[Sleep apnea-hypopnea syndrome and stroke]

For many years attention has been drawn to the frequent association between sleep apnea-hypopnea syndrome and stroke. Numerous and very different epidemiological studies are available that point to a possible causal relation. In a parallel way, there has been an increase over these years in the knowledge of the different intermediate physiopathological mechanisms by which apnea could theoretically favour the appearance of cerebral ischemia. An increase in arterial pressure, the appearance of arrhythmias, hemodynamic changes in cerebral circulation and a prothrombotic state are outstanding amongst these. Likewise, it was also proved that treatment with CPAP was beneficial for normalising some of these alterations. Nonetheless, it is only recently that, thanks to the appearance of different prospective studies, it has been irrefutably proved that SAHS is a risk factor that increases the possibility of suffering an stroke, independently of the presence of other classical risk factors. While awaiting new intervention studies that confirm whether treatment with CPAP reduces this risk, it is important to include in the anamnesis of patients who have suffered an stroke or a transitory ischemic accident the search for data that would lead us to think of SAHS and to send these patients for evaluation by the respiratory unit when necessary.

[Implementation of a protocol of management of chronic kidney disease between Nephrology and Primary Health Care. Preliminary results]

During the last years there has been an important advance in the knowledge of chronic kidney disease (CKD). In order to adapt our clinical practice to these new data, a protocol of management of CKD between Nephrology and Primary Health Care has been developed. The protocol includes several items like cardiac and renal protection strategies, diagnosis and treatment of complications, use of drugs and clear derivation criteria. Implementation of the protocol has been only partial and has implied, for the Renal Unit, an increase in the number of patients,specially the oldest ones, but a clear improve in the quality of the information too,and a first positive step in the right way to face the challenge of CKD. In view of analysed data we propose some modifications for the protocol.

[Evaluation of cefoxitin and cefotaxime screening plates for the detection of methicillin-resistance in Staphylococcus aureus]

Detection of methicillin-resistant Staphylococcus aureus (MRSA) isolates represents a serious problem to low and media level microbiology labs. In this work cefoxitin (FOX) and cefotaxime (CTX) screen plates (AS) (8-16 microg/ml) with and without 4% of NaCl were evaluated to detect MRSA. Sensitivity, specificity, positive and negative predictive values were determined. The AS oxacillin and the agglutination test MRSA-Screen Latex for the detection of PLP2a were used as reference methods for the evaluation of the different studied screening plates. The 100% (94 strains) PLP2a positive were detected as MRSA with FOX (8 microg/ml), and CTX (8 microg/ml with 4% NaCl) AS. The advantage of FOX AS (8 microg/ml) is that it does not need the addition of NaCl, and CTX AS (8 microg/ml with 4% NaCl) is that cefotaxime is an antimicrobial easily accessible in our country.

Prenatal diagnosis of 46, XX male fetus

Prenatal diagnosis of sex differentiation disorders is extremely rare and is estimated in 1/2500 analyzed gestations. A group of this disorders are the 46, XX males and its incidence is estimated in 1/20000 male neonates. We report a male XX fetus in which the diagnosis of sex determination was requested at 20 gestation weeks to clarify the real gender of the fetus. Discrepancy between cytogenetic and ultrasonographic was detected.

Suppression of ferromagnetic double exchange by vibronic phase segregation

From Raman spectroscopy, magnetization, and thermal expansion on the system La(2/3)(Ca(1-x)Sr(x))(1/3)MnO3, we have been able to provide a quantitative basis for the heterogeneous electronic model for manganites exhibiting colossal magnetoresistance (CMR). We construct a mean-field model that accounts quantitatively for the measured deviation of T(C)(x) from the T(C) predicted by de Gennes double-exchange in the adiabatic approximation and predicts the occurrence of a first-order transition for a strong coupling regime, in accordance with the experiments. The existence of a temperature interval T(C) < T < T*, where CMR may be found, is discussed in connection with the occurrence of an idealized Griffiths phase.

