An Unexpected Case of Lagochilascariasis: Interdisciplinary Management and Use of 12S and 18S rDNA Analysis.

A Mexican 24-year-old male patient was referred to our hospital due to increased left retroauricular volume with skin fistulisation, resembling an infection by the uncommon worm Lagochilascaris minor. The patient was submitted to lateral skull base surgery. No adult worms or eggs were observed during light and scanning electron microscopy analysis, as well as by histopathologic examination of the small piece of removed tissue, only L3 stage larvae of Lagochilascaris spp. were identified. Polymerase chain reaction-sequencing assays were performed using primers for the mitochondrial 12S and the nuclear 18S rDNA gene. DNA of some L minor adults, previously identified, were used as control. The molecular analysis identified the worm as L minor. According to previous reports, lagochilascariasis is a complicated infection that requires an interdisciplinary management by different clinical specialists. This is the first time that 12S and 18S rDNA genes are reported as molecular markers for diagnosis of L minor.

Inhibition of PI3K/AKT/mTOR and MAPK signaling pathways decreases progranulin expression in ovarian clear cell carcinoma (OCCC) cell line: a potential biomarker for therapy response to signaling pathway inhibitors.

Patients with advanced stage ovarian clear cell carcinoma (OCCC) have a poor prognosis due to resistance to conventional platinum chemotherapy. Recent studies have demonstrated that PI3K/AKT/mTOR and ERK1/2 signaling pathways are involved in this chemoresistance. Progranulin (PGRN) overexpression contributes to cisplatin resistance of epithelial ovarian cancer cell lines. Also, PGRN expression is regulated by AKT/mTOR and ERK1/2 signaling pathways in different cell types. Thus, the present study was designed to identify if PGRN expression is regulated by AKT, mTOR, and ERK1/2 signaling pathways in the OCCC cell line TOV-21G. Cultured TOV-21G cells were incubated with different concentrations of pharmacological cell signaling inhibitors. PGRN expression and phosphorylation of ERK1/2, AKT, and mTOR were assessed by Western blotting. Inhibition of AKT, mTOR, and ERK1/2 significantly reduced PGRN expression. Cell viability was not affected, while cell proliferation significantly decreased with all inhibitors used in this study. These observations demonstrated that inhibition of PI3K/AKT/mTOR and ERK1/2 signaling pathways reduces PGRN expression in TOV-21G cells. Thus, PGRN could be considered as a candidate for explaining the high resistance to platinum-based treatment and a potential biomarker for therapy response to cell signaling inhibitors in patients with OCCC.

Ribosomal S6 kinase 4 (RSK4) expression in ovarian tumors and its regulation by antineoplastic drugs in ovarian cancer cell lines.

Survival rate in ovarian cancer depends on the stage of the disease. RSK4, which has been considered as a tumor suppressor factor, controls cells invasion due to its antiinvasive and antimetastatic properties. Modulation of RSK4 expression could be an important event to increase the survival rate in ovarian cancer patients. Thus, the goal of the present study was to establish the differences in RSK4 expression among normal, benign and malignant ovarian tissues and to determine whether antineoplastic drugs regulate its expression in SKOV3 and TOV-112D cells. RSK4 levels in 30 malignant ovarian tumors, 64 benign tumors and 36 normal ovary tissues were determined by reverse transcription polymerase chain reaction and Western blot. Modulation of RSK4 expression by two antineoplastic drugs (cisplatin and vorinostat) was also studied in the SKOV3 and TOV-112D ovarian cancer cell lines using the same techniques. RSK4 mRNA and protein levels were decreased in malignant ovarian tumors as compared to benign tumors and normal tissue. These low-RSK4 levels were significantly associated with advanced stages of ovarian cancer. RSK4 expression was increased after incubation of SKOV3 and TOV-112D cell lines with cisplatin and vorinostat for 24 h. The combination of these antineoplastic drugs did not produce a synergistic or additive effect. These results suggest that RSK4 is expressed at low levels in malignant ovarian tumors, which correlates with advanced stages of the disease. Additionally, RSK4 expression is regulated by cisplatin and vorinostat in two ovarian cancer cell lines.

