AIMTo study the morphology of the enteric nervous system and the expression of beta-2 adrenergic (B2A) receptors in primary colorectal cancer.METHODSIn this study, we included forty-eight patients with primary colorectal cancer and nine patients for control tissue from the excision of a colonic segment for benign conditions. We determined the clinicopathological features and evaluated the immunohistochemical expression pattern of B2A receptors as well as the morphological changes of the enteric nervous system (ENS). In order to assess statistical differences, we used the student t-test for comparing the means of two groups and one-way analysis of variance with Bonferroni’s post hoc analysis for comparing the means of more than two groups. Correlations were assessed using the Pearson’s correlation coefficient.RESULTSB2A receptors were significantly associated with tumor grading, tumor size, tumor invasion, lymph node metastasis (P < 0.05), while there were no statistically significant associations with gender, CRC location and gross appearance (P > 0.05). We observed, on one hand, a decrease of the relative area for both Auerbach and Meissner plexuses with the increase of the tumor grading, and on the other hand, an increase of the relative area of other nervous elements not in the Meissner plexus or in the Auerbach plexus with the tumor grading. For G1 tumors we found that epithelial B2A area showed an inverse correlation with the Auerbach plexus areas [r(14) = -0.531, P < 0.05], while for G2 tumors, epithelial B2A areas showed an indirect variation with both the Auerbach plexus areas [r(14) = -0.453, P < 0.05] and the Meissner areas [r(14) = -0.825, P < 0.01]. For G3 tumors, the inverse dependence increased for both Auerbach [r(14) = -0.587, P < 0.05] and Meissner [r(14) = -0.934, P < 0.05] plexuses.CONCLUSIONB2A receptors play an important role in colorectal carcinogenesis and can be utilized as prognostic factors. Furthermore, study of the ENS in colorectal cancer may lead to targeted molecular therapies.
The aim of our study was to evaluate the expression of glial enteric cells at different stages of differentiation of colorectal neoplasms and to correlate these changes with the tumor proliferation index and with the sympathetic influences evaluated by the expression of beta-2 adrenoreceptors. Given that nowadays colorectal neoplasm is a major public health problem and that the molecular mechanisms responsible for malignant transformation are not fully yet elucidated, more studies are needed in order to establish other intracellular signaling pathways in such a neoplasm. By this study we concluded that the proportional decrease in the density of glial enteric cells in colorectal cancer with the degree of tumor differentiation and also their inverse correlation with the tumor proliferation index and with the expression of the adrenergic beta-2 adrenoreceptors can be considered a negative prognostic factor in this type of cancer.
Klippel-Trenaunay-Weber syndrome (KTWS) is a rare congenital disorder, characterized by capillary, venous and lymphatic vascular malformations in association with bone and soft tissue hypertrophy. We report a KTWS patient with extensive hemangiomatosis of the right lower limb, trunk and upper limbs; bone and soft tissue hypertrophy of upper limbs, scapular girdle and right lower limb; and muscle atrophy on left lower limb with marked body asymmetry, scoliosis and toe malformations. These pathological features are associated with moderate mental retardation, mild renal and hepatic abnormalities. We identified by array CGH (Comparative Genomic Hybridization) a submicroscopic deletion 2q37.3 that could be related to impaired cognitive function. To our knowledge this is the first reported 2q37.3 microdeletion in a patient with KTWS.
The aim of our study was to assess the percutaneous coronary angioplasty versus coronary artery bypass grafting in the treatment of the left main coronary artery disease. The study was a prospective, analytical, observational descriptive one, it included a total number of 83 patients, consecutively included in order to avoid bias, for a period of three years between October 2012 and December 2015. The follow-up was performed for 3 years, initially at one month, then at an interval of three to six months. The primary clinical endpoint was mortality of any cause of the patients included in the study. Other main objectives assessed in our study were symptomatic ischemic heart disease manifested with angina pectoris, the need for myocardial revascularization, nonfatal myocardial infarction, and reduction of left ventricular ejection fraction. In patients with LMCAD, we noticed an increase in mortality in patients with PCI vs. CABG, recurrence of angina pectoris, acute myocardial infarction, myocardial revascularization, and depression of the ejection fraction of the left ventricle. In conclusion, the treatment of left main coronary artery disease by using coronary artery bypass grafting is superior to treatment using percutaneous coronary angioplasty.
The aim of this study was to identify correlations between electrocardiographic and echocardiographic changes in patients with silicosis prior to the occurrence of chronic pulmonary heart disease. We conducted a prospective, descriptive, analytical study, in which we included a group of 67 patients consecutively admitted to the Health Promotion and Occupational Medicine Clinic between December 2016 and January 2018, aged 47 to 78 years.There was a biochemical and electrocardiographic evaluation for each patient as well as a right ventricle echocardiographic evaluation (diameters, volumes, function). A control group, including 25 patients with benign minor diseases that required a cardiologist consultation, was also used. From the electrocardiographic point of view, slight changes were observed regarding the waves of electrical activity of the right ventricle. Taking into account the degree of ventilatory dysfunction (depending on FEV1), changes in right heart echocardiographic parameters were identified. Thus, in what the most important right ventricular parameters, including the tricuspid annular plane systolic excursion (TAPSE) or the RV index of myocardial performance (RVMPI) were concerned, values at the upper limit of normality were recorded in most patients with moderate and severe ventilatory dysfunction. Values of echocardiographic parameters of the right heart at the upper limit of normality, correlated with the degree of ventilatory dysfunction, are early markers for cardiovascular damage in patients with pulmonary silicosis prior to the occurrence of chronic pulmonary heart disease also known ascor pulmonale.
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