The role of somatostatin receptor scintigraphy in patients with pituitary adenoma or post-surgical recurrent tumours

To assess the role of scintigraphy with 111In-DTPA-D-Phe-octreotide (111In-octreotide) in the diagnosis of pituitary adenomas and in the evaluation of post-surgical recurrent or residual tumours, we performed scintigraphy with 111In-DTPA-D-Phe-octreotide (SRS) in 35 patients: 14 patients with confirmed pituitary tumours and 15 with confirmed recurrent tumours. Clinical, biochemical and histological analyses, conventional images (CT/MRI), and follow-up assessments during a period of 1 year to 4 years were recorded in all patients. In the present study, scintigraphy with 111In-octreotide showed positive uptake in 10 out of 14 patients with confirmed pituitary tumour and in 13 out of 15 patients with confirmed recurrent tumour, with an overall sensitivity of 79%. SRS showed better results in growth hormone (GH)- and prolactin (PRL)-secreting tumours (7/8 patients correctly identified) than in other adenomas (3/9). SRS detected recurrence of adenocorticotrophic hormone (ACTH)-secreting tumours (4/5 patients correctly identified) and non-secreting tumours (5/7 patients correctly identified). 111In-octreotide scintigraphy, in combination with other imaging modalities, is useful in the diagnosis and follow-up of pituitary tumours. It allows scar tissue to be differentiated from tumour recurrence after surgical treatment and ensures better selection of patients who will benefit from medical treatment with somatostatin analogues.

New approach for the refinement of the location of the X-chromosome breakpoint in a previously described female patient with choroideremia carrying a X;4 translocation

Choroideremia (CHM) is an X-linked recessive ophthalmic disease characterized by a progressive degeneration of the choroid and the pigmented epithelium of the retina. We present the genetic characterization of a female patient affected with CHM who has been previously studied cytogenetically and showed a balanced translocation between chromosomes X and 4 [46,X,t(X;4)(q21;p16)]. The breakpoint in the X chromosome lies in the locus of CHM gene and for this reason, we have elucidated whether or not CHM was disrupted in the X chromosome involved in the translocation using different techniques. FISH showed that the 3'UTR and the last exons of the CHM were on the der(X) chromosome, and the 5'UTR and first exons of this gene were on the der(4) chromosome. Expression level analysis revealed that the breakpoint in the der(X) was located between exons 8 and 9 of the CHM gene because the expression level decreased from this point onwards. Based on this result the expression level analysis proved to be a valid method to pinpoint the location of breakpoints when the gene being expressed in peripheral blood is disrupted. Our results confirmed that the CHM gene was indeed disrupted in the X chromosome involved in the translocation. Besides, the nonrandom inactivation of the normal X chromosome observed using a methylation-specific polymerase chain reaction (M-PCR) technique explained the CHM in the female patient.

The structure and ultrastructure of the sinus venosus in the mature dogfish (Scyliorhinus canicula): the endocardium, the epicardium and the subepicardial space

The sinus venosus of fish is the most caudal chamber of the heart. It is often reduced in teleosts but well developed in elasmobranchs. The sinus venosus of the dogfish (Scyliorhinus canicula) is vital, since it harbours key elements such as a little known neuroendocrine system and the nodal tissue. However, the study of its structure is still incomplete. We examined the endocardium, epicardium and subepicardium of the sinus venosus in mature dogfishes. The wall is 100-250 microm thick and comprises three main layers. Large bundles of myocardial cells occupy the middle layer. The endothelial ensheathing is composed of thin endocardial cells with prominent nuclei towards the lumen, whose cytoplasm contains numerous dense bodies and moderately dense bodies, 150-800 nm in diameter and large vacuoles. The possible functions of these organelles are discussed. The outermost layer is made of a robust sheet of cuboidal epicardial cells separated from the subepicardium by a conspicuous basal lamina. Numerous microvilli towards the pericardial cavity and elliptical vesicles are located in the apex of epicardial cells. A thick layer richly endowed with dense bundles of collagen fibres forms the subepicardial space. This structure should be contrasted with the venous return mechanism of elasmobranchs.

Msx1 expression in the adult mouse brain: characterization of populations of beta-galactosidase-positive cells in the hippocampus and fimbria

