RESUMEN
OBJECTIVE: This article aims to show the usefulness of the pneumo-computed tomography gastric distention technique in the detection and morphological characterization of subepithelial gastric lesions. We correlate the pneumo-computed tomography and pathology findings in lesions studied at our institution and review the relevant literature. CONCLUSION: Pneumo-computed tomography, combined with multiplanar reconstructions, three-dimensional reconstructions, and virtual endoscopy, is useful for delineating the morphological details of subepithelial gastric lesions, thanks to the additional gastric distention. This technique better delimits and characterizes the upper and lower margins of the lesions. Pneumo-computed tomography can be considered a useful noninvasive imaging techniques for characterizing these lesions.
Asunto(s)
Gastroscopía , Neoplasias Gástricas , Gastroscopía/métodos , Humanos , Neoplasias Gástricas/diagnóstico por imagen , Neoplasias Gástricas/patología , Tomografía Computarizada por Rayos X/métodosRESUMEN
Objetivo: El propósito de este artículo es destacar la utilidad de la técnica de distensión gástrica neumo-tomografía computarizada en la detección y caracterización morfológica de las lesiones subepiteliales gástricas estudiadas en nuestra institución, con su correlación de anatomía patológica y una revisión de la literatura. Conclusión: La neumo-tomografía computarizada combinada con las reconstrucciones multiplanares, las reconstrucciones tridimensionales y la endoscopia virtual es útil para delinear los detalles morfológicos de las lesiones subepiteliales gástricas debido a la distensión gástrica adicional. Se logra una mejor delimitación de sus bordes superior e inferior, así como las características de sus márgenes. Puede considerarse una técnica de imagen útil y no invasiva para la caracterización de estas lesiones.(AU)
Objective: This article aims to show the usefulness of the pneumo-computed tomography gastric distention technique in the detection and morphological characterization of subepithelial gastric lesions. We correlate the pneumo-computed tomography and pathology findings in lesions studied at our institution and review the relevant literature. Conclusion: Pneumo-computed tomography, combined with multiplanar reconstructions, three-dimensional reconstructions, and virtual endoscopy, is useful for delineating the morphological details of subepithelial gastric lesions, thanks to the additional gastric distention. This technique better delimits and characterizes the upper and lower margins of the lesions. Pneumo-computed tomography can be considered a useful noninvasive imaging techniques for characterizing these lesions.(AU)
Asunto(s)
Humanos , Tomografía Computarizada por Rayos X , Estómago , Neoplasias Gástricas/diagnóstico por imagen , Tórax/diagnóstico por imagen , RadiografíaRESUMEN
Interaction between the motor and nociceptive systems seems to play an important role in chronic pain. In this pilot study we used a combination of functional near-infrared spectroscopy (FNIRS) and laserevoked potentials (LEPs) during concurrent finger tapping task and noxious laser stimulation in fibromyalgia (FM) patients and controls. The study included 9 healthy subjects and 15 FM patients. During concurrent FNIRS and LEP recording, participants were required either to remain in resting relaxed condition or to execute a finger tapping task with the right hand. In the control group, the left motor cortex showed increased oxyhaemoglobin levels, while the early N1 LEP component was reduced, during the finger tapping task. In FM patients, motor cortex oxyhaemoglobin concentrations were lower during movement, which did not reduce LEPs. The left motor cortex oxyhaemoglobin concentrations had 79.2% diagnostic accuracy. The interplay between motor and pain-related circuits seems to be dysfunctional in FM patients. These results may support a role for motor cortex modulation in the treatment of this disabling disease.
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Fibromialgia/fisiopatología , Corteza Motora/fisiopatología , Nocicepción/fisiología , Adulto , Femenino , Humanos , Potenciales Evocados por Láser , Masculino , Persona de Mediana Edad , Actividad Motora , Dimensión del Dolor , Proyectos Piloto , Espectroscopía Infrarroja CortaRESUMEN
This preliminary study aims to establish the Virtual Chromoendoscopic Magnification (VCM) feasibility to visualize and distinguish the Intraepithelial Papillary Capillary Loops (IPCL) patterns of benign oral pathologies from malignant ones. Thirty-one consecutive subjects affected by oral lesions/pathologies underwent white light examination and VCM imaging by the Narrow Band Imaging System (Olympus Medical Systems Corp., Tokyo, Japan). A class system of four IPCL types corresponding to progressive vessel disarray was adopted. IPCL type IV were considered criterion of malignancy. A histopathological exam completed the diagnosis: sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy were calculated. IPCL patterns of benign oral entities ranged from types I to III. IPCL type IV was associated with malignancy in 4 out of 6 cases. Sensitivity, specificity, PPV, and NPV were 100%, 93%, 67% and 100%, respectively. This study preliminarily describes IPCL patterns of different oral mucosal diseases and confirms the association between IPCL IV and oral cancer.
