Matrix Metalloproteinases and Stress Hormones in Lung Cancer Progression.

Several matrix metalloproteinases (MMPs) and psychological stress are associated with poor cancer prognosis. The current work goal was to determine MMPs' and stress hormones' blood concentrations from lung adenocarcinoma (LAC) patients. Patients were divided into the following groups: tobacco smokers (TS), wood smoke-exposed (W), passive smokers (PS), TS exposed to wood smoke (TW), and patients with no recognizable risk factor (N). MMPs, tissue inhibitors of metalloproteinases (TIMPs), adrenaline, noradrenaline, and cortisol blood concentrations were measured by ELISA. Zymography and Western blot assays were performed to determine MMP-2 and MMP-9 active and latent forms. MMP-2, MMP-3, MMP-9, and TIMP-1 blood concentrations, and MMP-9 gelatinase activity were augmented, while MMP-12, MMP-14, and TIMP-2 were diminished in LAC patients. Cortisol was increased in LAC samples. Adrenaline concentrations were higher in W, TS, and TW, and noradrenaline was increased in W and N groups. Positive correlations were observed among cortisol and TIMP-1 (r s = 0.392) and TIMP-2 (r s = 0.409) in the W group and between noradrenaline and MMP-2 (r s = 0.391) in the N group. MMPs' blood concentration increments can be considered as lung cancer progression markers. Although stress hormones were also augmented, only weak correlations were observed between them and MMPs and TIMPs.

Estudio epidemiológico del trauma de pabellón auricular en el Hospital General Dr. Manuel Gea González, México / Epidemiological study of auricle trauma at Hospital General Dr. Manuel Gea González, México

Introducción y Objetivo: La posición expuesta del pabellón auricular lo predispone a una gran cantidad de lesiones. Su reconstrucción tras amputación traumática o laceración requiere una evaluación cuidadosa y experiencia en reconstrucción auricular para lograr un resultado exitoso. El tratamiento temprano de este tipo de lesiones previene la cicatrización defectuosa y por lo tanto mejores condiciones para una reconstrucción estética. El objetivo del presente estudio es conocer la población más afectada por el trauma del pabellón auricular y su etiología en nuestro medio. Material y Método: Realizamos un estudio retrospectivo de pacientes diagnosticados de trauma del pabellón auricular atendidos por la División de Cirugía Plástica y Reconstructiva del Hospital General Dr. Manuel Gea González de la Ciudad de México (México), durante un período de 5 años, con un total de 214 pacientes. Resultados: Dada la especial exposición del pabellón auricular en varones que usan pelo corto, la proporción en cuanto a sexo fue 4.5:1 en nuestra serie. La edad más frecuente fue los 33 años; entre los 0 y 40 años se encontró el 82% de los pacientes, con un promedio de 26 años de edad. El lado izquierdo fue el más afectado (54.6% de los casos). La mayoría de las lesiones fueron, de acuerdo a la clasificación de Weerda, de grado I (abrasiones o heridas sin compromiso del cartílago), con un 37.8% de los casos, seguidas por las de grado IV (lesiones por avulsión con pérdida de segmento o amputación total) con pérdida de cartílago en el 35.5%. El mecanismo más frecuente fue un traumatismo directo seguido por la mordedura humana. El área anatómica más afectada fue el hélix, seguramente por ser la estructura más externa. No hubo ningún caso candidato a reimplante. Conclusiones: Este trabajo nos permitió establecer el grupo de edad más afectado en nuestro medio por trauma auricular, así como las principales causas del mismo. Aportamos también 2 casos de lesión iatrogénica en pabellón auricular en pacientes pediátricos que nos ayudaran a prevenir o evitar dichas complicaciones El 59.3% de los casos se debió a riñas o agresión por tercera persona, cifra que refleja la problemática social de nuestro país

Background and Objective: The anatomical localization or the auricles make them susceptible of trauma. Reconstruction after traumatic amputation requires a careful evaluation and experienced surgeon in auricle reconstruction for a good result. Early treatment of this kind of lesions avoids pathologic wound healing and gets proper conditions for auricle reconstruction. The objective of our study is to know which is the most affected population by auricle trauma and the etiology of this lesions in our area. Methods: We realized a retrospective study analyzing clinical and photographic files of the patients attended by auricle trauma in a 5 years period at Hospital General Dr. Manuel Gea González in the City of México (México): a total of 214 patients. Results: Because of the exposed localization of the auricle in males with short hair, we found a rate 4.5:1 male/female in our study. The most frequent age was 33 years and 82% of the patients were between 10 and 40 years old, with a media of 26 years old. Left side was involved in 54.6%. Concerning Weerda classification 37.8% cases were I degree (wounds without cartilage compromise) followed by 35.5% cases in IV degree (avulsion with certain degree of cartilage lost). The most frequent mechanism of injury was by direct trauma followed by human bite. The most frequent localization was the helix that could be explained by being the most external part of the auricle. None of our patients were reimplantation candidate. Conclusions: Our study let us establish the most frequently affected age group in our area by auricle trauma, and its main etiology. Besides, we report two cases of iatrogenic auricle lesion in pediatric patients than can help us to prevent or avoid these complications. In our series, 59.3% of the cases was due to fights or aggressions for a third person, that reflect the social problematic in our country

Interstitial collagen turnover during airway remodeling in acute and chronic experimental asthma.

