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Objective. The objective of the present study is to investigate the effect of rosiglitazone, metformin, ezetimibe, and valsartan (alone or in combinations) on paraoxonase (PON) activity and PON-mRNA expression in nonalcoholic fatty liver disease (NAFLD). Methods. 54 Male Sprague-Dawley rats were divided to 9 groups: chow diet group (15 weeks); methionine-choline-deficient diet (MCDD) group (15 weeks); MCDD-treated groups for the last 6 weeks with either metformin (M), rosiglitazone (R), metformin plus rosiglitazone (M+R), ezetimibe (E), valsartan (V), or a combination of R+M+V or of R+M+V+E for a total period of 15 weeks. Results. PON activities in serum and liver were decreased in MCDD rats. PON activity in serum increased significantly in all treatment groups. PON activity in liver was also increased significantly, except only in groups R, E, V, R+M+V, and R+M+V+E. Liver PON3 mRNA expression increased significantly in groups R+M, E, V, R+M+V, and R+M+V+E whereas liver PON2 mRNA expression increased significantly in MCDD, R+M, E, V, R+M+V, and R+M+V+E. Conclusions. PON activities in serum and liver were decreased in NAFLD. Treatment with insulin sensitizers, ezetimibe, and valsartan increased PON activity and reduced oxidative stress both in serum and liver.
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AIM: To evaluate the prevalence of genetic and acquired prothrombotic risk factors and their association with the extent of fibrosis and fatty infiltration in patients with non-alcoholic fatty liver disease (NAFLD). METHODS: Forty-four patients with chronic hepatitis (28 men and 16 women, with mean age of 45+/-11 and 49+/-12 years, respectively) constituted the patient population of this study. The groups were divided as follows: 15 patients with fatty liver (FL); 15 with non-alcoholic steatohepatitis (NASH); 14 with chronic viral hepatitis (CH) diagnosed by histology and liver technetium scan or ultrasound; and 10 healthy individuals. Thrombophilic, coagulation factors and genetic mutations were diagnosed by standard hemostatic and molecular coagulation assays. RESULTS: Activated protein C (APC) resistance and protein S were the most prevalent thrombotic risk factors (6% and 10% in NAFLD vs 21% and 14% in CH; P<0.01 and P<0.05, respectively). One thrombotic risk factor was identified in 41% of patients (23% mild fibrosis, 18% severe fibrosis) and two thrombotic risk factors in 6% of patients with NAFLD and severe fibrosis. While no differences in APC ratio, lupus anticoagulant, fibrinogen, factor V Leiden, prothrombin, and MTHFR mutation were found. Protein S levels were significantly lower in NASH patients than in patients with FL alone (92+/-19 vs 106+/-2, P<0.01). Protein C levels were markedly higher in patients with NAFLD and mild or severe fibrosis as compared to the patients with CH, respectively (128+/-40 vs 96+/-14, P<0.001 or 129+/-36 vs 88+/-13, P<0.01). CONCLUSION: Up to 46% of patients with NAFLD may have thrombotic risk factors, and the presence of thrombotic risk factors is correlated with the extent of hepatic fibrosis, suggesting a crucial role of the coagulation system in the pathogenesis of hepatic fibrosis.
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Hígado Graso/patología , Fibrosis/patología , Trombosis/patología , Adulto , Anticoagulantes/metabolismo , Factores de Coagulación Sanguínea/metabolismo , Femenino , Predisposición Genética a la Enfermedad , Humanos , Masculino , Persona de Mediana Edad , Proteína C/metabolismo , Proteína S/metabolismo , Factores de RiesgoRESUMEN
We examined the presence and distribution of components of the secretory immune system (SIS) in fetal endocrine organs and their embryonic precursors. Specimens from 16 embryos (4 to 8 weeks of development) and 32 fetuses (9 to 38 weeks) were divided into those that had not been exposed to massive foreign antigenic effects (Group I, n=28) and those that had suffered from chorioamnionitis (Group II, n=20). An immunohistochemical study was performed using antibodies against the secretory component (SC), joining (J) chain, IgA, IgM, IgG, subsets of T and B lymphocytes, and macrophages. Positive immunostaining for SIS components in the precursors of endocrine organs was seen from 4 to 6 weeks of development, and was present thereafter in the pituitary body, thyroid, pancreatic islets and adrenals. J chain and immunoglobulins were found in all endocrine cells throughout intrauterine development, but the massive antigenic influence caused by chorioamnionitis decreased the latters immunoreactivity. The presence of SC in the precursors of adenohypophysis and pancreatic islet cells decreased significantly after their transformation into definitive endocrine organs. In the thyroidal follicular epithelium and the pars intermedia of the pituitary body cells, SC was present during the entire period of pregnancy. In adrenals, SC was not found. Maternal immunoglobulins, together with SC and J chain, are accumulated in endocrine gland cells from the early stages of intrauterine life. They are the major mechanism of endocrine cell defense during the early prenatal period when the common immune system is still structurally and functionally incompetent.
