Contractile activity of human decidual stromal cells. II. Effect of interleukin-10

CONTEXT: Human decidual stromal cells (DSC) are myofibroblast-like cells that express alpha-smooth muscle (alpha-SM) actin, a protein associated with cell contractility. Several lines of experimental evidence in humans and mice show that antiinflammatory cytokines favor normal pregnancy, whereas Th1 and inflammatory cytokines play a role in abortion. We previously demonstrated that IL-2, a Th1 cytokine, increased the contractility of human DSC. OBJECTIVE: We studied the effect of the antiinflammatory cytokines IL-10 and IL-4 on the contractility of DSC from first-trimester pregnancy. SETTING AND PATIENTS: We studied 10 healthy women who underwent elective vaginal termination of first-trimester pregnancy at Clínica El Sur, Málaga, and Clínica Ginegranada, Granada. MAIN OUTCOME MEASURE(S): After isolation of DSC, cell contractility was measured with the collagen gel contraction assay. alpha-SM actin was detected with Western blotting and immunofluorescence. RESULTS: We found that IL-10, but not IL-4, increased the volume of the collagen gel matrixes in which the cytokine-treated DSC were cultured, showing that IL-10 decreased DSC contractility. By Western blotting we demonstrated that this effect was not related to an alteration in the synthesis of alpha-SM actin. Nevertheless, we observed by immunofluorescence microscopy that DSC treated with IL-10 exhibited stress fibers with a lower content of alpha-SM actin than untreated control DSC. CONCLUSIONS: IL-10 relaxes DSC by reducing the incorporation of alpha-SM actin into their stress fibers. This relaxing activity may be of relevance for the maintenance of pregnancy.     

Intraductal papillary mucinous tumor: diagnostic and therapeutic approach

Primary cystic pancreatic neoplasms are rare tumors, with an approximate prevalence of 10% of cystic pancreatic lesions. Most of these lesions correspond to mucinous cystic neoplasm, serous cystoadenoma and intraductal papillary mucinous tumor (IPMT). IPMT is characterized by diffuse dilatation of the main pancreatic duct and/or side branches with inner defects related to mucin or tumor, or mucin extrusion from a patent ampulla. IPMT has a low potential for malignancy, with a low growth rate, a low rate of metastatic spread and postsurgical recurrence. Over the last few years, major advances have been made in the diagnostic and therapeutic management of this tumor.     

Gender images and sexual and reproductive conduct

OBJECTIVE: To analyze some of the factors associated with material living conditions of adolescents and their means for earning a living, such as idea construction and gender representations, related to sexual and reproductive conduct. MATERIAL AND METHODS: The investigation was conducted in Asuncion, Paraguay, in 2000. Qualitative data collection techniques (in-depth interviews) and interpretive analysis were used. A total of 40 interviews were conducted of young people between the ages of 15 and 20, grouped as "schooled" and "not schooled." RESULTS: Gender constructions exist, denominated in this study as "modern" and "traditional," that classify perceptions about gender roles for women and their position in relation to males, as well as for partner relationships and the exercise of power in such contexts. Ideas and representations about maternity are also defined. CONCLUSIONS: The distinct gender image "types" associated with the adolescents means for earning a living simultaneously condition certain perceptions about gender roles and reproductive conduct.     

Peutz-Jeghers syndrome

Peutz-Jeghers syndrome is an autonomic dominant disease characterized by hamartomatous polyps and mucocutaneous hyperpigmentation. We present 16 cases; females were more affected. The most common presenting complaints were of gastrointestinal tract. All polyps found were hamartomatous with general distribution through gastrointestinal tract. Endoscopic polypectomy should be carried out for treatment. Radiologic, endoscopic and histologic studies should be conducted for long-term follow-up, because of high risk of malignancy.     

Pharmacological suppression of rat distal colon chloride secretion requires two blockers

Rat distal colon epithelium is frequently employed to assess the effect of natural and synthetic chemicals on chloride secretion. Inhibition of chloride secretion is often reported as the loop diuretic-sensitive portion of short-circuit current (Isc). The present work challenges the hypothesis that a loop diuretic alone is able to fully abolish chloride secretion. Isolated mucosa preparations were mounted in an Ussing chamber. The effects on short-circuit current of replacement of normal Ringer by a low (2.5 mmol/L) Cl solution and of blockers of basolateral Na, K, 2 Cl symport (bumetanide), apical Cl channels (diphenylamine-2-carboxylate, DPC), and anion exchange (4-acetamido-4'-isothiocyanatostilbene-2,2'-disulfonic acid, SITS) alone and combined were assessed. Low Cl reversibly decreased Isc by 76%. In normal Ringer, bumetanide decreased Isc by 65%. SITS also had a significant effect at the serosal side, but not at the apical side, where DPC caused a 40% decrease. Chloride replacement, bumetanide and DPC, but not SITS, increased epithelial resistivity. Combined blockade of Na, K, 2 Cl symport and apical Cl channels, of Na, K, 2 Cl symport and anion antiport, or of anion antiport and apical Cl channels was needed to achieve reduction of short circuit current to the same extent seen with chloride replacement. Present results indicate that Isc of the unstimulated epithelium is mostly due to chloride secretion, and at least two blockers are required to abolish it. This fact should be taken into account in studies of chloride secretion-stimulating agents.     

Cost of care of arterial hypertension and its impact on the budget assigned to health in Mexico

OBJECTIVE: To assess the medical care costs of hypertension and their impact on the health care expenditures and on Mexico's Gross National Product (GNP). MATERIAL AND METHODS: An ecological study was conducted from June to November 1999, at Instituto Mexicano del Seguro Social (Mexican Institute of Social Security, IMSS), in Monterrey, Nuevo Leon, Mexico. A random sample of medical charts of patients with hypertension was selected, to extract data on utilization of health services and unitary costs per care episode. The cost per care episode and per hypertensive patient was calculated by adjusting the unitary cost as a function of standard and extreme utilization of IMSS health services. The resulting figure was then projected to the total population of hypertensive patients and compared to the annual health care expenditures of Mexico. RESULTS: The annual cost per patient with hypertension was $1,067 in the standard scenario and $3,913 in the extreme scenario. The annual expenditures from hypertension corresponded to 13.95% of the budget allocated to health care and to 0.71%, of Mexico's GNP. These figures changed to 51.17% and 2.61% in the extreme scenario, respectively. CONCLUSIONS: The costs of hypertension medical care account for a good portion of healthcare resources. This problem should be analyzed by multidisciplinary health teams in search of more efficient medical care alternatives.