Matrix metalloproteinase-8 promoter gene polymorphisms in Mexican women with ovarian cancer.

Increased levels of matrix metalloproteinase-8 (MMP-8) have been associated with tumor grade and stage in ovarian cancer. Also, it has been reported that higher concentrations of this enzyme in fluid from malignant ovarian cysts compared with benign ovarian cysts. However, no genetic analysis has been conducted yet to assess the contribution of MMP-8 polymorphisms in ovarian cancer. Thus, this study was performed to investigate the frequencies of MMP-8 genotypes in Mexican women with ovarian cancer. MMP-8 promoter genotypes were examined in 35 malignant ovarian tumors, 51 benign tumors, and 37 normal ovary tissues. Two single nucleotide polymorphisms were selected and characterized using polymerase chain reaction-restriction fragment length polymorphism analysis. The chi-square test was used to calculate statistical significance. Haplotype analysis was performed using the SNPstats web tool. Of the two polymorphisms, only the MMP-8 -799 T/T genotype was significantly associated with an increased risk of ovarian cancer (OR 3.78, 95 % CI 1.18-12.13). The Kaplan-Meier analysis for this polymorphism showed that patients with the T/T genetic variant had a tendency toward significant worse overall survival compared with patients with the C/C + C/T genotypes. Haplotype analysis revealed no significant differences in haplotype distribution between benign ovarian tumors, malignant ovarian cancer, and controls. This study suggests that MMP-8 promoter gene polymorphism -799 T/T is significantly associated with an increased risk of ovarian cancer in Mexican women.

[Anti-Müllerian hormone serum levels in women with and without uterine fibroids]. / Concentraciones en suero de hormona antimülleriana en mujeres con y sin miomatosis uterina.

BACKGROUND: The etiology of uterine leiomyomatosis is multifactorial and it is unknown if a relation between anti-Müllerian hormone (hormona anti-mülleriana) and uterine leiomyomatosis exists. OBJECTIVE: To determine the differences of hormona anti-mülleriana levels in women with and without uterine leiomyomatosis. METHODS: 60 women were studied (30 with and 30 without uterine leiomyomatosis). The diagnosis was confirmed by histopathology. Both groups were paired by age and in all them serum levels of hormona antimülleriana were measured using ELISA, also estradiol and progesterone serum levels were determined. hormona anti-mülleriana-RII immunohistochemistry was done in healthy myometrium and in leiomyomas. RESULTS: The mean age between the groups didn't show statistical difference (41.8 +/- 5.6 years vs. 41.4 +/- 5.7 years). Also no differences were found in weight, height and body mass index. Serum levels of hormona antimülleriana were lower in those with leiomyomatosis [0.21 (0-10.4) ng/ml vs. 1.83 (0-6.38) ng/ml, p < 0.005]. No statistical differences were found in estradiol and progesterone serum levels between the groups. The hormona antimülleriana receptor was no expressed neither in the healthy myometrium nor in the leiomyomas. CONCLUSIONS: Women with leiomyomatosis had lower hormona antimülleriana levels. More studies are needed to determine if a relation exists between hormona antimülleriana and uterine leiomyomas.

[Changes in maturation index and vaginal dryness in postmenopausal women who use or not calcitriol]. / Índice de maduración y sequedad vaginal en la posmenopausia con uso de calcio o calcitriol.

BACKGROUND: it is known that vitamin D increases the population of superficial cells, so the objective of the present work was to evaluate the effect in Mexican postmenopausal women who were using or not oral calcitriol. METHODS: postmenopausal women with vaginal dryness that received at random: calcium 500 mg orally every 24 h or calcitriol 0.25 µg every 24 h during two months. At the beginning of treatment and at two months a vaginal Pap smear was performed. The maturation index was determined and the estrogenic value was calculated. Vaginal dryness was evaluated using an analog visual scales and vaginal by the moistening of a pH test strip. Student's t test was used for statistical analysis. RESULTS: 23 postmenopausal women were studied and divided as follows: group I (calcium) = 11 women and group II (calcitriol) = 12 women. In the analyzed parameters only the average of superficial cells was significantly greater at the end of treatment in the calcitriol group. CONCLUSION: calcitriol use increased the average of superficial cells in vaginal cytology, but didn't modify vaginal dryness.