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Neoplasias de la Boca/diagnóstico por imagen , Neoplasias de la Boca/patología , Boca/diagnóstico por imagen , Imagen de Banda Estrecha , Humanos , Sensibilidad y EspecificidadRESUMEN
Pemphigus vulgaris (PV) is an autoimmune disease that manifests as intraepithelial blisters in skin and mucous membranes. We report the case of a 62-year-old female patient with clinical picture of desquamative gingivitis and a histological and serological diagnosis of pemphigus vulgaris. The aim of this study is to analyse bollous oral diseases in order to evaluate the feasibility to image epithelial architecture of oral mucosae using in vivo optical coherence tomography. Optical coherence tomography seems to be a valid non-invasive auxiliary diagnostic device able to show in vivo the epithelial layers and basal membrane.
RESUMEN
Multidrug resistance associated with the overexpression of ATP-dependent binding cassette (ABC) proteins is widely accepted as an important cause of treatment failure in patients with neoplastic or infectious diseases. Some of them play also a pivotal role in detoxification processes. Herein, we investigated the effect of hepatitis C virus (HCV) replication and nonstructural 5A (NS5A) protein on the expression and functional activity of two ABC transport proteins: MDR1 and BCRP. RT-quantitative real-time polymerase chain reaction (qPCR) was carried out for mdr1 and bcrp mRNAs in both Huh7 cells expressing NS5A and Huh7.5 cells containing either full-length- or subgenomic-HCV replicon systems. The functional activity of these pumps was studied by performing a dye efflux assay with DiOC2 and Rhodamine 123. A dose-dependent down-regulation of mdr1 expression was documented in Huh7 cells expressing the NS5A protein, as well as in both replicon systems. In contrast, a significant increase of bcrp expression in both systems was recorded, which were in full agreement with the dye efflux assay results. These results warrant further in vivo studies in HCV patients with cholestasis and/or patients that are refractive to the pharmacotherapy due to the activity of these pumps.
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Miembro 1 de la Subfamilia B de Casetes de Unión a ATP/biosíntesis , Expresión Génica , Hepacivirus/fisiología , Proteínas Proto-Oncogénicas c-bcr/biosíntesis , Proteínas no Estructurales Virales/metabolismo , Replicación Viral , Subfamilia B de Transportador de Casetes de Unión a ATP , Carbocianinas/metabolismo , Línea Celular , Perfilación de la Expresión Génica , Hepatocitos/virología , Humanos , Reacción en Cadena en Tiempo Real de la Polimerasa , Rodamina 123/metabolismoRESUMEN
BACKGROUND AND AIMS: Ectopic artery calcification has been documented in women with postmenopausal osteoporosis, in whom an imbalance in the number of circulating osteoprogenitor cells (OPCs) has been identified. Circulating OPCs form calcified nodules in vitro; however, it remains unknown whether an association exists between the number of circulating OPCs and aortic calcifications. We investigated the relationship between OPCs and aortic calcifications in women with postmenopausal osteoporosis. METHODS AND RESULTS: The number of circulating OPCs was quantified by FACS analysis in 50 osteoporotic postmenopausal women. OPCs were defined as CD15-/alkaline-phosphatase(AP)+ cells coexpressing or not CD34. Participants underwent measurement of markers of bone metabolism, bone mineral density and abdominal aortic calcium (AAC) by 64-slice computed tomography. Patients with AAC were older, had lower 25(OH)vitamin D levels and higher circulating CD15-/AP+/CD34- cells than those without AAC. Significant correlates of AAC included age (rho = 0.38 p = 0.006), calcium (rho = 0.35 p = 0.01), 25(OH)vitamin D (rho = -0.31, p = 0.03) and the number of CD15-/AP+/CD34- cells (rho = 0.55 p < 0.001). In regression analyses, the log-transformed number of CD15-/AP+/CD34- cells was associated with the presence (OR = 6.45, 95% CI 1.03-40.1, p = 0.04) and severity (ß = 0.43, p < 0.001) of AAC, independent of age, 25(OH)vitamin D, calcium and other potential confounders. Patients with low 25(OH)vitamin D and high CD15-/AP+/CD34- cells had higher median AAC than other patients (1927/µL, 862-2714/µL vs 147/µL, 0-1665/µL, p = 0.003). CONCLUSION: In women with postmenopausal osteoporosis, the number of circulating CD15-/AP+/CD34- cells is significantly associated with increased aortic calcifications, that appear to be correlated also with reduced 25(OH)vitamin D levels.
