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Biomedical subjects

A Gamboa-Domínguez

Publications and source records attributed to A Gamboa-Domínguez.

At least 19 recordsLinked to original sources

Progesterone receptor isoforms expression pattern in human astrocytomas.

Progesterone receptors (PR) have been detected in human astrocytomas; however, the expression pattern of PR isoforms in these brain tumors is unknown. Progesterone receptor isoforms expression was studied in 13 biopsies of astrocytomas (6 grade III, and 7 grade IV) from adult Mexican patients by using reverse transcription-polymerase chain reaction and immunohistochemistry. Progesterone receptor expression was observed at mRNA and at protein levels in 66% and 83% of astrocytomas grade III, respectively, whereas 100% of astrocytomas grade IV expressed PR. Almost all PR mRNA content in astrocytomas grades III and IV corresponded to PR-B. The number of immunoreactive cells expressing PR-B was higher than that expressing PR-A in 73% of the cases. Estrogen receptor-alpha protein was only observed in 33% of astrocytomas grade III, whereas no astrocytomas grade IV expressed it. These data suggest that PR-B is the predominant isoform expressed in human astrocytomas grades III and IV, and that estrogen receptor-alpha is not expressed in astrocytomas grade IV.

Adult↗

Carcinoid tumors of the duodenum and ampulla of vater: a clinicomorphologic, immunohistochemical, and cell kinetic comparison.

Carcinoid tumors of the ampulla of Vater (ACs) differ from duodenal carcinoid tumors (DCs). A search for AC and DC was made between 1980 and 2000. The clinicopathologic features and follow-up were assessed. Immunohistochemistry for panneuroendocrine markers, hormone products, proliferating cell nuclear antigen (PCNA), Ki- 67, p21(cip1), and p27(kip1) were performed. A blind proliferative index counting 500 cells was made. Differences were contrasted using the Fisher exact and 2-sided Student t test. Five ACs and 8 DCs were identified in 9 women and 4 men with median ages of 59 and 64 years and mean tumor diameters of 1.6 and 1.85 cm, respectively. All patients with AC presented jaundice, and most patients with DC were asymptomatic (P = .047). Metastases were present in 4 ACs and 1 DC (P =.03). Tumor cells expressed synaptophysin and chromogranin in 60% of ACs and in 100% and 87% of DCs. Gastrin was expressed in 75% of DCs and 20% of ACs (P < .05). The mean value for PCNA index was 4.0% in ACs and 3.2% in DCs, and mean values for Ki-67 were 12.2% and 10.2%, respectively (P = NS). Expression of p21(cip1) and p27(kip1) was observed in 40% of ACs and 37.5% and 12.5% of DCs. Three of 5 patients with AC died of the disease within an average of 11 months, and none of the patients with DC had died at 103 months of follow-up. The more aggressive behavior of ACs is not associated with higher proliferative indices or with different expression of cell cycle inhibitors.

Ampulla of Vater↗

Accuracy of sentinel lymph node in papillary thyroid carcinoma.

BACKGROUND: The sentinel lymph node has been used in several tumors. The aim of this study was to analyze the accuracy of the sentinel node in papillary thyroid carcinoma. METHODS: A series of 22 patients with papillary thyroid carcinoma were included. Approximately 0.5 cc of isosulfan blue dye was injected at operation to trace the sentinel node. Lymph node dissection of the ipsilateral central compartment and extensive sampling of the jugular compartment were performed in addition to sentinel node resection. Surgical specimens were stained with hematoxylin-eosin, and negative sentinel nodes were subsequently stained with immunohistochemistry for cytokeratin-7. RESULTS: Mean age was 37 +/- 14 years. Twenty patients were women, and 2 were men. Mean tumor size was 2.5 +/- 1 cm. A sentinel lymph node was found in 20 patients. With use of hematoxylin-eosin, metastases were identified in 12/20 sentinel nodes (60%). Eleven patients with positive sentinel nodes presented additional lymph node metastases: 9 in the central compartment, 1 in the jugular compartment, and 1 in both compartments. Two patients with negative sentinel nodes had lymph node metastases elsewhere. When sentinel nodes were processed by immunohistochemistry, accuracy increased to 100%. CONCLUSIONS: Sentinel node is highly accurate for diagnosing metastases in papillary thyroid carcinoma.