[Endometrial tissue in myometrium vessels. Two cases report and literature review]. / Tejido endometrial en vases del miometrio. Comunicación de dos casos y revisión de la bibliografía.

Endometrial tissue in the myometrium vessels space, whit no relation to menstrual period, is a rarely reported event. It is unknown if it is part of the natural history of ectopic localization of endometrial tissue or it is related to more or less aggressive behavior of endometriosis. This paper reports two cases: a 35- and 51-year-old women. The first one made suspect a clear cells adenocarcinoma undiagnosed before hysterectomy, because there were no endometrial glands in the myometrium vessels space, but only nest of stromal cells isolated, simulating thrombus of an invasive neoplasm. Since a wrong diagnosis affects the integral treatment of patients, differential diagnosis must be established in order to increase certainty.

[Vulvar cellular angiofibroma. A report of a case and bibliographic review]. / Angiofibroma celular de la vulva. Comunicación de un caso y revisión de la bibliografía.

The vulvar cellular angiofibroma is a rare mesenchymal tumor. It can be located in many places, but it is more frequent in the vulvar area. It is characterized for being of superficial and slow-growth and for having low propensity of local recurrence. It was described in 1997 by Nucci and it had been reported 51 cases worldwide, from which 18 had vulvar location. This is the first case in Mexico City. It was found in a 36 years-old woman. The specimen was processed by structural and immunohistochemical analysis. Misdiagnosis is common and it can be confounded with spindle cell lipoma, hydrocele of the canal of Nuck, fibromas, angiomyofibroblastoma and many other mesenchymal tumors. It should be distinguished from the aggresive angiomixoma. To improve the clinical diagnosis and treatment, it is very important to have in mind this relatively new entity.

Linfadenitis histiocítica necrosante (enfermedad de Kikuchi-Fujimoto) / Histiocytic necrotizing lymphadenitis (Kikuchi -Fujimoto's disease)

Introducción. La enfermedad de Kikuchi-Fujimoto es una linfadenitis histiocítica necrosante poco frecuente, sobre todo en la edad pediátrica. Caso clínico. Niña de 9 años de edad con historia de fiebre, adenomegalias y pérdida de peso que requirió biopsia de ganglios, reportándose una linfadenitis necrosante (enfermedad de Kikuchi-Fujimoto); respondió a antiinflamatorios, pero presentó una recaída 5 años después. Conclusión. Debe sospecharse enfermedad de Kikuchi-Fujimoto en todo paciente con fiebre, adenomegalias, pérdida de peso y mal estado general, sobre todo cuando se ha descartado etiología infecciosa y un proceso oncológico. El diagnóstico definitivo es por medio de biopsia de alguno de los ganglios afectados.

Introduction. Kikuchi-Fujimoto's disease is a histiocytic necrotizing lymphadenitis, not frequent in children. Case report. Nine year-old girl with history of fever, adenomegaly and loss of weight that required a lymph node biopsy which was interpreted as necrotizing lymphadenitis (Kikuchi-Fujimoto's disease), she responded to anti inflammatory medication but presented a relapse 5 years later. Conclusion. Kikuchi-Fujimoto's disease should be suspected in the patients with fever, lymphadenitis, and weight loss after infectious and malignant etiologies have been ruled out. The definitive diagnosis is skin biopsy.

Angiomiofibroblastoma vulvar informe de un caso y revisión de la literatura / Angiomyofibroblastoma of the vulva. One case presentation and literature review

El angiomiofibroblastoma es un raro tumor derivado del mesénquima de localización principalmente vulvar. Se caracteriza por ser benigno. de crecimiento superficial, Lento , no recidivante y con frecuencia se confunde con quistes de la glándula de Bartholin hernias del canal de Nuck. Se presenta el informe de un caso de angiomiofibroblastoma vulvar en Una mujer de 56 años, al que se le realizó estudio estructural e inmunohistoquímico. Es importante sospechar clínicamente el diagnóstico y distinguirlo del angiomixoma agresivo.