17ß-oestradiol acts as a negative modulator of insulin-induced lactotroph cell proliferation through oestrogen receptor α, via nitric oxide/guanylyl cyclase/cGMP.

OBJECTIVES: 17ß-oestradiol interacts with growth factors to modulate lactotroph cell population. However, contribution of isoforms of the oestrogen receptor in these activities is not fully understood. In the present study, we have established participation of α and ß oestrogen receptors in effects of 17ß-oestradiol on lactotroph proliferation induced by insulin and shown involvement of the NO/sGC/cGMP pathway. MATERIALS AND METHODS: Cell cultures were prepared from anterior pituitaries of female rats to evaluate lactotroph cell proliferation using bromodeoxyuridine (BrdUrd) detection, protein expression by western blotting and cGMP by enzyme immunoassay. RESULTS: In serum-free conditions, 17ß-oestradiol and α and ß oestrogen receptor agonists (PPT and DPN) failed to increase numbers of lactotroph cells undergoing mitosis. Co-incubation of 17ß-oestradiol/insulin and PPT/insulin significantly decreased lactotroph mitogenic activity promoted by insulin alone. Both ICI 182780 and NOS inhibitors (L-NMMA and L-NAME) induced reversal of the anti-proliferative effect promoted by 17ß-oestradiol/insulin and PPT/insulin. Moreover, 17ß-oestradiol, PPT and insulin increased sGC α1 protein expression and inhibited ß1, whereas co-incubation of 17ß-oestradiol/insulin or PPT/insulin induced increases of the two isoforms α1 and ß1. 17ß-oestradiol and insulin reduced cGMP production, while 17ß-oestradiol/insulin co-incubation increased this cyclic nucleotide. CONCLUSIONS: Our results suggest that 17ß-oestradiol is capable of arresting lactotroph proliferation induced by insulin through ER α with participation of the signalling NO/sGC/cGMP pathway.

Usefulness of endoscopic ultrasonography in preoperative gastric cancer staging: diagnostic yield and therapeutic impact.

OBJECTIVES: To evaluate the diagnostic yield of endoscopic ultrasonography in loco-regional staging of gastric cancer in our medium and to determine the impact of this technique on later therapeutic management. MATERIAL AND METHODS: This is a retrospective study carried out on patients histologically diagnosed with gastric adenocarcinoma who had been referred for endoscopic ultrasonographic examination. The technique results were compared with those obtained from surgical samples and/or from exploratory laparoscopy- laparotomy. We compared the initial therapeutic decision based on conventional diagnostic techniques with the final therapeutic management based on the endoscopic ultrasonography results. RESULTS: Forty-six patients with gastric adenocarcinoma were included in the study (a reference exploration was available in 36 cases). Diagnostic precision was 70% in stage T, while in stages T1, T2, T3 y T4 was 100, 38, 82, and 100%, respectively. The sensitivity and specificity to differentiate T1-2 from T3-4 was 94 and 85%, respectively. We could not identify factors associated with obtaining a correct diagnosis in staging T. Diagnostic precision was 72% for stage N (N0: 58%; Nx 88%). The presence of free perigastric fluid was identified in 7 cases; the presence of peritoneal carcinomatosis was later confirmed in 5 of these. The result of endoscopic ultrasonography led to a modification in the subsequent therapeutic management in 13 patients (28%). CONCLUSIONS: Endoscopic ultrasonography is a useful technique for loco-regional staging of gastric adenocarcinoma, which may have important implications in the therapeutic management of these patients.