Adult↗

Histologic diagnosis of primary hyperparathyroidism: a concordance analysis between three pathologists.

Primary hyperparathyroidism (HPT) is caused by a parathyroid adenoma, hyperplasia or carcinoma. Difficulties for the histologic diagnosis of abnormal parathyroid tissue are widely recognized. The aim of the study was to evaluate the reproducibility of the morphologic criteria through a concordance study among three pathologists. Representative slides of 40 patients with biochemically primary HPT stained with hematoxylin and eosin were blindly reviewed by three pathologists. Each pathologist established the diagnosis of adenoma or hyperplasia and assessed the presence of fat cells, a rim of normal tissue, a fibrous capsule, the number of cellular types, the lobular pattern, and the characteristics of the blood vessel's wall. A concordance analysis was then performed. Mean age of the group was 55 +/- 14 yr, 7 were males and 33 females. The concordance analysis among the three pathologists for the differential diagnosis between adenoma and hyperplasia, showed a Kappa index of 0.5. Kappa index for the presence of fat cells was 0.56, for the presence of a rim of normal tissue 0.47, and for the number of cellular types 0.29. The concordance for the differential diagnosis between parathyroid adenoma and hyperplasia in this study was low.

Adenoma↗

Sporadic type composite pheochromocytoma with neuroblastoma: clinicomorphologic, DNA content and ret gene analysis.

Composite pheochromocytomas (CP) account for only 3% of all pheochromocytomas. We analyzed the clinical, immunohistochemical, ultrastructural, DNA content, and 634 ret mutation features in a 56-year-old Mexican woman with CP localized in the right adrenal gland and associated to a blood pressure of 140/90 mmHg. Clinical symptoms were absent after surgery. The tumor showed pheochromocytoma and neuroblastoma components. This dual phenotype was supported by light microscopy and corroborated by immunohistochemistry and ultrastructural findings. Flow cytometric analysis showed that both components were diploid. A genetic mutational analysis of the ret oncogene in exon 11 showed no 634 mutation. This case demonstrates the indolent behavior of neuroblastoma associated to a sporadic-type CP in an adult patient.

Adrenal Gland Neoplasms↗

Progesterone receptor isoforms expression pattern in human chordomas.

Steroid hormone receptors are involved in the regulation of tumor growth. Two progesterone receptor (PR) isoforms have been identified in humans: a larger form (PR-B) and the N-terminally truncated one (PR-A). PR isoforms can exert opposite functions and are differentially regulated by estrogens. PR have been detected in several brain tumors including chordomas, however, it is unknown which PR isoform is expressed in brain tumors. The aim of this study was to determine by reverse transcription-polymerase chain reaction (RT-PCR) and by immunohistochemistry the expression pattern of PR isoforms in chordomas as well as its correlation with the expression of estrogen receptor a (ER-alpha). All studied chordomas expressed both PR and ER-alpha. PR-B was the predominant isoform in chordomas both at the mRNA and at the protein level. These data suggest that PR-B should be the predominant PR isoform expressed in human chordomas.

Adolescent↗

Toxic pseudomembranous colitis in a patient with ulcerative colitis.

UNLABELLED: Toxic colitis is a severe disease that may be caused by several inflammatory and/or infectious diseases. Ulcerative colitis is one of the most frequent causes of toxic colitis in the United States. Toxic megacolon complicating Clostridium difficile colitis is a rare occurrence with significant morbidity and mortality. CASE REPORT: A 52-year-old male presented with rectal bleeding and tenesmus. He had been treated for amebiasis with metronidazole, and had improved. Two weeks later, symptoms recurred, and he was referred to our hospital. A sigmoidoscopy and biopsies demonstrated mucosal ulcerative colitis. He underwent treatment with systemic prednisone, mesalamine, and hydrocortisone enemas with adequate response. He was asymptomatic for 2 months, but later presented with a tender abdomen and rectal bleeding. Plain abdominal and thorax films showed colonic distention and free intraperitoneal air. Emergency laparotomy was performed, and an inflamed and distended colon, with free inflammatory liquid in the peritoneum, was found. A total abdominal colectomy with temporary ileostomy and Hartmann's pouch was performed. The histopathology analysis demonstrated a Clostridium difficile pseudomembranous colitis. CONCLUSION: The presence of toxic megacolon due to Clostridium difficile in patients with ulcerative colitis is a rare complication that may be suspected in patients with initial relapse who are on antibiotics.

