erosive and infiltrative patterns. Apparently, the epithelial-mesenchymal phenomenon, with important participation of E-cadherin is implicated. We investigated the expression of E-cadherin in advanced OSSC and correlated its expression with the clinical characteristics and histologic patterns of bone invasion. Immunoexpression of E-cadherin was studied in 15 cases of OSCC with histological evidence of bone invasion. Most patients were men (10 patients) and presented mandible invasion (9 cases). The expression of E-cadherin was negative in OSCC in erosive bone invasion and positive in the infiltrative bone invasion. E-cadherin expression in bone invasion suggests that participation of epithelial-mesenchymal phenomenon is dependent on the patterns of tumour bone invasion.

La reactividad constitucional del sujeto: una piedra de rosetta interdisciplinaria / A reatividade constitucional do sujeito. Uma pedra de roseta interdisciplinar / Subject’s constitutional reactivitya: interdisciplinary rosetta stone

Aprender a identificar de manera integral, mixta y dinámica la constitución de un sujeto significa, por un lado, ayudarlo a autoconocerse en su manera de reaccionar (por eso se habla de reactividad constitucional y no más de biotipos o rasgos), de desarrollarse (madurar o destruirse), de relacionarse y aceptar a los demás tal como son; por otro lado, sirve para personalizar diagnóstico, terapia y pronóstico. La historia del constitucionalismo y un esquema sinóptico interdisciplinario (filosofía griega, teología, medicina hipocrática, galénica, homeopática, china, ayurvédica y holística, biología, embriología, bioquímica, fisiopatología, neurología, endocrinología, psicología y espiritualidad) muestra una precisa correspondencia y un denominador común sobre la base de la teoría constitucional embriológica que habla de endoblasto, mesoblasto y ectoblasto. Una coherencia que dura por más de 24 siglos en occidente y pasa también las barreras culturales (oriente y occidente) y paradigmáticas (biomedicina y homeopatía), no puede ser casual.

To learn to identify in an integral, mixed and dynamic way the subject’s constitution means, on one hand, to help him to a self-knowledgement of his reactive way (for this, we speak of constitutional reactivity and no more of biotipe or trait), to develop himself (to mature or to destroy), to join and accept the others like they are; on the other way, it serve to personalize diagnosis, therapy and prognosis. The constitution history and a synoptic interdisciplinary diagram (Greek philosophy, theology, hippocratic, galenic, homeopatic, chinese, ayurvedic and holistic medicines, biology, embriology, biochemistry, physiopathology, neurology, endocrinology, psychology and spirituality) shows a precise link and a common denominator according to an embriologic constitutional theory, that speaks about endoblast, mesoblast and ectoblast. A coherence thas lasts for more than 24 centuries in occident and goes through even the cultural borders (eastern and western world) and paradigmatic logics (biomedicine and homeopaty) cannot be casual.

Aprender a identificar de maneira integral, mista e dinâmica a constituição de um sujeito significa, por um lado, ajudá-lo a se autoconhecer na sua maneira de reagir (por isso se fala de reatividade constitucional e não mais de biotipos ou traços), de desenvolver-se (amadurecer ou destruir-se), de relacionar-se e aceitar os demais taisl como são; por outro lado, serve para personalizar diagnóstico, terapia e prognóstico. A história do constitucionalismo e um esquema sinóptico interdisciplinar (filosofia grega, teologia, medicina hipocrática, galênica, homeopática, chinesa, ayurvédica e holística, biologia, embriologia, bioquímica, fisiopatologia, neurologia, endocrinologia, psicologia e espiritualidade) mostra uma precisa correspondência e um denominador comum sobre a base da teoria constitucional embriológica que fala de endoblasto, mesoblasto e ectoblasto. Uma coerência que dura por mais de 24 séculos no ocidente e ultrapassa também as barreiras culturais (oriente e ocidente) e paradigmáticas (biomedicina e homeopatia), não pode ser casual.

Peripheral blood fibrocytes: new information to explain the dynamics of Leishmania infection

Fibrocytes are important for understanding the progression of many diseases because they are present in areas where pathogenic lesions are generated. However, the morphology of fibrocytes and their interactions with parasites are poorly understood. In this study, we examined the morphology of peripheral blood fibrocytes and their interactions with Leishmania (L.) amazonensis . Through ultrastructural analysis, we describe the details of fibrocyte morphology and how fibrocytes rapidly internalise Leishmania promastigotes. The parasites differentiated into amastigotes after 2 h in phagolysosomes and the infection was completely resolved after 72 h. Early in the infection, we found increased nitric oxide production and large lysosomes with electron-dense material. These factors may regulate the proliferation and death of the parasites. Because fibrocytes are present at the infection site and are directly involved in developing cutaneous leishmaniasis, they are targets for effective, non-toxic cell-based therapies that control and treat leishmaniasis.