We have analyzed Msx1 expression in the mature mouse brain using in situ hybridization and beta-galactosidase activity in Msx1(nLacZ) mice. The study revealed that Msx1 is strongly expressed in the circumventricular organs, such as the subcommissural organ and choroid plexus, and in some epithelia, such as that of the dorsal, but not the ventral part of the third ventricle. Immunohistochemical analysis revealed that the Msx1-expressing cells of the hippocampus and fimbria are astrocytes, oligodendrocytes or immature oligodendrocytes. In contrast, no co-expression was detected in these structures using several neuronal markers. These results were confirmed, using transmission electron microscopy, by the presence of 5-bromo-3-indolyl-beta-D-galactopyranosideprecipitates in astrocytes and oligodendrocytes in both sites. Moreover, using an anti-glial fibrillary acidic protein antibody (GFAP), our study reveals two populations of astrocytes in the adult hippocampus and other areas, such as the fimbria, namely Msx1+/GFAP+ and Msx1-/GFAP+. Beta-galactosidase activity was also observed in endothelial cells of hippocampal fissure blood vessels. We also observed co-localization of polysialic acid neural cell adhesion molecule, a marker of the polysialylated form of the neural cell adhesion molecule, in Msx1-expressing cells in the fimbria. These cells may be precursors of glial cells and originate from the epithelium of the fimbria. The present study indicates, in the mature mouse brain, that Msx1 may be linked to secretory activity in circumventricular organs, and to glial proliferation and differentiation in the hippocampus and fimbria, and presumably also in other cerebral areas. We suggest that Msx1 could be associated with brain homeostasis and blood-brain barrier function.

Msx1-Deficient Mice Fail to Form Prosomere 1 Derivatives, Subcommissural Organ, and Posterior Commissure and Develop Hydrocephalus

Msx1 is a regulatory gene involved in epithelio-mesenchymal interactions in limb formation and organogenesis. In the embryonic CNS, the Msx1 gene is expressed along the dorsal midline. Msx1 mutant mice have been obtained by insertion of the nlacZ gene in the Msx1 homeodomain. The most important features of homozygous mutants that we observed were the absence or malformation of the posterior commissure (PC) and of the subcommissural organ (SCO), the collapse of the cerebral aqueduct, and the development of hydrocephalus. Heterozygous mutants developed abnormal PC and reduced SCO, as revealed by specific antibodies against SCO secretory glycoproteins. About one third of the heterozygous mutants also showed hydrocephalus. Other defects displayed by homozygous mutants were ependymal denudation, subventricular cavitations and edema, and underdevelopment of the pineal gland and subfornical organ. Some homozygous mutants developed both SCO and PC, probably as a consequence of genetic redundancy with Msx2. However, these mutants did not show SCO-immunoreactive glycoproteins and displayed obstructive hydrocephalus. This suggests that Msx1 is necessary for the synthesis of SCO glycoproteins, which would then be required for the maintenance of an open aqueduct.

[Transbronchial needle aspiration in bronchogenic carcinoma with visible lesions: diagnostic yield and cost]

BACKGROUND

Transbronchial needle aspiration (TBNA) is a bronchoscopic technique whose usefulness in diagnosing endobronchial lesions has not yet been clearly established.

OBJECTIVE

We aimed to determine whether the diagnostic yield of fiberoptic bronchoscopy could be increased, without a negative impact on diagnostic costs, if TBNA were used in combination with conventional diagnostic techniques (bronchial washings and bronchial brushings and forceps biopsy).

PATIENTS AND METHODS

The cases of 130 patients diagnosed with bronchogenic carcinoma with endoscopically visible lesions were analyzed retrospectively. All had undergone conventional diagnostic procedures; TBNA was also performed if the bronchoscopist considered it was indicated. The final cost was calculated in euros for each diagnosis as the sum of the cost of the procedures needed to reach the diagnosis, including both endoscopic procedures and others (transthoracic needle aspiration, lymph node biopsy). Diagnostic yield and costs in cases diagnosed using only conventional techniques were compared to the yield and costs in cases in which both conventional techniques and TBNA were used.

RESULTS

TBNA was performed in 49 patients and provided the diagnosis in 85.7%. Conventional techniques led to cytological and histological diagnosis in 80.2% of the cases, and the combination of conventional techniques and TBNA gave a diagnosis in 89.7% (P=.01). Significant differences were observed in extrinsic compression (conventional 37.5%; conventional+TBNA 100%; P=.01), submucosal infiltration (conventional 54.6%; conventional+TBNA 85%; P=.03), and exophytic mass with necrosis (conventional 80%; conventional+TBNA 100%; P=.01). The mean (SD) cost of diagnosis was euros 381.60 (euros 156.53) using conventional techniques and euros 413.25 (euros 112.91) for conventional techniques in combination with TBNA. By adding TBNA, costs decreased for diagnoses of submucosal infiltration, exophytic mass with necrosis and extrinsic compression, although the saving was significant only for extrinsic compression.

