mRNA concentrations of MIF in subcutaneous abdominal adipose cells are associated with adipocyte size and insulin action.

OBJECTIVE: To determine whether the mRNA concentrations of inflammation response genes in isolated adipocytes and in cultured preadipocytes are related to adipocyte size and in vivo insulin action in obese individuals. DESIGN: Cross-sectional inpatient study. SUBJECTS: Obese Pima Indians with normal glucose tolerance. MEASUREMENTS: Adipocyte diameter (by microscope technique; n=29), expression of candidate genes (by quantitative real-time PCR) in freshly isolated adipocytes (monocyte chemoattractant protein (MCP) 1 and MCP2, macrophage inflammatory protein (MIP) 1alpha, MIP1beta and MIP2, macrophage migration inhibitory factor (MIF), tumor necrosis factor alpha, interleukin (IL) 6 and IL8; n=22) and cultured preadipocytes (MCP1, MIP1alpha, MIF, IL6 and matrix metalloproteinase 2; n=33) from subcutaneous abdominal adipose tissue (by aspiration biopsy, n=34), body fat by dual-energy X-ray absorptiometry, glucose tolerance by 75 g oral glucose tolerance test and insulin action by euglycemic-hyperinsulinemic clamp (insulin infusion rate 40 mU m(-2) min(-1)) (all n=34). RESULTS: MIF was the only gene whose expression in both freshly isolated adipocytes and cultured preadipocytes was positively associated with adipocytes diameter and negatively associated with peripheral and hepatic insulin action (all P<0.05). In multivariate analysis, the association between adipocyte MIF mRNA concentrations and adipocytes diameter was independent of the percentage of body fat (P=0.03), whereas adipocyte MIF mRNA concentrations, but not adipocyte diameter, independently predicted peripheral insulin action. The mRNA expression concentrations of the MIF gene in adipocytes were not associated with plasma concentrations of MIF, but were negatively associated with plasma adiponectin concentrations (P=0.004). In multivariate analysis, adipocyte MIF RNA concentrations (P=0.03) but not plasma adiponectin concentrations (P=0.4) remained a significant predictor of insulin action. CONCLUSIONS: Increased expression of MIF gene in adipose cells may be an important link between obesity characterized by enlarged adipocytes and insulin resistance in normal glucose tolerant people.

[PET-CT with intravenous contrast in the evaluation of patients with lymphoma. Contribution to diagnostic indications]. / PET-TAC con contraste intravenoso en la valoración de pacientes con linfoma. Aproximación hacia las indicaciones diagnósticas.

AIM: To define the utility of intravenous contrast administration in the PET-CT (PET-CTc) in patients with lymphoma in order to determine its possible indications. MATERIAL AND METHODS: 78 patients with lymphoma were prospectively evaluated. All underwent simultaneous PET-CTc scans in a hybrid system for staging (8), evaluation of response to treatment (29), suspicion of recurrence (9) and complete remission control (48). The PET scan was acquired by a conventional method and the diagnostic CT scan was performed according to radiological protocol. Both examinations were evaluated blinded and independently, analyzing 28 anatomical locations in order to determine the degree of agreement. Final diagnosis was established by the clinician based on the histological study, results of other diagnostic techniques or clinical follow-up. RESULTS: The final result of both techniques were concordant in 87/94 studies (92.5%). A total of 158 (36 FP) pathological locations were detected with PET-CT and 189 (71 FP) with CTc, with 72 locations being discordant between both techniques. Global sensitivity, specificity, PPV and NPV were 93%, 98%, 77% and 99%; and 94%, 97%, 62% and 99%, respectively. CONCLUSIONS: Administration of intravenous contrast does not seem to provide any advantage in the determination of nodal and extranodal disease in lymphoma patients. The low prevalence of disease probably accounts for the limited PPV of both techniques. An increase of our sample size, with a greater homogeneity of the groups, should offer more reliable results.

Photocatalytic degradation of indigo carmine by hydrothermally synthesized Bi2MoO 6 in presence of EDTA.

Bi2MoO6 oxide was synthesized by hydrothermal reaction in the presence of EDTA under different experimental conditions (time of reaction and EDTA concentration) in order to obtain materials with specific textural properties. It was determined that the addition of EDTA influences the final physical properties of Bi2MoO6. The photocatalytic activity of Bi2MoO6 samples was evaluated in the degradation reaction of indigo carmine (IC) in aqueous solution under solar radiation type. The best results as photocatalyst were obtained with the sample hydrothermally synthesized at 150 ºC for 4h in presence of a 0.031 M EDTA solution. This sample was able to whiten a solution of IC in a 94% after 120 min of lamp irradiation with t 1/2 = 31 min. In general, the samples prepared with lower concentrations of EDTA were the best photocatalysts. A gradual decrease in the activity was observed in the samples prepared with the same EDTA concentration as was increased in the reaction time. Beyond differences in morphology and textural properties of the samples prepared, the presence of EDTA by-products on the samples and the decomposition degree of it were important factors in determining the activity of the photocatalysts. Analysis of total organic carbon (TOC) of samples irradiated for 100 h confirmed that Bi2MoO6 oxide is able to mineralize the complex organic molecule of IC to CO2 and H2O in 55 %.

Case report: MRI in the diagnosis of testicular Leydig cell tumour.

We report the appearance of three cases of Leydig cell tumours on MRI. This imaging method showed well-defined and peripheral intratesticular tumours displaying marked and homogeneous enhancement when contrast medium was used. This latter finding was only observed in Leydig cell tumours when they were compared in a series of 104 patients with different scrotal pathologies.

Pulmonary actinomycosis with thoracic soft tissue mass: a rare onset form.