Utilidad de la ecoendoscopia en la estadificiación preoperatoria del cáncer gástrico: rentabilidad diagnóstica e impacto terapéutico / No disponible

Objetivos: valorar la rentabilidad diagnóstica de la ecoendoscopiaen la estadificación locorregional del cáncer gástrico ennuestro medio y determinar el impacto de la técnica sobre el manejoterapéutico posterior.Material y métodos: estudio retrospectivo realizado en pacientesdiagnosticados histológicamente de adenocarcinoma gástricoque habían sido remitidos para la realización de ecoendoscopia.Se comparó el resultado de la técnica con el estudio final obtenidoen la pieza operatoria y/o laparoscopia-laparotomía exploradora.Se comparó la decisión terapéutica inicial basada en los resultadosde las técnicas diagnósticas convencionales, con el manejo terapéuticofinal basado en el resultado de la ecoendoscopia.Resultados: se incluyeron en el estudio 46 pacientes conadenocarcinoma gástrico (en 36 de los cuales se disponía de exploraciónde referencia). La precisión diagnóstica fue del 70%para el estadio T, y para T1, T2, T3 y T4 del 100, 38, 82 y100%, respectivamente. La sensibilidad y especificidad para diferenciarel estadio T1-2 del T3-4 fue del 94 y 85% respectivamente.No se identificaron factores relacionados con la obtención deun diagnóstico correcto en la estadificación T. La precisión diagnósticafue del 72% para el estadio N (N0: 58%; Nx 88%). En 7pacientes se identificó la presencia de líquido libre perigástrico, en5 de los cuales se confirmó posteriormente la existencia de carcinomatosisperitoneal. En 13 pacientes (28%) del resultado de laecoendoscopia se derivó una modificación en el manejo terapéuticoposterior.Conclusiones: la ecoendoscopia es una técnica útil en la estadificaciónlocorregional del adenocarcinoma gástrico, lo quepuede tener importantes implicaciones en el manejo terapéuticode estos pacientes(AU)

Objectives: to evaluate the diagnostic yield of endoscopic ultrasonographyin loco-regional staging of gastric cancer in ourmedium and to determine the impact of this technique on latertherapeutic management.Material and methods: this is a retrospective study carriedout on patients histologically diagnosed with gastric adenocarcinomawho had been referred for endoscopic ultrasonographic examination.The technique results were compared with those obtainedfrom surgical samples and/or from exploratory laparoscopylaparotomy.We compared the initial therapeutic decision basedon conventional diagnostic techniques with the final therapeuticmanagement based on the endoscopic ultrasonography results.Results: forty-six patients with gastric adenocarcinoma wereincluded in the study (a reference exploration was available in 36cases). Diagnostic precision was 70% in stage T, while in stagesT1, T2, T3 y T4 was 100, 38, 82, and 100%, respectively. Thesensitivity and specificity to differentiate T1-2 from T3-4 was 94and 85%, respectively. We could not identify factors associatedwith obtaining a correct diagnosis in staging T. Diagnostic precisionwas 72% for stage N (N0: 58%; Nx 88%). The presence offree perigastric fluid was identified in 7 cases; the presence of peritonealcarcinomatosis was later confirmed in 5 of these. The resultof endoscopic ultrasonography led to a modification in thesubsequent therapeutic management in 13 patients (28%).Conclusions: endoscopic ultrasonography is a useful techniquefor loco-regional staging of gastric adenocarcinoma, whichmay have important implications in the therapeutic managementof these patients(AU)

Pancreatitis autoinmune asociada a fibrosis retroperitoneal: evolución tras dos años de seguimiento / No disponible

Introducción: la pancreatitis autoinmune es un tipo de pancreatitiscrónica caracterizado por un infiltrado linfoplasmocitarioy una elevación de IgG e IgG4, que se ha descrito asociada a diversasmanifestaciones extrapancreáticas y enfermedades autoinmunes,lo cual apoya la teoría de un mecanismo autoinmune fisiopatólogicode base.Caso clínico: presentamos el caso de un varón que debutó simultáneamentecon una pancreatitis autoinmune asociada a fibrosisretroperitoneal y lesión de la vía biliar extrapancreática, conrespuesta total tras tratamiento con corticoides durante 4 meses yausencia de recurrencia tras 24 meses de seguimiento.Discusión: la pancreatitis autoinmune es un tipo de pancreatitiscrónica que probablemente forme parte de un proceso sistémicoautoinmune, cuyas manifestaciones extrapancreáticas másfrecuentes son la fibrosis retroperitoneal y las lesiones de la vía biliarextrapancreática. Su correcto diagnóstico e inicio precoz deltratamiento puede favorecer la resolución completa de las lesiones,principalmente en los casos de bajo grado de actividad, conmenor probabilidad de recurrencia