CONCLUSION

The diagnostic yield of TBNA is high for endoscopically visible bronchial anomalies suggesting neoplasm, particularly when the lesion is due to extrinsic compression, submucosal infiltration, or exophytic mass with necrosis.

[Scintigraphy with thallium chloride in a case of clear cell sarcoma of the tendons and aponeurosis]

Clear cell sarcoma of the soft parts (CCSSP) is a rare and highly malignant tumor. This is a case report of a 31 years old woman who presented with a tumor in the internal face of left thigh. The tumor biopsy was suggestive of a possible malignant tumor of the peripheral nerve sheath (malignant schwannoma). Biochemical analyses, computed tomography and magnetic resonance were performed and reported a sarcoma of soft parts (CCSSP) without abnormal inguinal lymph nodes. With this diagnostic suspicion, the patient was sent to the Nuclear Medicine Service of our center where a 201Thallium scintigraphy study was performed. In this study, it showed the primary tumor together with a hot spot in the homolateral inguinal region, suggestive of the presence of a metastastic lymph node. This finding would change the surgical attitude in the patient, including inguinal lymphadenectomy. The post-surgical histological study confirmed a clear cell sarcoma of soft parts (CCSSP) with a metastatic inguinal lymph node.

Huntington disease-unaffected fetus diagnosed from maternal plasma using QF-PCR

The discovery of fetal DNA in maternal plasma from early pregnancies has led to new opportunities for clinical application. In the last few years there have been numerous reported applications, mainly fetal gender and RhD genotyping. The prenatal diagnosis of some inherited genetic diseases such as Huntington disease is also very frequently required in the prenatal diagnosis routine. We have successfully diagnosed, with a non-invasive procedure, an unaffected HD fetus at the 13th week of gestation using fetal DNA from maternal plasma and the quantitative fluorescent PCR method, which is one of the most sensitive ways to detect fetal DNA in maternal plasma at such an early time of gestation.

Quality of life and psychological well-being in Spanish long-term survivors of Hodgkin's disease: results of a controlled pilot study

Nowadays, the chemoradiotherapeutic protocols for Hodgkin's disease (HD) achieve high curability rates. Hemato-oncologists focus on both avoiding medical and psychological sequelae of the treatment and returning patients to a normal life. The quality of life and psychological well-being of Spanish patients who are long-term survivors of HD were studied and compared to the results obtained from healthy controls. Questionnaires on quality of life [European Organization for Research and Treatment of Cancer (EORTC) QLQ30] and psychological status [hospital anxiety and depression (HAD) scale] were mailed to HD patients without active disease and free of second malignancies and were also given to healthy controls. Of 67 selected patients (68.6%), 46 were included in this study. The median follow-up for these 46 patients was of 7.6 years (0.8-22.1) after being diagnosed. Although there were no differences between patients and controls with regard to their global state of health and quality of life (72.9+/-22.7 vs 79.3+/-18.7; p=0.22), patients presented a lower physical function (88.2+/-18.1 vs 96.5+/-9.7; p=0.05) and a worse social operation scale (81.5+/-25.4 vs 96.3+/-13.1; p= 0.0015) together with higher symptoms of dyspnea (8.6+/-14.7 vs 0+/-0; p=0.03) and higher economic difficulties (23.1+/-38.3 vs 0.7+/-4.9; p=0.017) when compared with healthy controls. However, we did not find differences in the scores and the proportion of cases of anxiety and depression between the two groups. The quality of life questionnaire disclosed differences between patients and controls in some functional and symptomatic scales. These differences can be read as a consequence of either the disease itself or the treatment received. However, the results of this controlled pilot study should be confirmed in a larger series of Spanish HD survivors. In the future, these results could be a reference when new therapeutic protocols are designed to reduce the impact on the quality of life of the patients. Socioeconomic support to the patients should also be provided in order to improve their medical care.

Aniridia as part of a WAGR syndrome in a girl whose brother presented hypospadias

Aniridia can arise as part of the WAGR syndrome (Wilms tumour. aniridia, genitourinary anomalies, and mental retardation), due to a deletion or chromosomal region 11p13. We report a girl with a complete WAGR syndrome, whose brother presented hypospadias. Cytogenetic, FISH and molecular studies showed a deletion in one chromosome 11 of the patient. No cytogenetic rearrangement or deletion affecting the genes included in this region (PAX6 and WT1) were observed in her brother and parents. This excludes a higher risk than that of the general population for developing Wilms tumour in the brother and supports that the presence of WAGR syndrome in the patient and hypospadias in her brother is a chance association. We conclude that the identification and definition of the deletions in the WAGR region, which include the WT1 locus are important in order to identify a high tumour risk in infant patients with aniridia including those without other WAGR anomalies.