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Glándulas Endocrinas/inmunología , Glándulas Endocrinas/metabolismo , Feto/inmunología , Sistema Inmunológico/embriología , Sistema Inmunológico/metabolismo , Linfocitos B/inmunología , Glándulas Endocrinas/química , Feto/química , Edad Gestacional , Humanos , Inmunoglobulina A/análisis , Inmunoglobulina G/análisis , Cadenas J de Inmunoglobulina/análisis , Inmunoglobulina M/análisis , Inmunohistoquímica , Macrófagos/inmunología , Linfocitos T/inmunologíaRESUMEN
PROBLEM: The immune protection of genital organs in embryogenesis has not been sufficiently studied. The purpose of this study was to investigate the development of the secretory immune system (SIS) in the gonads and genital tracts of human embryos and fetuses. MATERIALS AND METHODS: Developing gonads at different stages and genital tracts from 18 embryos and 39 fetuses in the first to third trimester of gestation were analyzed for presence of different component of SIS: secretory component (SC), joining (J) chain. IgA, IgM, IgG, macrophages, and subsets of lymphocytes. The material was divided into two groups: cases not subjected to foreign antigenic effects (group I, n = 31) and those under antigenic attack (chorioamnionitis, group II, n = 26). RESULTS: In embryos and fetuses of group I, SC, J chain, and IgG were seen in the epithelium of mesonephric and paramesonephric ducts, proliferating coelomic epithelium, epithelium of the uterine tubes and uterus, epithelium of the vas deferens, epididymis, and rete testis. IgA and IgM appeared in 6-week-old embryos. J chain, IgA, IgM, and IgG, but not SC, were found in the primary oocytes and oogonia, spermatogonia. and interstitial cells. An abundance of macrophages was seen in 4-week-old embryos. T and B lymphocytes first appeared in 6-7-week-old embryos. In embryos and fetuses of group II, reactivity of immunoglobulins (Igs) decreased until they disappeared altogether. CONCLUSIONS: Components of SIS were seen in genital organs in 4-5-week-old embryos and were present during the whole intrauterine period. We suggest the presence of two forms of immune protection of fetal genital organs. One form contains SC, J chain, and Igs and is present in the genital tract epithelium. The second form contains only J chain and Igs and is present in germ cells of gonads. The loss of Igs in cases with chorioamnionitis reflects the functional participation of the SIS of genital organs in response to antigen attack.
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Genitales Femeninos/inmunología , Genitales Masculinos/inmunología , Antígenos CD/análisis , Femenino , Genitales Femeninos/embriología , Genitales Femeninos/patología , Genitales Masculinos/embriología , Genitales Masculinos/patología , Gónadas/inmunología , Humanos , Inmunoglobulina A/análisis , Inmunoglobulina G/análisis , Inmunoglobulina M/análisis , Inmunohistoquímica , MasculinoRESUMEN
BACKGROUND: The association of amyloidosis and tumors is well known, but only rarely has it been found in the nasopharynx. Moreover, only a single case of tumor-associated amyloidosis in the nasopharynx has been diagnosed by exfoliative cytology and reported in the English-language literature. We describe a case of localized amyloidosis in metastatic nasopharyngeal carcinoma diagnosed by fine needle aspiration and confirmed by histology and electron microscopy. CASE: Bilateral neck enlargement appeared six months before consultation in a 57-year-old man. Both masses were resected, and during exploration of the nasopharynx, several blind biopsies were taken. Smears from the fine needle aspirate showed malignant epithelial cells, consistent with metastatic carcinoma, and Congo red stain showed the presence of amyloid. Histologic examination of the resected cervical masses and nasopharyngeal biopsies confirmed the diagnosis of nasopharyngeal carcinoma, nonkeratinizing variant with amyloid, and metastases in two lymph nodes. Electron microscopic examination of a lymph node showed extracellular, ribbon-like amyloid deposits as well as masses of amorphous amyloid, apparently intracellular. CONCLUSION: The origin of this form of amyloidosis is unclear in this patient since he had no other known etiologic factors for the condition. Increased awareness of the potential association of these two conditions and the use of fine needle aspiration may reveal a higher frequency than hitherto reported.