Introduction: autoimmune pancreatitis is a kind of chronicpancreatitis characterized by the presence of lymphoplasmacyticinfiltration and severely elevated serum IgG and IgG4, which hasbeen associated to many extrapancreatic lesions and other autoimmunedisorders, leading to the theory of an autoimmunemechanism involved in the pathogenesis of this disease.Case report: we report the case of a man who simultaneouslypresented with autoimmune pancreatitis associated withretroperitonal fibrosis, and a lesion of the extrapancreatic bileduct, with total response to corticosteroid treatment for 4 mothsand absence of recurrence after 24 months of follow-up.Discussion: autoimmune pancreatitis is a kind of chronicpancreatitis that is probably a part of a systemic autoinmune disease,with retroperitoneal fibrosis and extrapancreatic bile duct lesionbeing the most commonly associated extrapancreatic lesions.A correct diagnosis and early treatment of this disease may aid inthe total resolution of lesions, especially in cases with a low activity grade (AU)

[Endosonographic examination of the common bile duct in patients with acute biliary pancreatitis]. / Estudio por ecoendoscopia de la vía biliar extrahepática en pacientes con pancreatitis aguda biliar.

OBJECTIVE: the objective of our study was to evaluate the usefulness of endoscopic ultrasonography (EUS) for the study of the common bile duct in patients diagnosed with acute biliary pancreatitis, and to establish clinical and laboratory factors related to this technique. MATERIALS AND METHODS: seventy-three consecutive patients with acute biliary pancreatitis were included in the study (31 males and 42 females with a mean age of 64 +/- 15) who were admitted to our department for biliopancreatic EUS. In all patients the technique was followed by ERCP with sphincterotomy, and endoscopy to remove stones when endoscopy revealed choledocholithiasis. RESULTS: mean time from admission to echoendoscopy was 7 +/- 6 days. In 18 patients (24%) the presence of choledocholithiasis was revealed by EUS, and in 17 a sphincterotomy was performed. Choledocholithiasis was more frequent in patients with common bile duct dilation (55 vs. 14%; p < 0.05). Thirteen patients (18%) showed severe acute pancreatitis. Fourteen (19%) showed complications related to acute pancreatitis, and one patient died. Four patients had a new episode of acute pancreatitis. No significant difference was seen in the percentage of complications between patients treated conservatively and patients with choledocholithiasis treated with endoscopic sphincterotomy (18 vs. 22%; p > 0.05). No difference was also detected for the subgroup of patients with severe acute pancreatitis (45 vs. 55%; p > 0.05). CONCLUSIONS: EUS is a useful technique for the selection of patients with acute biliary pancreatitis who may benefit from endoscopic sphincterotomy.

Expression patterns in mouse embryos of neuroleukin/glucose-6-phosphate isomerase and autocrine motility factor receptor.

The pattern of expression by using in situ hybridization in whole mouse embryos of the neuroleukin/glucose-6-phosphate isomerase (NK/GPI) gene and its receptor (AMF-R) is reported. NK/GPI expression was first seen at embryonic day 9 whereas AMF-R was detected at embryonic day 8; both were detected up to day 12 with NK/GPI showing peaking in the limbs around day 11. The main regions of expression are limb buds, spinal cord and brain. This work contributes to understanding how both proteins act in the development of somatosensory and motoric neural structures.