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Estenosis de la Válvula Aórtica/fisiopatología , Válvula Aórtica/patología , Calcinosis/fisiopatología , Osteoblastos/metabolismo , Osteoporosis Posmenopáusica/fisiopatología , Células Madre/metabolismo , Anciano , Fosfatasa Alcalina/sangre , Antígenos CD34/sangre , Aorta Abdominal/metabolismo , Aorta Abdominal/fisiopatología , Válvula Aórtica/fisiopatología , Estenosis de la Válvula Aórtica/complicaciones , Biomarcadores/sangre , Densidad Ósea/efectos de los fármacos , Huesos/citología , Huesos/metabolismo , Calcinosis/complicaciones , Calcio/sangre , Estudios Transversales , Femenino , Fucosiltransferasas/sangre , Humanos , Antígeno Lewis X/sangre , Persona de Mediana Edad , Osteoporosis Posmenopáusica/complicaciones , Posmenopausia , Análisis de Regresión , Células Madre/citología , Vitamina D/sangre , Deficiencia de Vitamina D/complicaciones , Deficiencia de Vitamina D/fisiopatologíaRESUMEN
Nonasthmatic eosinophilic bronchitis (NAEB) is a condition characterized by corticosteroid-responsive chronic cough, sputum eosinophilia and absence of symptoms or objective evidence of variable airflow obstruction and airway hyper-responsiveness. Like asthma, NAEB can be associated with exposure to occupational sensitizers and can be considered as being a variant of occupational asthma when it develops as a consequence of work exposure. Few case reports of NAEB caused by workplace exposure have been reported. Bakers are at high risk of developing occupational respiratory disorders and three cases of occupational NAEB have been described. We describe the first case of occupational NAEB due to storage mites in a baker in which the offending agent was identified by means of the basophil activation test (BAT), a new tool which has never been proposed in diagnostic procedures of occupational respiratory allergy. BAT's results allowed the recognition of the offending agent, that is mandatory for diagnosis.
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Prueba de Desgranulación de los Basófilos , Bronquitis Crónica/diagnóstico , Eosinofilia/diagnóstico , Ácaros , Enfermedades Profesionales/diagnóstico , Androstadienos/administración & dosificación , Androstadienos/uso terapéutico , Animales , Bronquitis Crónica/complicaciones , Bronquitis Crónica/tratamiento farmacológico , Bronquitis Crónica/inmunología , Broncodilatadores/administración & dosificación , Broncodilatadores/uso terapéutico , Tos/inmunología , Eosinofilia/complicaciones , Eosinofilia/tratamiento farmacológico , Eosinofilia/inmunología , Harina , Fluticasona , Humanos , Masculino , Persona de Mediana Edad , Ácaros/inmunología , Enfermedades Profesionales/complicaciones , Enfermedades Profesionales/tratamiento farmacológico , Enfermedades Profesionales/inmunología , Valor Predictivo de las Pruebas , Pruebas de Función Respiratoria , Factores de Riesgo , Sensibilidad y Especificidad , Índice de Severidad de la Enfermedad , Fumar/efectos adversos , Esputo/citología , Resultado del Tratamiento , Lugar de TrabajoRESUMEN
The aim of this report was to determine retrospectively the prevalence of hepatitis viruses infection by both HBV and HDV, and to identify the genotype in a population of blood donors. From 42,055 sample of donors, the authors study the hepatitis B virus and hepatitis D virus prevalence and molecular analysis in an Argentinean population. The results obtained are detailed in the article.