Actinomycosis is unusual, and rare especially when the lung and the thoracic wall are involved. It is more frequent in immunocompromised patient. US, CT, or MRI are imaging methods of diagnosis with high sensibility to recognise the disease and are able to the management. We point out a rare case in a normal teenager with thoracic abscess.

[Spontaneous mediastinal hemorrhage: a study of 2 cases]. / Hemorragia mediastínica espontánea: estudio de 2 casos.

The clinical symptoms of two cases of spontaneous mediastinal hemorrhage, a rare entity of unknown etiology, are presented. In both cases the evolution was acute with initial symptomatology similar to that observed in the upper caval vein syndrome. The appearance of a large hematoma in the cervical-thoracic region constituted the outstanding clinical symptom. Imaging techniques provided the second key to diagnosis, which was made following the exclusion of the other causes of bleeding in the mediastinum. Given the apparent stability of the lesion and the absence of hemodynamic changes, treatment should only be symptomatic.

[Phantom tumor (author's transl)]. / Tumor fantasma.

Phantom tumors are accumulations of pleural effusion in the interlobular spaces of the lungs. They appear in patients with heart failure simulating a lung tumor but disappearing with medical treatment. The encystment of the fluid is apparently due to congenital defects in the pleura, which tends to store up the transudate produced by heart failure. Another pathogenetic possibility is the existence of pleural adherences. The most common localization is in the minor cissure, perhaps because it is more easily identified in the posterior view of the chest X-ray. In most of these cases the pleural effusion is due to left heart failure, though pleural effusion in normally associated with right congestive heart failure. On the posterior chest X-ray the fluid is observed as a round or fusiform mass. Differential diagnosis should be established for measotheliomas, pulmonary infarctions, pulmonary or metastatic tumoral nodules, hydatic cysts, and tuberculomas. Sixteen cases of phantom tumors are reported; nine of them were localized on the minor cissure, five on the right major cissure, one on the left major cissure, and one case of double localization on the left major cissure and minor cissure. All of them were due to left congestive heart failure.

[Roentgenologic characteristics of Gaucher's disease (author's transl)]. / Aspectos radiológicos de la enfermedad de Gaucher.

Gaucher's disease is a rare metabolic disorder in which there is an abnormal accumulation of cerebrosides in the reticuloendothelial system due to a deficit of beta-glucuronidase. Three patients with this disease, 8, 14, and 23 years old, were studied. The purpose of this paper is to point out some of the roentgenologic findings, such as areas of femoral osteolysis, renal venous thrombosis, and in one patient, sclerosis of the sacroiliac joint. Splenomegaly and alteration of the tubular bony structure of the distal end of the femur were present in all three cases. The roentgenologic images of the disease are discussed. The osteoarticular system is the most often affected. Osteolysis is the basic lesion with expansion of the bone marrow and sclerosis. The earliest symptom and sometimes the only one is the Erlenmeyer flask deformity or widening of the distal portion of the femur. Sometimes there is a high degree of deossification without definite osteolytic lesions. Pathologic fractures and fractures caused by pressure of the vertebral bodies are common. Aseptic femoral necrosis are often present. Other less frequent sites of osteoarticular pathology are the skull, jaws, ribs, and sacroiliac joints. Splenomegaly is the most frequent visceral lesion. Other organs sometimes affected are the liver, kidneys, heart, lymphatic system, and lungs, with nodular or basal reticular infiltrations.

[Pulmonary infarction as a cause of pneumothorax: report of two cases (author's transl)]. / El infarto pulmonar como causa de neumotórax: a propósito de dos casos.

Pulmonary infarction is a very uncommon cause of pneumothorax. The authors report two patients with pneumothorax arising as a complication of pulmonary infarction. One was a 72-year-old man who had hemoptysis, pleural effusion, and alveolar condensation. Four days later he developed a hydropneumothorax and pulmonary cavitation. He died of heart failure. The pulmonary infarction was not septic in this case. The other patient was a 12-year-old boy who suffered a septic embolism with cavitation as a result of an infected wound. He later developed a tension pneumothorax and died in a state of shock. The authors have found only 16 cases of pneumothorax as a complication of pulmonary infarction in the literature. It is surprising that, even though all infarctions are in contact with the pleural surface, the incidence of pneumothorax is not higher. The infarctions may or may not be septic. Cavitation is not necessarily present, though infarctions are usually cavitated before pneumothorax develops. Tension pneumothorax occurs in some cases.

[Subcapsular renal hematoma: report of a case of unusual etiology]. / Hematoma renal subcapsular: presentación de un caso de etiología inusual.

The authors present a case of myeloproliferative syndrome with an exceptional clinical picture of pain in the right hypochondrium and right iliac fossa, with no mictional syndrome or hematuria, caused by the appearance of a spontaneous subcapsular hematoma. They discuss the frequency of the different kinds of kidney hematomas and their causes. They also describe the typical radiological signs of the subcapsular hematoma in comparison with the other forms of kidney hematomas.

[Comparative study of ureteral displacements]. / Estudio comparativo de los desplazamientos ureterales.

A study ia mde of 15 patients with a known neoplasia: 2 retroperitoneal tumours, 5 lymphomas, 3 prostate neoplasias, 3 seminomas and 2 uterus neoplasias; with displacement of the ureter and in some cases ectasia of the excretion system. The displacement was always one-sided and most frequently found in the lower third of the ureter. Ectasia was found in two patients; we have never found this in any patients without a known neoplasia. Adenopathies were the most frequent cause of inferior ureter deviation but in only one case did they infiltrate into the wall and they were more constant on the right side. These cases are compared with other patients suffering from different pathologies, some of which are also neoplastic but in which no displacement or ectasia appeared even when the retroperitoneum was affected, and with another group of patients in whom there was found to be ureteral displacement or ectasia without any retro- or intraperitoneal pathology.