Estudio por ecoendoscopia de la vía biliar extrahepática en pacientes con pancreatitis aguda biliar / No disponible

Objetivo: el objetivo de nuestro estudio fue valorar la utilidad de laecoendoscopia en el estudio de la vía biliar extrahepática en los pacientesdiagnosticados de pancreatitis aguda biliar y determinar los factoresclínicos y analíticos relacionados con el resultado de la técnica.Material y métodos: se incluyeron en el estudio de modo consecutivo73 pacientes (31 varones, 42 mujeres; media de edad 64 ±15 años) con pancreatitis aguda biliar remitidos a nuestro serviciopara la realización de ecoendoscopia biliopancreática. En todos lospacientes se realizó la técnica seguida de CPRE con esfinterotomía ytécnica endoscópica para la extracción de cálculos cuando se identificópor ecoendoscopia la existencia de coledocolitiasis. Se compararonlas características clínico-evolutivas de estos pacientes con respectoal resultado obtenido con la ecoendoscopia.Resultados: la media de tiempo transcurrido desde el ingresohasta la realización de la ecoendoscopia fue de 7 ± 6 días. En 18pacientes (24%) se observó en la ecoendoscopia la existencia decoledocolitiasis y en 17 de ellos se realizó esfinterotomía endoscópica.La presencia de coledocolitiasis fue más frecuente en aquellospacientes con dilatación de la vía biliar extrahepática (55 vs.14%; p < 0,05) y en aquellos con bilirrubina sérica superior a 3mg/dl (41 vs. 18%; p < 0,05). Trece pacientes (18%) presentaronpancreatitis aguda severa. Catorce (19%) presentaron algunacomplicación en relación con la pancreatitis aguda y un pacientemurió. Se observó una complicación relacionada con la esfinterotomíaendoscópica. Cuatro pacientes presentaron un nuevo episodiode pancreatitis aguda. No se observaron diferencias significativasen el porcentaje de complicaciones en los pacientestratados de modo conservador respecto a aquellos con coledocolitiasistratados con esfinterotomía endoscópica (18 vs. 22%; p >0,05). Tampoco se observó esta diferencia en el subgrupo de pacientescon pancreatitis aguda severa (45 vs. 55%; p > 0,05).Conclusiones: la ecoendoscopia es una técnica útil en la selecciónde los pacientes con pancreatitis aguda biliar que se beneficiaránde la realización de una esfinterotomía endoscópica

Objective: the objective of our study was to evaluate the usefulnessof endoscopic ultrasonography (EUS) for the study of thecommon bile duct in patients diagnosed with acute biliary pancreatitis,and to establish clinical and laboratory factors related to thistechnique.Materials and methods: seventy-three consecutive patientswith acute biliary pancreatitis were included in the study (31 malesand 42 females with a mean age of 64 ± 15) who were admittedto our department for biliopancreatic EUS. In all patients the techniquewas followed by ERCP with sphincterotomy, and endoscopyto remove stones when endoscopy revealed choledocholithiasis.Results: mean time from admission to echoendoscopy was7 ± 6 days. In 18 patients (24%) the presence of choledocholithiasiswas revealed by EUS, and in 17 a sphincterotomywas performed. Choledocholithiasis was more frequent in patientswith common bile duct dilation (55 vs. 14%; p < 0.05).Thirteen patients (18%) showed severe acute pancreatitis. Fourteen(19%) showed complications related to acute pancreatitis,and one patient died. Four patients had a new episode of acutepancreatitis. No significant difference was seen in the percentageof complications between patients treated conservativelyand patients with choledocholithiasis treated with endoscopicsphincterotomy (18 vs. 22%; p > 0.05). No difference was alsodetected for the subgroup of patients with severe acute pancreatitis(45 vs. 55%; p > 0.05).Conclusions: EUS is a useful technique for the selection ofpatients with acute biliary pancreatitis who may benefit from endoscopicsphincterotomy

[Autoimmune pancreatitis associated with retroperitoneal fibrosis: outcome after 24 months of follow-up]. / Pancreatitis autoinmune asociada a fibrosis retroperitoneal: evolución tras dos años de seguimiento.