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Humanos , Análisis Químico de la Sangre , Donantes de Sangre , Genotipo , Virus de la Hepatitis B , Virus de la Hepatitis Delta , Estudios Seroepidemiológicos , Pruebas Serológicas , VirologíaAsunto(s)
Acaridae/inmunología , Prueba de Desgranulación de los Basófilos , Bronquitis/diagnóstico , Hipersensibilidad/diagnóstico , Enfermedades Profesionales/diagnóstico , Animales , Bronquitis/inmunología , Conjuntivitis/inmunología , Culinaria , Tos/etiología , Tos/inmunología , Eosinofilia/diagnóstico , Eosinofilia/inmunología , Humanos , Hipersensibilidad/inmunología , Masculino , Persona de Mediana Edad , Enfermedades Profesionales/inmunología , Rinitis/inmunología , Pruebas CutáneasRESUMEN
According to EUSOMA position paper 'The requirements of a specialist breast unit', each breast unit should have a core team made up of health professionals who have undergone specialist training in breast cancer. In this paper, on behalf of EUSOMA, authors have identified the standards of training in breast cancer, to harmonise and foster breast care training in Europe. The aim of this paper is to contribute to the increase in the level of care in a breast unit, as the input of qualified health professionals increases the quality of breast cancer patient care.
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Neoplasias de la Mama/terapia , Educación Médica , Personal de Salud/educación , Oncología Médica/educación , Educación en Enfermería/métodos , Femenino , Cirugía General/educación , Humanos , Medicina Nuclear/educación , Radiología/educaciónRESUMEN
The aim of the study was to examine the acaricidal effect of essential oil of Melaleuca alternifolia (tea tree oil, TTO) at different doses (4, 6, 8 and 10 microl) and for different exposure times (30, 60, 90 and 120 min) on nymphs of Ixodes ricinus. A dose of 8 microl TTO was lethal for more than 70% of ticks when inhaled and this effect was enhanced when the dose was increased to 10 microl (> 80%). The effect was correlated with the duration of exposure of ticks to TTO, with a significant effect being observed after 90 min exposure. The findings show that TTO has acaricidal properties and could be extremely useful in controlling ticks that are efficient vectors of pathogens.
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Insecticidas/farmacología , Ixodes/efectos de los fármacos , Melaleuca/química , Aceite de Árbol de Té/farmacología , Animales , Vectores Arácnidos/efectos de los fármacos , Vectores Arácnidos/crecimiento & desarrollo , Relación Dosis-Respuesta a Droga , Ixodes/crecimiento & desarrollo , Ninfa , Distribución Aleatoria , Control de Ácaros y Garrapatas/métodos , Factores de TiempoRESUMEN
We have studied three members of a family (mother and two siblings) where the mother and father were first cousins and who presented a history of progressive mental deterioration, hyperkinetic extrapyramidal disorders, and epileptic seizures. They underwent the following examinations: cupremia, cupruria, and level of ceruloplasmin, genetic analysis for SCA1, 2, 3, 6, dentato-rubric-pallido-luysian atrophy, and Huntington's disease, electromyography (EMG), electroencephalography (EEG), brain magnetic resonance imaging (MRI), and investigation of acanthocytes with scanning electron microscopy. Genetic analysis was negative in all patients and acanthocytes were positive. EMG showed an axonal neuropathy in one sibling, EEG showed epileptiform activity in the two siblings, and MRI showed cortical atrophy in all subjects. This family shows the great variability of neuroacanthocytosis and a dominant autosomal transmission, as described only once previously in the literature.