Abdominal Pain↗

Acute abdomen and lupus enteritis: thrombocytopenia and pneumatosis intestinalis as indicators for surgery.

Bowel symptoms occur often in systemic lupus erythematosus (SLE), but enteric complications in patients on steroid therapy are rare. We report a case of a 14-year-old Mexican girl with SLE on high-dose steroid therapy complicated by abdominal vasculitis and small bowel perforation. Accompanying this serious complication were thrombocytopenia and radiographic changes of pneumatosis intestinalis. These findings suggested necrotizing enteritis and prompted urgent surgery. Four jejunal perforations, pneumatosis intestinalis, and submucosal vasculitis were present in the resected specimen. Persistent SLE activity responded to cyclophosphamide, which is indicated in patients with digestive symptoms who fail to respond to high-dose steroids.

Abdomen, Acute↗

Immunocytochemical detection of estrogen and progesterone receptors in the rabbit submandibular gland.

Rabbit submandibular glands produce secretions involved in olfactory communication. The histology of these glands and their secretory activity are: sexually dimorphic; vary across the female reproductive cycle; and are modified by gonadectomy. This suggests that gonadal steroids regulate the structure and function of such glands. To further support this idea we assessed by immunocytochemistry the presence of estrogen and progesterone receptors in male and female rabbit submandibular glands. Immunoreactivity was detected only in the nucleus of acini cells. The number of estrogen receptor-immunoreactive cells/field varied among estrus (26 +/- 6; mean +/- S.E.), ovariectomized (19 +/- 2), and ovariectomized-estrogen-treated animals (13 +/- 3). Intact males showed a significantly smaller number of estrogen receptor-immunoreactive cells/field (12 +/- 1) than estrous females. Interestingly, progesterone receptor-immunoreactive cells were more abundant in estrous (32 +/- 7) than in ovariectomized animals (7 +/- 1). Estradiol benzoate (5 micrograms daily for 5 days) increased the number of progesterone receptor-immunoreactive cells/field in ovariectomized females (17 +/- 1). Intact males showed fewer progesterone receptor-immunoreactive cells/field (16 +/- 2) than estrous females. Results show that the rabbit submandibular gland is a target for estrogen and progesterone and support the idea that these hormones participate in regulating the physiology of this gland.

Animals↗

Tissue damage in the male murine reproductive system during experimental Taenia crassiceps cysticercosis.

Chronic infection with Taenia crassiceps cysticerci in male mice increases the level of estradiol in serum, whereas it reduces that of testosterone. In addition, male mice lose their typical male reproductive behavior. The effects of cysticerci infection on the histomorphology of male reproductive tissues are unknown. The present study was undertaken to determine the histological changes in testes, seminal vesicles, and prostate of male mice infected with T. crassiceps cysticerci. At 16 wk of infection, all tissues exhibited high inflammatory infiltrate. Tissue lesions included marked dilation and peripheral fibrosis. In the testes, a diminution of spermiogenesis was observed. The overall results indicated that the histological changes in chronically parasitized male mice occurred with changes in hormone levels, simultaneously with the high inflammatory immune response.

Animals↗

A clinicopathologic variant of intramucosal early gastric cancer with widespread dissemination: report of three cases.

We describe the clinicopathological characteristics and postmortem findings of three cases of intramucosal early gastric cancer (EGC) selected from nine cases of our series to characterize its unusual clinical behavior. All patients were treated at the Instituto Nacional de la Nutricion in Mexico City between January 1986 and December 1995. The following features were the most salient of the three cases: (1) The tumors were constituted by only few nests of intramucosal cells; two of them were signet-ring cell carcinomas and the other one was of the intestinal type. (2) Grossly, all tumors were inconspicuous. (3) All the patients had a short clinical course and in none of them the clinical diagnosis was suspected. (4) A wide dissemination was found at autopsy; additionally, in two of the cases, extensive lymphatic and venous thrombi and multiple secondary hemorrhages were found. (5) In all patients, the symptoms and deaths were caused by the metastases. No cases as early as those reported here were found either in the Japanese or in Western literature. Although larger series of EGC should be studied in our country, these findings suggest that at least in Mexico there is a group of EGC with unusual aggressive behavior.