INTRODUCTION: Autoimmune pancreatitis is a kind of chronic pancreatitis characterized by the presence of lymphoplasmacytic infiltration and severely elevated serum IgG and IgG4, which has been associated to many extrapancreatic lesions and other autoimmune disorders, leading to the theory of an autoimmune mechanism involved in the pathogenesis of this disease. CASE REPORT: We report the case of a man who simultaneously presented with autoimmune pancreatitis associated with retroperitonal fibrosis, and a lesion of the extrapancreatic bile duct, with total response to corticosteroid treatment for 4 months and absence of recurrence after 24 months of follow-up. DISCUSSION: Autoimmune pancreatitis is a kind of chronic pancreatitis that is probably a part of a systemic autoimmune disease, with retroperitoneal fibrosis and extrapancreatic bile duct lesion being the most commonly associated extrapancreatic lesions. A correct diagnosis and early treatment of this disease may aid in the total resolution of lesions, especially in cases with a low activity grade.

Growth hormone (GH) treatment reduces peripheral thyroid hormone action in girls with Turner syndrome.

OBJECTIVE: Turner syndrome (TS) is an indication for GH therapy in spite of the modest growth response. Somatic growth depends not only on GH insulin-like growth factor I (IGF-I) axis but also on thyroid hormone (TH) status. We have previously reported that supraphysiological IGF-I levels diminished TH actions in rat tissues by reducing the nuclear TH receptor (TR). GH treatment to TS patients induces high IGF-I levels and therefore a reduction of TH action in tissues may be expected. We aimed at evaluating the effect of GH therapy in TS girls on peripheral TH action. DESIGN AND PATIENTS: We set up a reverse transcription-polymerase chain reaction (RT-PCR) for TR mRNA estimation in peripheral blood mononuclear cells (PBMC) and compared TR mRNA levels from 10 normal, 10 TS and 10 TS girls under GH therapy (0.33 mg/kg/week for 0.5-2 years). MEASUREMENTS: After RNA extraction from PBMC, TR and beta-actin mRNAs were coamplified by RT-PCR. In addition serum biochemical markers of TH action were measured: thyrotropin (TSH), sex hormone binding globulin (SHBG), osteocalcin (OC), beta-crosslaps (beta-CL), iodothyronines by electrochemiluminescency and IGF-I by immunoradiometric assay (IRMA) with extraction. RESULTS: TR mRNAs from PBMC were reduced in TS patients under GH treatment. In turn, serum TSH, OC, beta-CL and IGF-I were increased while SHBG was reduced by GH treatment in TS patients. CONCLUSIONS: GH treatment reduced TR expression in PBMC and biochemical serum markers of TH action. These results suggest that GH treatment in TS patients impair peripheral TH action at tissue level and prompt a role in the reduced growth response to the therapy.

[Angioma-like liver lesions in patients with chronic liver disease]. / Lesiones hepáticas sugestivas de angioma en pacientes con hepatopatía crónica.

OBJECTIVE: The aim of this study was to evaluate in our healthcare area the clinical, ultrasonographic, and evolutionary features of patients with chronic liver disease and angioma-like liver lesions on ultrasonography. MATERIALS AND METHODS: We conducted a retrospective study amongst patients seen at the Ultrasonography Unit, Gastroenterology Department between January 2000 and June 2004. Included in the study were patients that presented with clinical and/or laboratory complaints consistent with chronic liver disease of any etiology, and those in which abdominal ultrasounds revealed the existence of at least one angioma-like liver lesion. All relevant epidemiological, clinical, ultrasonographic, and evolutionary data were carefully collected and recorded. RESULTS: In the course of our study, 58 patients were diagnosed with chronic liver disease and angioma-like liver lesions, of which 13 showed clinical, laboratory, ultrasonographic, and/or histological signs of liver cirrhosis. In 50% of patients these lesions were less than 10 mm in diameter, and in most cases were located in the right hepatic lobe. During an average follow-up period of 35 months (6-168 months) we verified that, in two patients, these lesions, initially interpreted as angiomas were in fact malignancies (one hepatocellular carcinoma and one metastatic adenocarcinoma of the gallbladder). In both cases, the patients were cirrhotic. Thus, our study revealed that 15% of lesions found in cirrhotic patients initially interpreted as angiomas were actually malignant. CONCLUSIONS: Our study revealed that, in patients with chronic liver disease, particularly in cirrhotic patients, a considerable percentage of ultrasonographic lesions originally interpreted as angiomas are in fact malignant tumors.