Quality of life and psychological well-being in Spanish long-term survivors of Hodgkin's disease: results of a controlled pilot study

Nowadays, the chemoradiotherapeutic protocols for Hodgkin's disease (HD) achieve high curability rates. Hemato-oncologists focus on both avoiding medical and psychological sequelae of the treatment and returning patients to a normal life. The quality of life and psychological well-being of Spanish patients who are long-term survivors of HD were studied and compared to the results obtained from healthy controls. Questionnaires on quality of life [European Organization for Research and Treatment of Cancer (EORTC) QLQ30] and psychological status [hospital anxiety and depression (HAD) scale] were mailed to HD patients without active disease and free of second malignancies and were also given to healthy controls. Of 67 selected patients (68.6%), 46 were included in this study. The median follow-up for these 46 patients was of 7.6 years (0.8-22.1) after being diagnosed. Although there were no differences between patients and controls with regard to their global state of health and quality of life (72.9+/-22.7 vs 79.3+/-18.7; p=0.22), patients presented a lower physical function (88.2+/-18.1 vs 96.5+/-9.7; p=0.05) and a worse social operation scale (81.5+/-25.4 vs 96.3+/-13.1; p= 0.0015) together with higher symptoms of dyspnea (8.6+/-14.7 vs 0+/-0; p=0.03) and higher economic difficulties (23.1+/-38.3 vs 0.7+/-4.9; p=0.017) when compared with healthy controls. However, we did not find differences in the scores and the proportion of cases of anxiety and depression between the two groups. The quality of life questionnaire disclosed differences between patients and controls in some functional and symptomatic scales. These differences can be read as a consequence of either the disease itself or the treatment received. However, the results of this controlled pilot study should be confirmed in a larger series of Spanish HD survivors. In the future, these results could be a reference when new therapeutic protocols are designed to reduce the impact on the quality of life of the patients. Socioeconomic support to the patients should also be provided in order to improve their medical care.

Prenatal detection of a cystic fibrosis mutation in fetal DNA from maternal plasma

OBJECTIVES

Maternal plasma and serum are being used to detect fetal DNA by PCR in order to determine certain conditions such as fetal gender and RhD without invasive procedures. Because of the presence of maternal DNA in plasma, these approaches are limited to paternally inherited disorders or those de novo present in the fetus. We have assessed the possibility of performing the detection of a single-gene disorder such as a fetal paternally inherited Cystic Fibrosis mutation (Q890X) in maternal plasma.

METHODS

The analysis was performed at 13 weeks of gestation using DNA extracted from maternal plasma. We used a PCR amplification of the Q890X mutation and a posterior restriction analysis of the PCR product.

RESULTS

We were able to detect the presence of the mutation and thus the fetal condition of being a carrier of the paternal mutation.

CONCLUSIONS

We have made evident the possibility of detecting an inherited paternal mutation in a non-invasive way at the 13t(hr) weeks of pregnancy. This methodology could be very useful in cases of paternally inherited dominant disorders. The technical improvements in fetal DNA detection and analysis might lead to the development of new applications in the non-invasive prenatal diagnosis field.

Effect of ascorbic acid on the stability of beta-carotene and capsanthin in paprika (Capsicum annuum) powder

The effect of ascorbic acid, light, and storage on the stability of the pigments beta-carotene and capsanthin in red pepper (Capsicum annuum) powder has been elucidated by determining the amount of pigment in samples treated by various concentrations of ascorbic acid. Determination of pigment concentration has been performed after different storage times using high-performance liquid chromatography. The dependence of the concentration of pigments on the concentration of ascorbic acid, presence of light and the storage time has been assessed by stepwise regression analysis. The concentration of pigments decreased at longer storage time and increased at higher concentration of ascorbic acid, beta-carotene being more sensitive towards storage time and concentration of ascorbic acid than capsanthin. Interaction between the effects of light and storage time, and light and concentration of ascorbic acid has been established.