Apicoformación en dientes permanentes jóvenes / Apexification in young permanent teeth

La endodoncia regenerativa desarrolla técnicas basadas en ingeniería de tejidos para reponer tejidos perdidos. Con el desarrollo del conocimiento actual de la biología molecular, la microbiología y la genética, entre otras disciplinas, estamos en condiciones de introducirnos en el conocimiento de las cascadas de señales intracelulares desencadenadas por los sistemas complejos autoorganizados en sus procesos de autoreparación. Esto nos permite definir los pasos que debemos efectuar para la regeneración ad integrum de los tejidos que conforman el sistema de inserción dental

Displasia mesenquimal placentaria: caso clínico / Placental mesenchymal dysplasia: a case report

La displasia mesenquimal placentaria es una entidad poco conocida, de etiología incierta y subdiagnosticada. Frecuentemente, es confundida con enfermedad trofoblástica gestacional debido a que se presenta con hallazgos ultrasonográficos caracterizados por una placenta engrosada, con quistes e imágenes hipoecogénicas y niveles de gonadotrofina coriónica humana normales o levemente aumentados. El feto es frecuentemente viable y puede manifestar retraso del crecimiento intrauterino, prematurez o asociarse al síndrome de Beckwith-Wiedemann. Se presenta el caso de una mujer joven con un parto pretérmino con placentomegalia, sospecha de mola hidatidiforme parcial y un recién nacido pequeño para la edad gestacional.

The placental mesenchymal dysplasia is a not well known entity, with an uncertain etiology and under diagnosed. It is frequently confused with gestational trophoblastic disease because of its ultrasonographic features of a thick placenta, cysts and hypoechogenic images, with normal or slightly increased levels of human chorionic gonadotrophic hormone. The fetus is often viable and can manifest intrauterine growth restriction, prematurity or be associated with Beckwith-Wiedemann syndrome. We present a case report of a young woman with a preterm delivery, placentomegaly, suspicious of a partial hydatidiform mole and a low growth newborn.

Lipoma gigante de Membro inferior com repercussão no sistema vascular / Giant lipoma of the lower limb and its impact on the vascular system

Lipomas are the most common mesenchymal tumors, which may develop in different parts of the body. However giant lipomas are rare and sometimes difflcult to diagnose owing to their location and the presenting clinical consequences. In this report, we present the case of a patient with a giant lipoma in lhe left popliteal region that was surgícally treated after a detailed radiologícal assessment. Further, we discuss lhe preoperative diagnosis and its difficulties, often caused by the deep localization of the tumor and the impossibility of obtaining a conclusive radiological diagnosis. Moreover, we describe the successful treatment, along with the step-by-step surgical approach and the final outcome achieved.

Os lipomas são os tumores Mesenquimais mais frequentes e podem ocorrer em diversas partes do corpo. Entretanto lipomas gigantes são raros por vezes de difícil diagnóstico, em decorrência de sua localização e com consequência clinicas. Neste artigo é apresentado um caso de lipoma gigante em região poplítea esquerda tratado cirurgicamente após detalhado estudo radiológico. São discutidos o diagnóstico pré-operatório e suas dificuldades, muitas vezes causadas pela localização profunda e pela impossibilidade de diagnóstico conclusivo pela imagem. O tratamento foi concluído com sucesso, sendo descritos a abordagem cirúrgica passo a passo e o resultado final.

Desarrollo del Aparato Digestivo / Digestive System Development

El aparato digestivo deriva del endodermo y el mesodermo, que forman su epitelio y la musculatura lisa respectivamente. Al igual que en el resto de los sistemas, existe un interacción epitelio-mesenquimática mediada por moléculas como Hedgehog, BMP y FoxF1 que determinan el crecimiento intestinal en sus ejes principales. Los genes Hox, junto con el resto de las moléculas, participan en la regionalización del sistema digestivo. En sus inicios lo denominaremos intestino primitivo, formado por un tubo endodérmico que deriva del saco vitelino; dividiéndose en intestino anterior, medio y posterior. En esta revisión veremos cómo estos 3 segmentos darán origen a las diferentes estructuras del sistema digestivo en los vertebrados.