Lesiones hepáticas sugestivas de angioma en pacientes con hepatopatía crónica / Angioma-like liver lesions in patients with chronic liver disease

Objetivo: el objetivo de nuestro estudio fue valorar en nuestro medio las características clínicas, ecográficas y evolutivas de los pacientes con hepatopatía crónica y lesiones ecográficas sugestivas de angiomas hepáticos. Material y métodos: estudio retrospectivo realizado entre los pacientes recogidos en la base de datos de la Unidad de Ecografías del Servicio de Aparato Digestivo entre enero de 2000 y junio de 2004. Incluimos en el estudio a pacientes que presentaban datos clínicos y/o analíticos compatibles con hepatopatía crónica de cualquier etiología y en los que la ecografía abdominal ponía de manifiesto la existencia de al menos una lesión hepática compatible con angioma. Se han recogido los datos epidemiológicos, clínicos, ecográficos y evolutivos de estos pacientes. Resultados: durante el periodo de estudio se diagnosticaron 58 pacientes con hepatopatía crónica y lesiones hepáticas sugestivas de angioma, de los cuales trece presentaban datos clínicos, analíticos, ecográficos y/o histológicos compatibles con cirrosis hepática. Ecográficamente se trataban de lesiones menores de 10 mm en el 50% de los pacientes y en la mayoría de los casos localizadas en lóbulo hepático derecho. Durante el periodo de medio de 35 meses (6 a 168 meses) se pudo comprobar cómo en dos pacientes (3%) las lesiones inicialmente interpretadas como angiomas se trataban en realidad de lesiones malignas (un hepatocarcinoma y unas metástasis de adenocarcinoma vesicular). En ambos casos los pacientes eran cirróticos. Por tanto, en el 15% de los pacientes cirróticos de nuestra serie se demostró la naturaleza maligna de las lesiones inicialmente interpretadas como angiomas. Conclusiones: en pacientes con hepatopatía crónica, sobre todo en cirróticos, un porcentaje no despreciable de las lesiones ecográficas interpretadas inicialmente como angiomas se tratan realmente de lesiones malignas

Objective: the aim of this study was to evaluate in our healthcare area the clinical, ultrasonographic, and evolutionary features of patients with chronic liver disease and angioma-like liver lesions on ultrasonography. Materials and methods: we conducted a retrospective study amongst patients seen at the Ultrasonography Unit, Gastroenterology Department between January 2000 and June 2004. Included in the study were patients that presented with clinical and/or laboratory complaints consistent with chronic liver disease of any etiology, and those in which abdominal ultrasounds revealed the existence of at least one angioma-like liver lesion. All relevant epidemiological, clinical, ultrasonographic, and evolutionary data were carefully collected and recorded. Results: in the course of our study, 58 patients were diagnosed with chronic liver disease and angioma-like liver lesions, of which 13 showed clinical, laboratory, ultrasonographic, and/or histological signs of liver cirrhosis. In 50% of patients these lesions were less than 10 mm in diameter, and in most cases were located in the right hepatic lobe. During an average follow-up period of 35 months (6-168 months) we verified that, in two patients, these lesions, initially interpreted as angiomas were in fact malignancies (one hepatocellular carcinoma and one metastatic adenocarcinoma of the gallbladder). In both cases, the patients were cirrhotic. Thus, our study revealed that 15% of lesions found in cirrhotic patients initially interpreted as angiomas were actually malignant. Conclusions: our study revealed that, in patients with chronic liver disease, particularly in cirrhotic patients, a considerable percentage of ultrasonographic lesions originally interpreted as angiomas are in fact malignant tumors

Extraintestinal manifestations of Crohn's disease: prevalence and related factors.