Adenocarcinoma↗

The rabbit submandibular gland: sexual dimorphism, effects of gonadectomy, and variations across the female reproductive cycle.

Sex differences and the effect of various endocrine conditions on the histology of the rabbit (Oryctolagus cuniculus L.) submandibular (chin) gland were investigated. The female gland contained significantly more acini/field than the male gland. The diameter of acini was significantly smaller than those of the male gland. Gonadectomy reduced the number of acini/field and increased their diameter in females but provoked the opposite effect in males. Gonadectomy drastically reduced the percent of acini with crystal bodies in both sexes, and the percent of acini with apocrine secretion only in females. Estrous does showed a significantly higher number of acini/field than pregnant (days 20 and 29) and lactating (day 6) does. Acini containing crystal bodies declined from 22% in estrous females to 8% and 3% in pre-parturient (gestation day 31) and lactating (day 6) does, respectively. By contrast, acini showing apocrine secretion increased from 12% in estrous females to 43% in pre-parturient does and declined to 23% on lactation day 6. In all glands glycoproteins were noted in crystal bodies but not in apocrine secretion. Results show a sexual dimorphism in the rabbit chin gland histology and support the participation of gonadal steroids in its physiological regulation.

Animals↗

Papillary thyroid carcinoma in Mexican patients: clinical aspects and prognostic factors.

The present study characterizes papillary thyroid carcinoma (PTC) in a Mexican patient sample and evaluates potential prognostic factors for recurrence. Clinical records of 229 patients with PTC were analyzed. Surgical specimens were rereviewed and DNA ploidy determined. Cox logistic regression was used to explore prognostic factors. Mean age +/- SD of the patients was 42 +/- 16 years, with a male/female ratio of 24:205. A thyroid mass was the initial manifestation in 99%. Extrathyroid invasion occurred in 45% and nodal metastases in 38%. Mean size +/- SD of the tumors was 3 +/- 2 cm. By flow cytometry 88% of the tumors were DNA euploid and 12% aneuploid. Complete tumor resection was achieved in 83% with an operative mortality of 0.4%. Postoperative hormone suppression was administered in 65% and remnant 131I thyroid ablation in 84%. The 10-year recurrence-free survival was 85%. In the group of patients with tumors totally removed and without distant metastases, none of the 14 evaluated variables demonstrated statistical significance as an independent prognostic factor for recurrence. However, the group of patients in whom a combination of the following factors was present--age > or = 40 years, tumor size > or = 3 cm, local invasion, and lymph node metastases--showed a higher incidence of tumor recurrence.

Adult↗

Cytokine gene expression in cirrhotic and non-cirrhotic human liver.

BACKGROUND/AIMS: In order to explore the role of cytokines in the pathogenesis of liver cirrhosis, we analyzed their gene expression in hepatic biopsies from patients with alcoholic liver cirrhosis, post-hepatitis C liver cirrhosis, and with idiopathic portal hypertension without cirrhosis. METHODS: We assessed the gene expression of interleukins 1 beta, 2, 6, 8, and 10, as well as of tumor necrosis factor-alpha, transforming growth factor-beta and interferon-gamma by a quantitative polymerase chain reaction. RESULTS: We found high levels of transforming growth factor-beta in post-hepatitis C liver cirrhosis, high to moderate in alcoholic liver cirrhosis and low in non-cirrhotic specimens. Expression of interleukin-10, tumor necrosis factor-alpha, and interferon-gamma genes was detected in most post-hepatitis C liver cirrhosis, but not in idiopathic portal hypertension or alcoholic liver cirrhosis biopsies. The interleukin1-beta, 6 and 8 gene expression was significantly lower in alcoholic liver cirrhosis compared to post-hepatitis C liver cirrhosis, but higher compared to idiopathic portal hypertension specimens. Thus, post-hepatitis C liver cirrhosis samples showed a high degree of cytokine gene expression, whereas in alcoholic liver cirrhosis it tended to be moderate, and restricted to some cytokines (transforming growth factor-beta, interleukin-1, 6 and 8, but not interleukin-10, tumor necrosis factor-alpha or interferon-gamma). In contrast, most non-cirrhotic specimens showed a restricted and low cytokine gene expression. CONCLUSIONS: These data suggest that transforming growth factor-beta may have an important role in liver fibrosis and inflammation. Interleukin-1 beta, 6, 8, tumor necrosis factor-alpha and interferon-gamma, appear to participate in the pathogenesis of the mild to severe inflammatory phenomena seen in alcoholic and post-hepatitis C liver cirrhosis, respectively. Our data suggest that tumor necrosis factor-alpha does not participate in the hepatocellular damage of alcoholic liver cirrhosis, and indicate that neither interferon-gamma nor interleukin-10, at least at the levels observed in post-hepatitis C liver cirrhosis, are able to counteract the fibrotic/inflammatory process seen in this condition.