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Corea/diagnóstico por imagen , Corea/fisiopatología , Salud de la Familia , Acantocitos/ultraestructura , Atrofia , Axones/patología , Encéfalo/diagnóstico por imagen , Encéfalo/fisiopatología , Corea/genética , Análisis Mutacional de ADN , Electroencefalografía , Electromiografía , Femenino , Humanos , Enfermedad de Huntington/fisiopatología , Italia , Imagen por Resonancia Magnética , Masculino , Microscopía Electrónica de Rastreo , Examen Neurológico , Radiografía , HermanosRESUMEN
PURPOSE: Fistula-in-ano anatomy and its relationship with anal sphincters are important factors influencing the results of surgical management. Preoperative definition of fistulous track(s) and the internal opening play a primary role in minimizing iatrogenic damage to the sphincters and recurrence of the fistula. METHODS: Physical examination and endoanal ultrasound (performed with a 10 MHz endoprobe), either conventionally or with an injection of hydrogen peroxide, were performed in 26 consecutive patients. Results were matched with surgical features to establish their accuracy in preoperative fistula-in-ano assessment. RESULTS: Accuracy rates of clinical examination endoanal ultrasound, and hydrogen peroxide-enhanced ultrasound were 65.4, 50, and 76.9 percent for primary tracks, 73.1, 65.4, and 88.5 percent for secondary tracks, and 80.8, 80.8, and 92.3 percent for horseshoe extensions, respectively. Compared with physical examination and endoanal ultrasound, accuracy of hydrogen peroxide-enhanced ultrasound was higher for transsphincteric and intersphincteric primary tracks and horseshoe extensions. Both endoanal ultrasound and hydrogen peroxide-enhanced ultrasound displayed a significantly higher accuracy in detecting the internal openings (53.8 and 53.8 percent, respectively) compared with clinical evaluation (23.1 percent; P = 0.027). CONCLUSIONS: Our data suggest that hydrogen peroxide-enhanced ultrasound can be very reliable and useful in the definition of fistula anatomy, its relationship with anal sphincters, and, hence, surgical strategy. It also improves identification of secondary extensions, particularly horseshoe tracks. This method, besides being safe, economic and reputable, both preoperatively and postoperatively, could be helpful in checking operative results and recurrence.
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Canal Anal/diagnóstico por imagen , Fístula Rectal/diagnóstico por imagen , Adulto , Canal Anal/patología , Femenino , Humanos , Peróxido de Hidrógeno , Masculino , Persona de Mediana Edad , Examen Físico , Cuidados Preoperatorios , Fístula Rectal/patología , Fístula Rectal/cirugía , Recurrencia , Sensibilidad y Especificidad , Índice de Severidad de la Enfermedad , UltrasonografíaRESUMEN
We have generated a panel of 55 somatic cell hybrids retaining fragments of human chromosome 4. Each hybrid has been characterized cytogenetically by FISH and molecularly by 37 STSs, evenly spaced along the chromosome. The panel can be exploited to map subregionally DNA sequences on chromosome 4 and to generate partial chromosome paints useful in the characterization of chromosomal rearrangements involving this chromosome. Furthermore, a panel of 84 YACs mapping on chromosome 4 has been characterized by FISH. A subset of this panel is recognized by STSs used in the somatic cell hybrid characterization. In this way a correlation between the genetic and the physical maps can be established. These resources have been used to investigate the conservation of the phylogenetic chromosome IV in great apes. The results indicate that all the pericentric inversions that differentiate chromosome IV in these species are distinct and that one of the breakpoints frequently lies very close to the centromere. In 4 instances, the YAC containing the breakpoint was identified. The breakpoint in IVq of PTR and MMU lies in the same YAC, suggesting that this breakpoint has been utilized twice in the evolutionary history of this chromosome.
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Cromosomas Humanos Par 4/genética , Cromosomas/genética , Gorilla gorilla/genética , Pan troglodytes/genética , Filogenia , Pongo pygmaeus/genética , Animales , Centrómero/ultraestructura , Inversión Cromosómica , Pintura Cromosómica , Cromosomas Artificiales de Levadura , Evolución Molecular , Marcadores Genéticos , Humanos , Células Híbridas , Macaca mulatta/genética , Lugares Marcados de Secuencia , Especificidad de la EspecieRESUMEN
Studies of large numbers of patients have enabled the identification of relatively infrequent chromosome changes, such as inv(3)(q21;q26), t(6;9)(p23;q34) and t(8;16)(p11;p11), whose clinico-biological significance is gradually becoming clearer. Translocations involving chromosomes 1 and 7 are relatively rare in myeloid neoplasias, being found in far less than 1% of cases; the rearrangement that occurs most frequently consists of an unbalanced translocation [t(1;7)(p11; p11)], resulting in complete loss of 7q, associated with therapy-related or environmentally-induced high-risk myelodysplasia. We recently observed three cases of acute myeloid leukaemia (AML) with a previously unreported balanced translocation t(1;7) (p36;q34). Case 1 underwent autologous bone marrow transplantation and remains alive in CR; cases 2 and 3 relapsed after 10 and 4 months, respectively. The response to chemotherapy observed in our cases suggests that variable clinical features might be present in the broad cytogenetic category usually referred to as '7q abnormalities' and contributes to an interesting previous observation of prolonged disease-free survival in a subset of AMLs with 7q- as the isolated chromosome change.