The digestive system is derived from the endoderm and mesoderm, which form its epithelium and smooth muscle, respectively. As in the other systems, there is an epithelial-mesenchymal interactions mediated by molecules such as Hedgehog, BMP and FoxF1, determining intestinal growth in the main axes. The Hox genes, together the rest of the molecules, involved in the regionalization of the digestive system. In the beginning we call it primitive gut, consisting of a tube derived of endodermal yolk sac, divided into foregut, midgut and hindgut. In this review we will see how these 3 segments give rise to different structures of the digestive system in vertebrates.

Variações anatômicas do tecido celular subcutâneo pós-perda ponderal / Anatomic variations of the subcutaneous tissue after ponderal weight lost

Introdução: Os dois estratos de gordura que compõem o tecido celular subcutâneo variamde espessura nas diversas regiões do corpo, com o peso, idade, sexo e genética. Quandosubmetidos a amplas variações volumétricas decorrentes de cirurgia bariátrica ou por dietasextremas, alterações macroscópicas e histológicas são evidentes e generalizadas pelocorpo. Método: Foram estudadas 28 peças cutâneas cirúrgicas selecionadas nas regiõesepigástrica, peri-umbilical, hipogástrio e lombar, para avaliações na diferença de espessurae das suas características estruturais macroscópicas e distribuídas em três grupos: opadrão normal para fins comparativos, os que foram submetidos a cirurgia bariátrica e osque somente tiveram grandes perdas ponderais por dietas alimentares. Resultados: Macroscopicamenteforam encontradas alterações diversas das características padrões, na cordo tecido adiposo, na estrutura da fáscia superficial e na arquitetura dos lóbulos adiposos,porém similares nas regiões selecionadas.

Background: The two adipose stratus that compose the subcutaneous tissue present different thickness in the body regions, that suffer effects with the weight variations, age, genders and genetics. When submitted to extended body weight variations by bariatric surgeries or extreme diets, generalized macroscopic and histological changes are also observed.Methods: Twenty eight surgical skin human specimens obtained after surgeries, were selected from the epigastric, peri-umbilical, hypogastrium and flank regions to be evaluated in their thickness and structural variations, from patients after been submitted by bariatric surgery or diets with extensive ponderal weight lost. Results: Macroscopic analysis showed changes from the original patterns related to the fat color, at the superficial fascia and the architectural of the adipose lobules but similar in the selected regions.

Osteogénesis imperfecta tipo II: estudio de dos casos / Osteogenesis imperfecta type II: report of two cases

Se presentan dos casos clínicos de fetos con osteogénesis imperfecta tipo II, productos de partos vaginales de pretérmino, de sexo femenino, ambos sin signos vitales y con malformaciones congénitas evidentes desde el punto de vista esquelético. En ambos fetos se evidencia al estudio macroscópico cráneo blando y aplastado, colapso de la región tóracoabdominal, acortamiento de las extremidades y genitales externos femeninos. En la disección se aprecia hipoplasia pulmonar y malrotación intestinal. El estudio radiológico evidencia ausencia total de osificación para el primer feto y solo puntos rudimentarios para la base del cráneo, omóplato, húmero, un hueso del antebrazo, el ilíaco, el fémur y un hueso de la pierna, para el segundo feto. El tratamiento actual del que se dispone está muy lejos de ser exitoso y se restringe a terapia ortopédica y administración de bifosfonatos. El trasplante de células mesenquimáticas y su transformación a células osteogénicas, abre nuevas perspectivas en el manejo de la enfermedad

We present two clinical cases of fetuses with osteogenesis imperfecta type II, products of preterm vaginal deliveries, both females, without vital signs and congenital malformations evident in the skeletal system. Macroscopical study shows in both fetuses soft and crushed skull, collapse of the thoracoabdominal region, shortening of the limbs and external female genitalia. Pulmonary hypoplasia and intestinal malrotation are evident at the dissection. Radiological screening shows total absence of ossification for the first fetus and only rudimentary points for the base of the skull, scapula, humerus, a forearm bone, the ilium, femur and leg bon for the second fetus. Current treatment available is far from being successful and is limited to orthopedic therapy and administration of bisphosphonates. Transplantation of mesenchymal cells and their transformation into osteogenic cells, opens new perspectives on the management of the disease

