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Biomedical subjects

T Caballero

Publications and source records attributed to T Caballero.

At least 37 records · Page 2Linked to original sources

Intraepithelial and lamina propria leucocyte subsets in inflammatory bowel disease: an immunohistochemical study of colon and rectal biopsy specimens.

AIMS: To gain new insights into the pathogenesis and differential diagnosis of ulcerative colitis and colonic Crohn's disease. METHODS: Immunohistochemistry for different leucocyte subsets was performed in biopsy specimens of the sigmoid colon and rectum from 55 patients with inflammatory bowel disease and 11 healthy controls. RESULTS: Colonic biopsy specimens from patients with active ulcerative colitis had significantly higher numbers of CD45+ and CD3+ leucocytes compared with those from patients with inactive disease, and higher numbers of total leucocytes and macrophages than those from patients with Crohn's disease. Rectal biopsy specimens from patients with Crohn's disease had greater numbers of intraepithelial leucocytes (CD45, CD3 and CD8 cells) than specimens from patients with active or inactive ulcerative colitis, or from healthy controls. CONCLUSIONS: Because of the phenotypic differences in the inflammatory infiltrate in the mucosa from the sigmoid colon and the rectum, the segment of the intestine to be biopsied should be specified. Assessment of the leucocytic component of the intraepithelial infiltrate in rectal biopsy specimens was more useful than examination of colonic biopsy specimens in the differential diagnosis of ulcerative colitis and Crohn's disease.

Adult↗

Detection of hepatitis B virus in the liver by in situ hybridization (ISH) in HBsAg seropositive and seronegative patients.

The presence of hepatitis B virus (HBV) DNA in the liver of 119 patients was studied to assess the diagnostic value of in situ hybridization (ISH) and its relationship with viral replication and histological liver damage. Liver biopsies of 119 patients (55 hepatitis B surface antigen -HBsAg- seropositive and 64 HBsAg seronegative) were studied retrospectively. Among the HBsAg seropositive patients, the ISH was positive in 26 cases (47%) and negative in 29 (53%) and the former group had higher levels of serum transaminases. The hepatocyte number with positivity for HBsAg and hepatitis B core antigen (HBcAg) in the liver were similar in both ISH-positive and -negative patients. The histological activity index (Knodell) was higher in ISH-positive patients (11 vs 7, p < 0.001). Six patients out of 12 were positive by PCR. In the HBsAg seronegative patients, the ISH was negative in 57 cases and positive in 7. These 7 were positive for anti-HBs (5 cases) and/or anti-HBc (6 cases); 4 were confirmed by PCR. Thus, our data suggest that the ISH technique is useful for detecting viral nucleic acid in the liver, but that the HBV-DNA cannot always be considered as a replication marker, because we also show that some HBsAg seronegative patients with chronic liver disease do have HBV-DNA in their liver cells.

DNA, Viral↗

Relationship between pollinosis and fruit or vegetable sensitization.

The prevalence of vegetable sensitization in children with pollinosis (Group A; n = 48) and the prevalence of pollen sensitization in children with fruit or vegetable allergy (Group B; n = 42) were studied by means of prick-test and determination of serum specific IgE to several pollens, fruits and vegetables. Fifteen patients from Group A (31%) showed sensitivity to fruits and/or vegetables, but only three of them had any symptoms after ingestions. Twenty nine patients from Group B (69%) showed pollen sensitization, mainly to grass and Compositae pollen. An association was found between sensitivity to Compositae pollen and sensitivity to several fruits and vegetables (Compositae, Fagaceae, Brassica, Betulaceae and Leguminoseae).

Adolescent↗

Asthma with sulfite intolerance in children: a blocking study with cyanocobalamin.