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Cromosomas Humanos Par 1/genética , Cromosomas Humanos Par 7/genética , Leucemia Mieloide Aguda/genética , Leucemia Mielomonocítica Aguda/genética , Translocación Genética/genética , Adulto , Femenino , Humanos , Hibridación Fluorescente in Situ , Cariotipificación , Masculino , Persona de Mediana EdadRESUMEN
Autoimmune events, although rarely reported during interferon beta-1b (IFNB) treatment of relapsing-remitting (RR) multiple sclerosis (MS), may be more frequent than expected due to the many immunologic abnormalities associated with this disease. We report the prospective two-year follow-up of autoimmune events in 40 RR MS patients treated with IFNB and in 21 untreated MS controls. Thyroid and liver function and serum level of 12 autoantibodies (autoAbs) against organ- (thyroid, gastric, pancreatic) and non-organ-specific antigens were serially monitored. In contrast to control patients, autoAbs (anti-nuclear, -smooth muscle or -thyroid antigens) were detected in 13 IFNB-treated patients, and these were associated with thyroid or liver function alteration in many cases. Persistent autoimmune thyroid dysfunction occurred in three IFNB-treated patients, all of whom were women with a familial history of thyroid disease or baseline anti-thyroid autoAb positivity. For improvement of the MS relapse rate, thyroid dysfunction was adequately treated without stopping IFNB. Liver function alteration (17 IFNB-treated patients, associated with non-organ-specific autoAbs in four) was transient and did not require IFNB treatment to be stopped, with the exception of one patient who was already suffering from a drug-induced hepatopathy at baseline. During the IFNB treatment of MS, several autoimmune events may occur, indicating that thyroid and liver function and autoAbs must be carefully monitored.
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Enfermedades Autoinmunes/inducido químicamente , Interferón beta/efectos adversos , Esclerosis Múltiple/complicaciones , Adulto , Autoanticuerpos/análisis , Enfermedades Autoinmunes/fisiopatología , Femenino , Estudios de Seguimiento , Humanos , Interferón beta-1a , Interferon beta-1b , Interferón beta/uso terapéutico , Pruebas de Función Hepática , Masculino , Persona de Mediana Edad , Esclerosis Múltiple/tratamiento farmacológico , Estudios Prospectivos , Ensayo de Unión Radioligante , Proteínas Recombinantes/efectos adversos , Proteínas Recombinantes/uso terapéutico , Recurrencia , Pruebas de Función de la Tiroides , Factores de TiempoRESUMEN
Twenty relapsing-remitting (RR) clinically definite MS patients were treated with 9 MIU intramuscular recombinant interferon alpha-2a (rIFNA) (Roferon-A, Roche) (n = 12) or placebo (n = 8) every other day for 6 months and followed up for a further 6 months after stopping treatment. Numbers of active lesions at MRI and of patients with clinical-MRI signs of disease activity and lymphocyte interferon gamma production, which were decreased during treatment, returned to values similar to baseline and placebos after stopping treatment. rIFNA chronic therapy seems therefore needed in order to maintain drug efficacy. Side effect profile was monitored, too, for over 1 year in the same 20 patients plus 25 additional RR MS patients. Besides the typical side effects of type I interferon therapy (fever, fatigue, depression, lymphopenia, hepatic enzyme elevation), occurrence of serum autoAbs was noted in 30% patients (in 60% antinuclear and in 80% antithyroid autoAbs). In two patients rIFNA treatment was stopped, in one case for antithyroid autoAbs and hypothyroidism, in the other for antinuclear autoAbs and a five-fold increase of ALT. A careful monitoring of serum autoAbs and of signs of thyroid or liver damage must always precede and accompany longterm type I IFN therapy.