Anomalias ósseas congênitas em sotalia guianensis (mammalia, cetacea, delphinidae) da costa centro-norte do estado do Rio de Janeiro / Congenital bone defects in guiana dolphin, sotalia guianensis (mammalia, cetacea, delphinidae) in the northcentral coast of Rio de Janeiro state, Brazil

Carcaças de botos-cinza Sotalia guianensis (van Bénéden, 1864) foram recuperadas entre 20 de agosto de 2001 e 13 de fevereiro de 2006, na costa centro-norte fluminense. A maior parte delas (85 por cento) entre Barra de São João (22º35'S 41º59'W) e Quissamã (22º06'S 41º28'W). Foram estudadas as colunas vertebrais dos 20 exemplares que apresentavam mais de 60 por cento das vértebras presentes. A coleção é formada por 75 por cento de animais imaturos, e todos os esqueletos mostram alterações tafonômicas mínimas. Duas categorias de anomalias congênitas foram diagnosticadas, ambas relacionadas ao desenvolvimento do mesoderma paraxial. A sétima vértebra cervical (C7) foi a única afetada, as costelas cervicais e o não fechamento do arco neural atingiram 15 (75 por cento) dos indivíduos analisados, dos quais três (15 por cento) apresentam ambas as anomalias. Nove (45 por cento) indivíduos apresentaram costelas cervicais uni ou bilateral, e nove (45 por cento) indivíduos apresentaram não fechamento do arco neural; em todos os casos as vértebras contíguas eram normais. A ocorrência de anomalias nesta série do Rio de Janeiro é maior do que as referidas na literatura brasileira para outras séries de Sotalia do Amazonas, Ceará e Santa Catarina. A série de Sotalia descrita vem de uma região do litoral muito limitada e provavelmente representa uma população local. As costelas cervicais são geneticamente determinadas e podem estar concentradas por uma condição de grande proximidade biológica entre os animais; o não fechamento do arco pode ter também um componente ambiental, a ser investigado futuramente.

Carcasses of Guiana dolphins, Sotalia guianensis (van Bénéden, 1864) were recovered from August 20, 2001 to February 13, 2006 along the north-central coast of Rio de Janeiro state. Most of the animals (85 percent) were found between Barra de São João (22º35'S 41º59'W) and Quissamã (22º06'S 41º28'W). We studied the vertebral columns of all the 20 specimens that had more than 60 percent of the vertebrae preserved. The series has 75 percent of immature animals and all skeletons displayed a minimum of taphonomic changes. Two categories of congenital anomalies were diagnosed, both related to the development of the paraxial mesoderm. The seventh cervical vertebra (C7) was the only affected; the cervical ribs and the cleft neural arches were present in 15 (75 percent) of the individuals, three (15 percent) of which had both anomalies. Nine (45 percent) individuals had unilateral or bilateral cervical ribs, and nine (45 percent) individuals had cleft neural arches; the contiguous vertebrae were normal in every case. The frequency of these anomalies was higher in that Rio de Janeiro series than in other Sotalia series previously reported in the Brazilian literature for Amazonas, Ceará and Santa Catarina States. The present Sotalia series here described comes from a very limited coastal region probably representing a local population. The cervical ribs are genetically defined and may be concentrated because of a condition of close biological proximity among the animals; the cleft arch could also be determined by environmental factors, to be investigated in the future.

Osteomalácia oncogênica: cintilografia com sestamibi-99mTc na localização do tumor / Oncogenic osteomalacia: localization of underlying peripheral tumor with99mTc-sestamibi scintigraphy

A osteomalácia oncogênica hipofosfatêmica (OOH) é uma síndrome paraneoplásica induzida por tumor, de tecidos mole ou ósseo. Apresenta-se com dor e fraturas, acompanhada de hipofosfatemia, hiperfosfatúria e concentrações plasmáticas de 1,25(OH)2D3 inapropriadamente normais/diminuídas. Após a remoção do tumor, a completa resolução das anormalidades clínicas e bioquímicas é sua maior característica. Uma mulher de 44 anos de idade é descrita no caso com dificuldade para caminhar por causa de dores nos membros inferiores, fraqueza muscular generalizada e hipofosfatemia com relativa hiperfosfatúria. A cintilografia de corpo total com sestamibi-99mTc mostrou acúmulo do radiofármaco no terço superior de coxa esquerda onde pequeno tumor foi detectado no exame pelo ultra-som. Com a retirada do tumor, um lipoma, os sintomas melhoraram após um mês, com recuperação completa ao redor do quarto mês. Neste caso, a cintilografia de corpo inteiro com sestamibi-99mTc foi decisiva na localização do tumor causador da osteomalácia oncogênica.