Asthma airway remodeling is characterized by the thickening of the basement membrane (BM) due to an increase in extracellular matrix (ECM) deposition, which contributes to the irreversibility of airflow obstruction. Interstitial collagens are the primary ECM components to be increased during the fibrotic process. The aim of the present study was to examine the interstitial collagen turnover during the course of acute and chronic asthma, and 1 month after the last exposure to the allergen. Guinea pigs sensitized to ovalbumin (OVA) and exposed to 3 further OVA challenges (acute model) or 12 OVA challenges (chronic model) were used as asthma experimental models. A group of animals from either model was sacrificed 1 h or 1 month after the last OVA challenge. Collagen distribution, collagen content, interstitial collagenase activity and matrix metalloproteinase (MMP)-1, MMP-13 and tissue inhibitor of metalloproteinase (TIMP)-1 protein expression levels were measured in the lung tissue samples from both experimental models. The results revealed that collagen deposit in bronchiole BM, adventitial and airway smooth muscle layers was increased in both experimental models as well as lung tissue collagen concentration. These structural changes persisted 1 month after the last OVA challenge. In the acute model, a decrease in collagenase activity and in MMP-1 concentration was observed. Collagenase activity returned to basal levels, and an increase in MMP-1 and MMP-13 expression levels along with a decrease in TIMP-1 expression levels were observed in animals sacrificed 1 month after the last OVA challenge. In the chronic model, there were no changes in collagenase activity or in MMP-13 concentration, although MMP-1 expression levels increased. One month later, an increase in collagenase activity was observed, although MMP-1 and TIMP-1 levels were not altered. The results of the present study suggest that even when the allergen challenges were discontinued, and collagenase activity and MMP-1 expression increased, fibrosis remained, contributing to the irreversibility of bronchoconstriction.

Cecum duplication in a 14-year-old female. Case report.

BACKGROUND: Duplications of the alimentary tract are a group of rare malformations occurring in about 1/5,000 live births. These may be either spherical or tubular and may communicate with the intestinal tract. Duplications of the cecum are very uncommon. CLINICAL CASE: A 14-year-old female was admitted to the emergency department with a 1-day history of abdominal pain, vomiting, constipation and abdominal distension. Abdominal examination revealed distension and tenderness around the umbilicus. Plain abdominal radiography showed dilated colon. The patient underwent surgical management with diagnosis of sigmoid volvulus. Laparotomy revealed spherical duplication from the cecum. Hemicolectomy was done and alimentary continuity was restored by end-to-end anastomosis. Pathological report was a spherical communicated duplication from the cecum (22 × 32 cm). CONCLUSIONS: Duplication of the cecum is extremely rare and is seen in 0.4% of duplications of the alimentary tract. The majority of cases (85%) are diagnosed before age 2 years. It is rare at 14 years of age. Diagnosis is difficult and volvulus, intussusception or appendicitis should be considered in the differential diagnosis. Ultrasonography and tomography are the imaging studies of choice. Plain abdominal x-ray is not specific. Resection of the duplication with restoration of alimentary continuity is the treatment of choice.

Mycobacterium tuberculosis effects on fibroblast collagen metabolism.

BACKGROUND: Type I collagen synthesis and degradation are important events during Mycobacterium tuberculosis (MTb) granuloma or cavity formation, and fibroblasts are cells involved in these processes. OBJECTIVE: We examined the MTb effects on fibroblast collagen metabolism to understand the virulence factors involved in tuberculosis pathogenesis. METHODS: Human lung fibroblasts were incubated with culture medium or sonicated MTb H37Ra (avirulent) or H37Rv (virulent) strains. The effects on collagen synthesis, fibroblast proliferation and collagenase activity were examined. Matrix metalloproteinase-1 (MMP-1), MMP-13 and tissue inhibitors of metalloproteinases (TIMP-1) mRNA levels were analyzed by quantitative real-time PCR amplification. Protein expression was explored by Western blot technique. RESULTS: Collagen synthesis and fibroblast proliferation were significantly increased by H37Ra medium. In contrast, cells incubated with H37Rv medium showed an increase in collagenase activity. MMPs quantitative real-time PCR amplification revealed an increase on MMP-13 mRNA levels in fibroblasts cultured with H37Rv medium, with little effect observed on MMP-1 expression. Western blot assay demonstrated that H37Rv medium stimulated MMP-1 and MMP-13 proenzyme synthesis. This medium had a large effect on MMP-1 activation. TIMP-1 transcription was increased in cells incubated with medium and sonicated from H37Ra, although the highest TIMP-1 protein expression was found in fibroblasts cultured with sonicated H37Rv. CONCLUSIONS: These results suggest that MTb had direct effects on fibroblast collagen turnover, with differences in collagen synthesis and degradation depending on the strain.