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Amiloidosis/diagnóstico , Amiloidosis/patología , Carcinoma/complicaciones , Carcinoma/patología , Neoplasias Nasofaríngeas/complicaciones , Neoplasias Nasofaríngeas/patología , Biopsia con Aguja , Carcinoma/diagnóstico , Humanos , Masculino , Microscopía Electrónica , Persona de Mediana Edad , Neoplasias Nasofaríngeas/diagnósticoRESUMEN
We present a case of a 13-year-old boy with a left-sided abdominal mass which proved to be a papillary cystic neoplasm of the pancreas. This low-grade malignant lesion of young patients is very rare, and exceedingly rare in males. The prognosis following resection of this tumor is good. We present the ultrasound and computed tomographic picture of this lesion, as well as the gross and microscopic pathology.
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Cistoadenoma Papilar/diagnóstico , Neoplasias Pancreáticas/diagnóstico , Tomografía Computarizada por Rayos X , Ultrasonografía , Adolescente , Cistoadenoma Papilar/patología , Cistoadenoma Papilar/cirugía , Humanos , Masculino , Páncreas/patología , Pancreatectomía , Neoplasias Pancreáticas/patología , Neoplasias Pancreáticas/cirugíaRESUMEN
PURPOSE: To report a rare case of solitary anaplastic large cell lymphoma, Ki-1+, of the eyelid. METHOD: Case report. A firm ulcerated mass of the lower eyelid in a 10-year-old boy was the initial and only sign of anaplastic large cell lymphoma. RESULTS: A local excision of the mass was performed. Histologic examination disclosed large lymphoid anaplastic cells that reacted positively for T-cell markers and CD30 antigen. CONCLUSION: A solitary eyelid mass can be an initial sign of anaplastic large cell lymphoma in children.
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Neoplasias de los Párpados/diagnóstico , Párpados/patología , Antígeno Ki-1/inmunología , Linfoma Anaplásico de Células Grandes/diagnóstico , Linfocitos T/inmunología , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapéutico , Biomarcadores , Biopsia con Aguja , Médula Ósea/patología , Quimioterapia Adyuvante , Niño , Diagnóstico Diferencial , Neoplasias de los Párpados/inmunología , Neoplasias de los Párpados/terapia , Estudios de Seguimiento , Humanos , Antígenos Comunes de Leucocito/inmunología , Linfoma Anaplásico de Células Grandes/inmunología , Linfoma Anaplásico de Células Grandes/terapia , Masculino , Piel/patología , Linfocitos T/patología , Tomografía Computarizada por Rayos X , Agudeza VisualRESUMEN
We report a case of enteropathy-associated T-cell lymphoma (EATL) of the jejunum in a 56-year-old man. The patient suffered for several years from nonspecific abdominal complaints, with no clinical evidence of malabsorption. The patient underwent extensive imaging procedures including barium meal and computed tomography. Computed tomography of the abdomen showed small mesenteric lymph nodes and an area of intestinal wall thickening. Barium meal demonstrated a short jejunal stricture. Histology revealed lymphoma of the jejunum, with microscopic changes distant from the lesion consistent with celiac disease. The spectrum of EATL ranges from patients with frank celiac disease, to patients with only immunohistochemical evidence of celiac disease, who develop small bowel lymphoma.