Oncogenic osteomalacia is a paraneoplastic syndrome usually induced by bone or soft tissue tumors. It is presented by the development of pain and fractures with hypophosphatemia, hyperphosphaturia, and inappropriate normal/low plasma 1,25(OH)2D3 concentration. After the removal of the tumor the complete resolution of all biochemical and clinical abnormalities is the main characteristic. A case of a 44-year-old female with difficulty in walking due to leg pain and generalized muscle weakness and hypophosphatemia, with relative hyperphosphaturia, is described. A whole-body 99mTc-sestamibi scintigraphy showed accumulation in the left thigh region, and a small tumor was detected by ultrasound examination. By removal of the tumor, a lipoma, the symptoms improved significantly after a month, with complete recovery by the fourth month. In this case, 99mTc-sestamibi scintigraphy was useful in identifying the location of the tumor, which caused oncogenic osteomalacia.

Asthma: where is it going?: [review]

Asthma is characterized by reversible airway obstruction, airway hyperresponsiveness, and airway inflammation. Although our understanding of its pathophysiological mechanisms continues to evolve, the relative contributions of airway hyperresponsiveness and inflammation are still debated. The first mechanism identified as important for asthma was bronchial hyperresponsiveness. In a second step, asthma was recognized also as an inflammatory disease, with chronic inflammation inducing structural changes or remodeling. However, persistence of airway dysfunction despite inflammatory control is observed in chronic severe asthma of both adults and children. More recently, a potential role for epithelial-mesenchymal communication or transition is emerging, with epithelial injury often resulting in a self-sustaining phenotype of wound repair modulation by activation/reactivation of the epithelial-mesenchymal trophic unit, suggesting that chronic asthma can be more than an inflammatory disease. It is noteworthy that the gene-environmental interactions critical for the development of a full asthma phenotype involve processes similar to those occurring in branching morphogenesis. In addition, a central role for airway smooth muscle in the pathogenesis of the disease has been explored, highlighting its secretory function as well as different intrinsic properties compared to normal subjects. These new concepts can potentially shed light on the mechanisms underlying some asthma phenotypes and improve our understanding of the disease in terms of the therapeutic strategies to be applied. How we understand asthma and its mechanisms along time will be the focus of this overview.

Role of nuclear factor kappa B and reactive oxygen species in the tumor necrosis factor-a-induced epithelial-mesenchymal transition of MCF-7 cells

The microenvironment of the tumor plays an important role in facilitating cancer progression and activating dormant cancer cells. Most tumors are infiltrated with inflammatory cells which secrete cytokines such as tumor necrosis factor-alpha (TNF-alpha). To evaluate the role of TNF-alpha in the development of cancer we studied its effects on cell migration with a migration assay. The migrating cell number in TNF-alpha-treated group is about 2-fold of that of the control group. Accordingly, the expression of E-cadherin was decreased and the expression of vimentin was increased upon TNF-alpha treatment. These results showed that TNF-alpha can promote epithelial-mesenchymal transition (EMT) of MCF-7 cells. Further, we found that the expression of Snail, an important transcription factor in EMT, was increased in this process, which is inhibited by the nuclear factor kappa B (NFkB) inhibitor aspirin while not affected by the reactive oxygen species (ROS) scavenger N-acetyl cysteine. Consistently, specific inhibition of NFkB by the mutant IkBalpha also blocked the TNF-alpha-induced upregulation of Snail promoter activity. Thus, the activation of NFkB, which causes an increase in the expression of the transcription factor Snail is essential in the TNF-alpha-induced EMT. ROS caused by TNF-alpha seemed to play a minor role in the TNF-alpha-induced EMT of MCF-7 cells, though ROS per se can promote EMT. These findings suggest that different mechanisms might be responsible for TNF-alpha - and ROS-induced EMT, indicating the need for different strategies for the prevention of tumor metastasis induced by different stimuli.

