[Giant cells arteritis. A disease previously reported as various syndromes (author's transl)]. / Arteritis de células gigantes. Enfermedad históricamente descrita como distintos síndromes.

Thirteen cases of giant cell arteritis admitted to a Department of Internal Medicine between 1962 and 1977 are reviewed. Giant cell arteritis exhibited different clinical forms, including: temporal arteritis, rheumatic polymyalgia, syndrome of the supra-aortic trunks, cranial arteritis in its ophthalmic and neurologic forms, and generalized arteritis. On the basis of the clinical data, overall examinations, laboratory tests, X-rays, angiograms and histopathologic findings the authors conclude that a single disease is involved. The fact that various of the symptoms occur simultaneously in different patients and that all of the clinical forms have a common pathologic basis points toward giant cell arteritis with different clinical manifestations.

[Anthropometric reference parameters for the aged population]. / Parámetros antropométricos de referencia de la población anciana.

BACKGROUND: Anthropometry is an effective method used in the evaluation of the state of nutrition. Anthropometric reference values obtained from the general population have frequently been used. The aim of this study was to determine the anthropometric parameters of the elderly in Manresa and demonstrate the different evolution of these values in both sexes between the ages of 65 and 85 or more. METHODS: Following randomization a representative sample of 1,034 healthy elderly subjects living in Manresa was obtained with the following being determined: weight, height, tricipital, subscapular and abdominal fat folds, arm circumference, arm muscle perimeter, weight/height indexes, muscle and fat areas of the arm and percentage of fat. All the measurements were obtained by the same person with the use of a tallimeter scale with a flexible metric tape and a Holtain lipocalibrater. RESULTS: The values are presented in percentiles by subgroups of age and sex. The weight, height and indexes of lean mass were greater in males while those determining fatty mass were greater in females. In females all the values decreased between 65 and 85 or more years of age (p < 0.001), while in males all decreased (p < 0.001) except; tricipital and abdominal skin folds. Upon comparison of these parameters with those obtained in other geographic areas, differences were observed between both. CONCLUSIONS: By the characteristics of the population studied it was considered that the anthropometric parameters obtained are extensible to all the elderly population of Catalonia and may be used as reference values of the same.

Immunohistochemical detection of Bcl-2 in Kaposi's sarcoma lesions varies according to histopathologic stage, whereas expression of Bcl-x and Mcl-1 differs according to human immunodeficiency virus serologic status of patients.

Expression of Bcl-2, Bcl-x, and Mcl-1 was immunohistochemically evaluated in 33 cases of Kaposi's sarcoma (KS) of the skin. Of these, classic KS (C-KS) accounted for 17 cases (10 in plaque stage and 7 in tumor stage) and acquired immunodeficiency syndrome-associated KS (AIDS-KS) accounted for 16 cases (8 in plaque stage and 8 in tumor stage). In both C-KS and AIDS-KS, Bcl-2 immunoreaction correlated with progression stage, its average score intensity being more than 2-fold in tumors than in plaques. In contrast, Bcl-x and Mcl-1 staining intensity was unrelated to progression stage but was dependent on human immunodeficiency virus infection status. Thus, whereas Bcl-x expression was stronger in C-KS cases, Mcl-1 immunostaining was more intense in AIDS-KS instances. These findings indicate that in cutaneous KS, some Bcl-2 family proteins exhibit differential expressions that are dependent on either progression stage or human immunodeficiency virus infection status.

Absence of Fas (CD95) and FasL (CD95L) immunohistochemical expression suggests Fas/FasL-mediated apoptotic signal is not relevant in cutaneous Kaposi's sarcoma lesions.

It has been suggested that Fas ligand (FasL), expressed by several neoplastic cell lines and some tumors in vivo, is able to trigger the apoptotic process in activated T-lymphocytes and may constitute a key element of the immunological escape mechanisms used by many types of neoplasia. In order to evaluate the possible role of Fas-mediated apoptosis in Kaposi's sarcoma (KS), we have studied the immunocytochemical expression of Fas and FasL in biopsy specimens showing different histopathological stages of classic KS (C-KS) and AIDS-associated KS (AIDS-KS), as well as in cultured cells derived from C-KS lesions. KS biopsy tissue failed to show Fas expression in all epidemiologic forms and histopathologic stages studied, while FasL positivity was present in a small number of cells in just a few cases. Double immunostaining ruled out the lymphocytic nature of these cells, whose morphology in adjacent sections stained with hematoxylin and eosin was consistent with KS cells. In contrast, cultured KS cells exhibited strong immunocytochemical cytoplasmic expression of both Fas and FasL. These findings indicate that the Fas-FasL system does not play a major role as a trigger of apoptosis in KS cells in vivo and that the upregulation of these molecules observed in KS cells in vitro probably is the result of cell stress induced by growth in culture.

Differential expression of c-Met in Kaposi's sarcoma according to progression stage and HIV infection status.

Several cytokines, growth factors and the HIV transactivator Tat have been shown to be involved in the pathogenesis of Kaposi's sarcoma (KS). Hepatocyte growth factor/scatter factor (HGF) is an angiogenic cytokine that stimulates proliferation of spindle cells cultured from human KS lesions. The receptor for HGF, the c-Met protein, is expressed by endothelial cells, dermal dendrocytes and KS tumor cells both in vitro and in vivo. KS cells synthesize and secrete HGF and express the hepatocyte growth factor receptor (c-Met), thus providing an autocrine loop for tumor proliferation and neovascularization which can be enhanced by proinflammatory cytokines. We studied the immunohistochemical expression of c-Met in 40 cases of classical Kaposi's sarcoma (C-KS) and AIDS-associated cutaneous Kaposi's sarcoma (AIDS-KS), including 22 plaque stage lesions (12 AIDS-KS cases) and 18 tumor stage lesions (7 AIDS-KS cases). Statistically significant differences in the average intensity of immunohistochemical staining according to the type of lesions progression stages) and the serologic status of the patients were identified. The staining intensity of c-Met was stronger in tumors than in plaques. When only plaques were taken into consideration, the mean staining score was nearly twice as high in C-KS as in AIDS-KS.