Sulfites have been implicated as the cause of bronchospasm in some subjects with asthma. However, there is still no universally accepted explanation of the pathogenesis of these reactions. We have studied five children with asthma with metabisulfite intolerance confirmed by oral challenge testing. The challenge test with metabisulfite was repeated after premedication of all the patients with 1.5 mg of oral cyanocobalamin. In four of the five patients treated with cyanocobalamin, bronchospasm did not develop in the second metabisulfite challenge. The possible mechanisms are discussed.

Administration, Oral↗

A rare case of a multicentric peripheral ameloblastoma of the gingiva. A light and electron microscopic study.

A rare case of a multicentric peripheral ameloblastoma of the gingiva in a 54-year-old male patient is described along with a light and electron microscopic study of the excised tumors. The peripheral ameloblastoma is considered to be the gingival counterpart of the more common intraosseous ameloblastoma. Although both tumors have similar histomorphologic characteristics, their clinical appearance and behavior are completely different. The peripheral ameloblastoma is slow growing and non-invasive, and recurrence is uncommon following excision. The more common central ameloblastoma, is locally invasive and can destroy large segments of the jaw. The histogenesis of the peripheral ameloblastoma and several other odontogenic tumors of the gingiva serves to illustrate the proliferative potential of the basal cell layer of gingival epithelium.

Ameloblastoma↗

Pseudomyxoma peritonei et ovarii associated with sequential ovarian and appendicular tumors and acromegaly.

Pseudomyxoma peritonei associated with highly differentiated mucinous, intestinal-type ovarian tumor is reported in a 46-year-old acromegalic patient. Five years after its discovery a second operation revealed a mucinous cystadenoma of the appendix. The coexistence of pseudomyxoma peritonei with ovarian and appendicular tumors is rare, raising questions about the primary was origin of the peritoneal tumor. In this case the primary was ovarian while the appendicular tumor occurred later. Since acromegaly is associated with a high risk for the development of colorectal tumors, it could also have elicited a similar response in the intestinal-type ovarian tumor and the appendicular neoplasm found in this patient. The role of appendectomy in the surgical treatment and staging of ovarian tumors is stressed.

Acromegaly↗

Diffuse sclerosing papillary carcinoma of the thyroid gland: immunohistochemical analysis of the local host immune response.

Surgical specimens from four patients with diffuse sclerosing papillary carcinoma of thyroid were examined by electronmicroscopy. In addition, immunohistochemical examination using a panel of monoclonal and polyclonal antibodies was carried out in order to investigate the expression of HLA-DR antigen, the presence of Langerhans' cells and the phenotypic characteristics of the inflammatory infiltrate. The ultrastructural study showed that the intraglandular dissemination, typical of this tumour, was due to massive lymphatic invasion. Many Langerhans' cells were observed among tumour cells and in the lymphoid infiltrates in proximity to tumour foci. HLA-DR expression was seen on macrophages, Langerhans' cells, endothelial cells, lymphoid cells, many tumour cells and in some non-neoplastic follicles close to tumour clusters and lymphoid infiltrates. The immunohistochemical analysis of the inflammatory infiltrates showed a high proportion of B- and T-cells, and moderate numbers of plasma cells. Our results suggest that the tumour-specific immune response can give rise to an autoimmune reaction involving non-neoplastic follicles. It is suggested that this could be one of the mechanisms responsible for immunofacilitation of tumour growth.

Adolescent↗

Hepatic sinusoidal dilatation in Hodgkin's disease.

Examination of needle liver biopsy specimens from 46 patients with Hodgkin's disease revealed sinusoidal dilatation with a predominantly centrolobular and midlobular localisation in 23 cases (50%). It was present in 90% of patients with general symptoms and in only 20% of those without them (p less than 0.001), and it was unrelated to the staging, the existence of hepatic infiltration by the disease and the lymph node histology. The pathogenesis of the sinusoidal ectasia is not known, but it might be a consequence of an alteration of the sinusoidal barrier, since no abnormality of the hepatocytes or of the hepatic venules was detected at light microscopy. Sinusoidal dilatation may be considered as a further systemic manifestation of Hodgkin's disease.