Adolescent↗

Immunohistochemical localization of intracellular progesterone and glucocorticoid receptors in the rabbit lung.

We have determined the presence and distribution of intracellular progesterone receptors (PRs) and glucocorticoid receptors (GRs) in the lung of adult female rabbits using immunohistochemistry. The effects of ovariectomy and administration of oestradiol benzoate (10 micrograms for 3 consecutive days) upon PR and GR immunoreactivity were also studied. The results demonstrated the presence of both steroid hormone receptors in the female rabbit lung. PR and GR immunoreactivity was predominantly nuclear and located in alveolar epithelial cells and various interstitial cells such as polymorphonuclear leucocytes. Tissue distribution of both receptors was similar in all cases. Oestradiol treatment induced a marked increase in the number of PR immunoreactive cells compared with intact and ovariectomized female animals. Neither ovariectomy nor oestradiol treatment modified the number of GR immunoreactive cells. The presence and localization of intracellular PRs and GRs in several lung cell types suggest that they may play an important role in mediating the effects of progesterone and glucocorticoids in various physiological processes in the rabbit lung. The data also indicated an oestrogen regulation of PRs in the rabbit lung.

Animals↗

Tall cell variant of papillary thyroid carcinoma. A cytohistologic correlation.

OBJECTIVE: To identify the cytologic characteristics of the tall cell variant of papillary thyroid carcinoma in fine needle aspiration biopsies and make a cytohistologic correlation. STUDY DESIGN: The study group consisted of six patients subjected to fine needle aspiration biopsy of the thyroid prior to surgical resection of the tumor. RESULTS: Nineteen cases of the tall cell variant were identified in 229 cases of papillary thyroid carcinoma (8.5%) from 1957 to 1993. Six cases had aspirates with tall cells. The patients were females with a median age of 43 years, and all had aggressive neoplastic diseases. The tumors had > 30% tall cells. The fine needle aspiration biopsy findings included nuclear grooves and abundant oxyphilic cytoplasm (100%), pseudonuclear inclusions (83.3%) and ground glass chromatin (67%). The majority of neoplastic cells had a nuclear/cytoplasmic ratio of 1:2. A tadpole shape was observed in noncohesive cells, and a respiratory epithelium-like arrangement was seen in cohesive cells. CONCLUSION: Fine needle aspiration biopsy is the best method of identifying tall cells preoperatively. Nuclear and cytoplasmic changes should be added to make a firm diagnosis of the tall cell variant and to rule out columnar cell carcinoma or squamous metaplasia in goiter or usual thyroid papillary carcinoma.

Adolescent↗

[Retrorectal tumors].

OBJECTIVES: To analyze the clinical presentation, and diagnostic and therapeutic implications in patients with retro-rectal tumors. METHODS: This paper reports two patients. Both patients had constipation and change in bowel habits, and the physical examination revealed the retro-rectal neoplasia. One of the patients had rectal intra-luminal invasion due to a schwannoma and underwent a transanal excision, with subsequent recurrence that required a combined abdomino perineal resection due to invasion of the tumor to the anorectal angle. The second patient had a teratoma and had a good outcome after a trans-sacral resection of the neoplasia. CONCLUSIONS: Clinical suspicion is imperative to diagnose these rare tumors. Treatment of choice is complete resection of the tumor. Localization of the neoplasia, as evidenced by image studies will help to decide the best surgical approach.

Adult↗