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Enfermedad Celíaca/complicaciones , Neoplasias del Yeyuno/diagnóstico por imagen , Linfoma de Células T/diagnóstico por imagen , Tomografía Computarizada por Rayos X , Colangiopancreatografia Retrógrada Endoscópica , Humanos , Neoplasias del Yeyuno/patología , Linfoma de Células T/patología , Masculino , Persona de Mediana EdadRESUMEN
Fine-needle aspiration cytology, immunohistochemistry, and histopathologic findings are described in a case of myoblastomatoid carcinoma of the breast. The aspirate contained many small and large clusters of cohesive atypical cells with abundant foamy-to-granular cytoplasm and nuclei that show moderate pleomorphism. These tumors can be easily misinterpreted as either fibrohistiocytic or myoblastomatoid (granular cell) tumors, and by using immunohistochemical stains, the epithelial origin can be elucidated. This case report provides the first description of the fine-needle aspiration cytomorphology of this distinctive variant of apocrine carcinoma.
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Apolipoproteínas , Neoplasias de la Mama/patología , Mama/patología , Glicoproteínas , Tumor de Células Granulares/patología , Proteínas de Transporte de Membrana , Neoplasias de las Glándulas Sudoríparas/patología , Anciano , Apolipoproteínas D , Biomarcadores de Tumor/análisis , Biopsia con Aguja , Neoplasias de la Mama/química , Neoplasias de la Mama/cirugía , Proteínas Portadoras/análisis , Diagnóstico Diferencial , Femenino , Tumor de Células Granulares/química , Tumor de Células Granulares/cirugía , Humanos , Inmunohistoquímica , Neoplasias de las Glándulas Sudoríparas/química , Neoplasias de las Glándulas Sudoríparas/cirugíaRESUMEN
Metanephric adenoma is a morphologically distinct renal tumor that appears histologically benign and whose epithelial component is predominant. We report a case of metanephric adenoma in a 42-year-old woman. The tumor was composed of immature epithelial cells forming tubules with abortive glomeruloid structures. The bland appearance of the cells forming this tumor were in accordance with the apparently benign postnephrectomy clinical course.
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Adenoma/patología , Neoplasias Renales/patología , Riñón/patología , Adenoma/cirugía , Carcinoma de Células Renales/patología , Diagnóstico Diferencial , Femenino , Humanos , Neoplasias Renales/cirugía , Persona de Mediana Edad , Nefrectomía , Tumor de Wilms/patologíaRESUMEN
We report a case of posttraumatic intestinal stenosis (PIS), an uncommon sequela of blunt abdominal trauma, in which injury to the mesentery and bowel wall results in later focal ischemic stricture of that segment. We include CT images at the time of trauma, and barium meal and abdominal sonography obtained during the subsequent admission. Examination of the resected bowel loop showed transmural infarct and posttraumatic changes in the adjacent peritoneal fat. This is the first report which includes both imaging at the time of trauma and sonographic appearance of the narrowed bowel loop. Posttraumatic intestinal stenosis should be considered in the differential diagnosis of a narrowed bowel loop in a patient with a history of blunt abdominal trauma.
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Traumatismos Abdominales/complicaciones , Obstrucción Intestinal/diagnóstico por imagen , Heridas no Penetrantes/complicaciones , Traumatismos Abdominales/diagnóstico por imagen , Accidentes de Tránsito , Anciano , Constricción Patológica , Humanos , Enfermedades del Íleon/diagnóstico por imagen , Enfermedades del Íleon/etiología , Obstrucción Intestinal/etiología , Masculino , Tomografía Computarizada por Rayos X , Ultrasonografía , Heridas no Penetrantes/diagnóstico por imagenRESUMEN
An intraoperative cytological imprint of a well study case of collecting duct carcinoma of the kidney is reported. Papillary structures, fibrotic desmoplastic stroma, tubular formations, and tumoral cells with high grade cytological atypia were found. Cytological details described help to avoid misinterpretation of collecting duct carcinoma as a metastatic tumor. The peculiar morphology, the immunohistochemical and biological behavior of this rare tumor justifies its classification in a special group.
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Neoplasias Renales/patología , Túbulos Renales Colectores/citología , Humanos , Masculino , Persona de Mediana EdadRESUMEN
Primary urachal carcinomas are very rare urological malignancies. In the present article we report an unusual case of a small cell carcinoma with neurendocrine features and adenocarcinoma arising in the urachus, and review the literature. The results of the immunohistochemical studies are presented.