Hamartoma mesenquimal hepático / Liver mesenchymal hamartoma

El Hamartoma mesenquimal hepático es una malformación congénita rara que en muchos casos, debido a su tamaño suele ser diagnosticado como una neoplasia verdadera. Ante esta realidad y a propósito de la presentación de un caso en nuestro hospital, nos planteamos la necesidad de definir las principales particularidades de esta patología, enfocándonos en las características imagenológicas y su correlación con la presentación clínica, patológica y epidemiológica de dicha entidad. Presentamos el caso de un niño de 18 meses de edad, que se presentó en este Instituto oncológico con un cuadro de distensión abdominal progresiva, siendo eventualmente diagnosticado de hamartoma mesenquimal hepático.

Mesenchymal hamartoma of the liver is a strange congenital malformation which in most cases, due to its size is diagnosed as a true neoplasia. In view of this reality and by means of a case report in our hospital we plant the necessity to define the principal characteristics of this pathology, focusing on imagenology and its correlation to clinical, pathologic and epidemiologic presentation of the entity. We present the case of an 18 month old boy that assisted to this hospital with progressive abdominal distention, where he was eventually diagnosed with liver mesenchymal hamartoma.

Observaciones en la hiperplasia mesenquimal placentaria con el microscopio electrónico de barrido / Observations in the placental mesenchymal hyperplasia by scanning electron microscopy

Material de una placenta de embarazo con diagnóstico de enfermedad mesenquimatosa placentaria a las 27 semanas de gestación y dolicocefalia fetal fue obtenido para ser procesado con las técnicas de microscopia electrónica de barrido previo análisis macro y microscópico del mismo. El examen macroscopico mostró placentomegalia, vellosidades troncales hidrópticas de tamaño entre 2 y 35 mm, placa carionica comprimida, hematoma retroplacentario

Insulin impairs the maturation of chondrocytes in vitro

The precise nature of hormones and growth factors directly responsible for cartilage maturation is still largely unclear. Since longitudinal bone growth occurs through endochondral bone formation, excess or deficiency of most hormones and growth factors strongly influences final adult height. The structure and composition of the cartilaginous extracellular matrix have a critical role in regulating the behavior of growth plate chondrocytes. Therefore, the maintenance of the three-dimensional cell-matrix interaction is necessary to study the influence of individual signaling molecules on chondrogenesis, cartilage maturation and calcification. To investigate the effects of insulin on both proliferation and induction of hypertrophy in chondrocytes in vitro we used high-density micromass cultures of chick embryonic limb mesenchymal cells. Culture medium was supplemented with 1 percent FCS + 60 ng/ml (0.01 æM) insulin and cultures were harvested at regular time points for later analysis. Proliferating cell nuclear antigen immunoreactivity was widely detected in insulin-treated cultures and persisted until day 21 and [ H]-thymidine uptake was highest on day 14. While apoptosis increased in control cultures as a function of culture time, terminal deoxynucleotidyl transferase-mediated dUTP nick end labeling (TUNEL)-labeled cells were markedly reduced in the presence of insulin. Type II collagen production, alkaline phosphatase activity and cell size were also lower in insulin-treated cultures. Our results indicate that under the influence of 60 ng/ml insulin, chick chondrocytes maintain their proliferative potential but do not become hypertrophic, suggesting that insulin can affect the regulation of chondrocyte maturation and hypertrophy, possibly through an antiapoptotic effect

Isolation and culture of umbilical vein mesenchymal stem cells

Bone marrow contains a population of stem cells that can support hematopoiesis and can differentiate into different cell lines including adipocytes, osteocytes, chondrocytes, myocytes, astrocytes, and tenocytes. These cells have been denoted mesenchymal stem cells. In the present study we isolated a cell population derived from the endothelium and subendothelium of the umbilical cord vein which possesses morphological, immunophenotypical and cell differentiation characteristics similar to those of mesenchymal stem cells isolated from bone marrow. The cells were isolated from three umbilical cords after treatment of the umbilical vein lumen with collagenase. The cell population isolated consisted of adherent cells with fibroblastoid morphology which, when properly stimulated, gave origin to adipocytes and osteocytes in culture. Immunophenotypically, this cell population was found to be positive for the CD29, CD13, CD44, CD49e, CD54, CD90 and HLA-class 1 markers and negative for CD45, CD14, glycophorin A, HLA-DR, CD51/61, CD106, and CD49d. The characteristics described are the same as those presented by bone marrow mesenchymal stem cells. Taken together, these findings indicate that the umbilical cord obtained from term deliveries is an important source of mesenchymal stem cells that could be used in cell therapy protocols