BACKGROUND: Patients with inflammatory bowel disease may suffer one or more extraintestinal manifestations during the course of their condition, these being more frequent in Crohn s disease. The aim of our study was to evaluate the prevalence of extraintestinal manifestations in patients with Crohn s disease in our healthcare area, and to assess the relationship between its presence and diverse clinical-evolutionary variables. MATERIAL AND METHODS: Extraintestinal manifestations in 157 patients diagnosed with Crohn s disease in our center were retrospectively studied. The clinical-evolutionary characteristics of this population were compared with respect to the presence or absence of different extraintestinal manifestations. RESULTS: Seventy-two patients (46%) presented at least with one extraintestinal manifestation. Thirty-one percent were colitis-related manifestations (22% rheumatologic, 13% muco-cutaneous, 4% ophthalmologic), 11% cholelithiasis, 8% nephrolithiasis, 3% thromboembolic illness, and other manifestations were less frequent. Fourteen percent presented with more than one extraintestinal manifestation. Rheumatologic and muco-cutaneous manifestations were significantly more frequent in patients with disease confined to the colon. Cholelithiasis was significantly associated to those over 40 and also to males. Nephrolithiasis was also significantly associated to those over 40, and thromboembolic illness was linked to females. CONCLUSIONS: forty-six percent of patients with Crohn s disease presented at least with one extraintestinal manifestation. Thirty-one percent presented with colitis-related manifestations, rheumatologic and muco-cutaneous manifestations being the most frequent, whereas hepatic manifestations were infrequent. Rheumatologic and muco-cutaneous manifestations were more frequent in patients with disease confined to the colon.

Manifestaciones extraintestinales de la enfermedad de Crohn. Prevalencia y factores relacionados / Extraintestinal manifestations of Crohn's disease: prevalence and related factors

Introducción: los pacientes con enfermedad inflamatoria intestinalpueden sufrir a lo largo de su evolución una o más manifestacionesextraintestinales, siendo estas más frecuentes en la enfermedadde Crohn. El objetivo de nuestro estudio fue valorar laprevalencia de las manifestaciones extraintestinales en los pacientescon enfermedad de Crohn en nuestro medio y la relación existenteentre su presencia y diversas variables clínico-evolutivas.Material y métodos: se recogieron de modo retrospectivolas manifestaciones extraintestinales de 157 pacientes diagnosticadosde enfermedad de Crohn en nuestro centro. Se compararonlas características clínico-evolutivas de esta población con respectoa la presencia o ausencia de las distintas manifestacionesextraintestinales.Resultados: setenta y dos pacientes (46%) presentaban almenos una manifestación extraintestinal. El 31% eran colíticas(22% articulares, 13% cutáneo-mucosas, 4% oculares), 11% colelitiasis,8% litiasis renal y 3% enfermedad tromboembólica. Otrasmanifestaciones presentaban una menor frecuencia. El 14% presentaronmás de una manifestación extraintestinal. Las manifestacionesarticulares y cutáneo-mucosas fueron significativamentemás frecuentes en la localización colónica. La colelitiasis se asociabasignificativamente con la edad mayor de 40 años y el sexomasculino. La litiasis renal se asociaba significativamente con laedad y la enfermedad tromboembólica con el sexo femenino.Conclusiones: el 46% de los pacientes con enfermedad deCrohn presentaron al menos una manifestación extraintestinal. El31% presentaban manifestaciones colíticas, siendo las articularesy cutáneo-mucosas las más frecuentes, mientras que las hepáticasfueron infrecuentes. Las manifestaciones articulares y cutáneomucosasfueron más frecuentes en la localización colónica