Adolescent↗

Lymphangioma of the duodenum: an ultrastructural study.

Two cases of duodenal lymphangioma were diagnosed by endoscopy, and light and electron microscopic findings are reported. Ultrastructural studies showed smooth muscle cells around lymphatic vessels, and amyelinic nerve fibers and smooth muscle cells in the interstitium. On the basis of the ultrastructural features, a hamartomatous rather than tumoral origin is suggested for the duodenal lymphangioma. Lymphangiectatic cysts of Letulle and lymphangiectasia are discussed in the differential diagnosis. Submucosal lymphangiomas of the small bowel might be considered lymphangiectatic cysts.

Adult↗

Fibrolamellar hepatocellular carcinoma. An immunohistochemical and ultrastructural study.

Two cases of fibrolamellar carcinoma of the liver are reported in young female patients of 12 and 21 years of age. Small amounts of perinuclear alpha-fetoprotein were found, unrelated to hyaline globules, as well as alpha 1-antitrypsin in a periglobular fashion in isolated cells. Ferritin was present in a large number of cells. Ultrastructurally, the well differentiated nature of the neoplasm was substantiated by previously unreported findings such as intercellular lumina analogous to bile canaliculi and peroxisome-like bodies containing a central crystalloid. Filamentous material resembling Mallory's type of hyaline was also found. We conclude that both immunohistochemical and ultrastructural features reflect a high degree of differentiation.

Adult↗

Idiopatic angioedema treated with dapsone.

The most commonly identified causes of angioedema are medications, allergens and physical agents, but most cases of angioedema are idiopathic. Treatment depends on identification of the causative agent and, especially when the mechanism is not identified, on the clinicians knowledge and experience with innovative therapeutic regimens. CASE REPORT: A 48-year-old man presented with a 3-month history of recurrent severe episodes of angioedema affecting the lips, tongue and throat. A fiberoptic examination revealed laryngeal edema during some episodes. He did not report abdominal pain, nausea or vomiting. No precipitating factors were identified. The patient was not receiving angiotensin-converting enzyme inhibitors. For the previous 4 years, the patient had been receiving levothyroxine for autoimmune thyroiditis. There was no history of facial palsy or hereditary angioedema. ALLERGY STUDY: Skin prick test with aeroallergens, food, latex, Anisakis and patch test to a standard series (true test) were negative. Laboratory investigations revealed normal complete blood count (CBC), erythrocyte sedimentation rate, urinalysis, blood biochemistry, serum protein electrophoresis and serum immunoglobulins. IgE concentration was 30 UI/ml. Antiperoxidase antibodies were positive (535 UI/ml). Antinuclear antibodies serum immune complexes and rheumatoid factor were negative. Complement study during acute and asymptomatic periods revealed normal values of C1 esterase inhibitor, C1q, C3, C4, functional activity of C1 inhibitor and CH50. No pathologic findings were observed in a lip biopsy. The patient was treated with sedating and nonsedating H1 antihistamines and corticosteroids (prednisone 30 mg/day for 3 months) with no clinical improvement and treatment with 50 mg of dapsone daily was started. Glucose 6 phosphate dehydrogenase deficiency had previously been ruled out. The patient improved and antihistamine and corticoid treatment was withdrawn 1 month after starting the dapsone regimen. No episodes of angioedema appeared during the subsequent year. No reductions in hematologic parameters or adverse events were detected. Dapsone may be an alternative drug in extreme cases of idiopathic angioedema in patients with poor response to conventional therapy.

Angioedema↗

Urticaria induced by caffeine.

Caffeine has rarely been reported as the cause of allergic reactions. We describe a 10-year-old child who developed urticaria after the intake of coffee and cola beverages. The prick test and the oral challenge test with caffeine were both positive. Nevertheless, the oral challenge test with theophylline, another methylxanthine, was negative.

Caffeine↗