Background: patients with inflammatory bowel disease maysuffer one or more extraintestinal manifestations during thecourse of their condition, these being more frequent in Crohn'sdisease. The aim of our study was to evaluate the prevalence ofextraintestinal manifestations in patients with Crohn's disease inour healthcare area, and to assess the relationship between itspresence and diverse clinical-evolutionary variables.Material and methods: extraintestinal manifestations in 157patients diagnosed with Crohn's disease in our center were retrospectivelystudied. The clinical-evolutionary characteristics of thispopulation were compared with respect to the presence or absenceof different extraintestinal manifestations.Results: seventy-two patients (46%) presented at least withone extraintestinal manifestation. Thirty-one percent were colitisrelatedmanifestations (22% rheumatologic, 13% muco-cutaneous,4% ophthalmologic), 11% cholelithiasis, 8% nephrolithiasis,3% thromboembolic illness, and other manifestations wereless frequent. Fourteen percent presented with more than one extraintestinalmanifestation. Rheumatologic and muco-cutaneousmanifestations were significantly more frequent in patients withdisease confined to the colon. Cholelithiasis was significantly associatedto those over 40 and also to males. Nephrolithiasis was alsosignificantly associated to those over 40, and thromboembolic illnesswas linked to females.Conclusions: forty-six percent of patients with Crohn's diseasepresented at least with one extraintestinal manifestation.Thirty-one percent presented with colitis-related manifestations,rheumatologic and muco-cutaneous manifestations being the mostfrequent, whereas hepatic manifestations were infrequent.Rheumatologic and muco-cutaneous manifestations were morefrequent in patients with disease confined to the colon

Thyroid hormone receptor beta1 gene expression is increased by Dexamethasone at transcriptional level in rat liver.

Triiodothyronine (T3) exerts most of its effect through nuclear thyroid hormone receptors (TR) which bind mainly as heterodimers with retinoid-X receptors (RXR) to thyroid hormone response elements (TRE) in target genes. It is well known that the synergistic interaction of T3 and glucocorticoids has a role on the synthesis of growth hormone in rat pituitary cell lines and in the T3-induced metamorphosis in amphibians. Glucocorticoids increased mRNAs of T3-regulated hepatic genes. Our laboratory reported increased specific metabolic actions of T3 in rat liver by Dexamethasone (Dex) through a mechanism involving an up-regulation of the maximal binding capacity of TR. In this study we further explored the participation of TR in the molecular mechanism of the Dex-induced increase on liver T3-specific metabolic action. Dex administration to adrenalectomized rats induced an increase of liver TRbeta1 protein and mRNA. Nuclear run-on assay revealed that Dex up-regulated the TR gene transcriptional rate. Transfection assay in COS-7 cells indicated that Dex increased the transcriptional activity of the TRbeta1 promoter. Electrophoretic mobility shift assay demonstrated that Dex induced the binding of additional proteins related to or neighboring the DNA sequence of a glucocorticoid receptor (GR) binding (GRE) half-site in the TRbeta1 promoter. Evidences for an interaction of GR on the TRbeta1 promoter have been obtained. Moreover, the specificity of the GR binding to GRE was determined not only by the GRE DNA sequence, but also by the interaction of the GR with other transacting factors bound to sequences flanking the GRE.

New haplotype for the Glu104Asp mutation in triose-phosphate isomerase deficiency and prenatal diagnosis in a Spanish family.

First-trimester prenatal diagnosis was undertaken by chorionic villus DNA analysis in a Spanish family with the inherited Glu104Asp triose-phosphate isomerase deficiency. The fetus was heterozygous for the mutation and therefore predicted to be clinically unaffected. To investigate the evolutionary origin of this mutation, studies were conducted on the intragenic 2262A/G polymorphism and the CD4 pentameric tandem repeat marker. A different haplotype was found to the one previously described, suggesting a different origin of the Spanish mutation.