Leptin treatment during the neonatal period is associated with higher food intake and adult body weight in rats

For this study, we have determined the effects of neonatal leptin treatment on the evolution of body weight. Experiment 1: pups were divided into two groups: LepF - injected with leptin (8 micro g/100 g of body weight) for the first 10 days of lactation and control (C) - receiving saline. Experiment 2: pups were divided into two groups: LepL - injected with the same leptin concentration of experiment one for the last 10 days of lactation, and C, which received saline. Body weight and food intake were monitored until age 150 days, after which leptin concentrations were measured by ELISA. The LepF group had a significant increase in body weight (p < 0.05) from day 98 onward, in food intake (p < 0.05) from day 74 onward, and higher serum leptin concentration compared to the control (108 %, p < 0.05). The LepL group had a significant increase in body weight (p < 0.05) from day 113 onward, in food intake from day 121 onward (p < 0.001), and higher serum leptin concentration compared to controls (6.9 %, p < 0.05). These results suggest that both periods of lactation constituted a critical window for body weight and food intake programming, but the effects are more marked when the leptin is injected within the first ten days.

Critical illness neuropathy

Critical illness neuropathy frequently accompanies the septic syndrome in intensive care units. Another entity that may occur independently or concurrently in critically ill patients is a myopathy, giving rise to difficulties in distinguishing between them. The two patients described had sensorimotor axonal peripheral neuropathy. Axonopathy as a rule has a poor prognosis for recovery, which is slow and often incomplete. There are few reports of the functional outcome after rehabilitation therapy. The two patients described had 5-6 weeks of active rehabilitation therapy with improvement from moderate/severe disability at the onset to slight debility at the end of therapy.

Nitrate leaching in important crops of the Valencian Community region (Spain)

In the Valencian Community there are many areas in which the nitrate content of groundwater is higher than the limit of 50 mg l(-1) established by the European Union. A recent survey of drinking water quality showed that around 8% of the Valencian Community population had water supplies with nitrate content above that limit. The Valencian Community has an intensive agricultural base that includes citrus trees, fruit trees, and vegetables. A summary of the available nitrate leaching results in vegetable fields and citrus orchards is presented. It is demonstrated in the main vegetables grown, that N inputs were much higher than the values recommended by some researchers, and that nitrate leaching values were in most cases within the range of 150-300 kg N ha(-1). Artichoke, early potato, and onion were the three crops with higher leaching rates than other crops, based on simulation studies made for several of the main vegetable growing areas of the Valencian Community. The mineral N content in the 0-60 cm layer at planting time in the vegetable fields is, in many cases, greater than 200 kg ha(-1); fertilizer application could be greatly reduced if some recommendation system similar to the N(min) system used in other European countries was adopted. A simplified N balance in onion and early potato crops showed that the lower limit for mineralization in the 0-60 cm soil layer during the crop period varied from 65 to 130 kg N ha(-1). In these two crops nitrate leaching varied from 240 to 340 kg N ha(-1), depending on the N fertilizer treatment, and representing about 66-70% of total N input in the onion crop, and from 38 to 65% in the potato crop. Nitrate leaching losses in citrus orchards were, in general, lower than 100 kg N ha(-1) year(-1), representing about 33% of the total N input. A comparison of these results with those obtained in other studies is made. Finally, prospects for improvements in the fertilizer practice of vegetable crops and citrus orchards in the Valencian Community are discussed.

Serologic and parasitologic demonstration of Trypanosoma cruzi infections in an urban area of central Mexico: correlation with electrocardiographic alterations

Trypanosoma cruzi infection in central Mexico has not been fully documented, yet some data suggest its presence. In this work, sera from 211 subjects living in the state of Morelos and at risk of T. cruzi infection due to their living in contact with the vector were analyzed for the presence of antibodies to a total antigen extract of a Mexican isolate of T. cruzi. A seropositivity of 20% was demonstrated by both an enzyme-linked immunosorbent assay and Western blotting. Furthermore, parasites were isolated from five seropositive individuals, and these were genetically characterized as T. cruzi by multilocus enzyme electrophoresis. A case-control electrocardiographic study was conducted that included the seropositive individuals and twice as many seronegative controls living in the same area. A significant correlation was found between seropositivity and electrocardiographic alterations. These findings have important implications for perception of the prevalence of Chagas' disease in Mexico. Moreover, the presence of this disease in rural communities rapidly transforming into urban ones might have important epidemiologic consequences.

Detection of indigenous Halobacillus populations in damaged ancient wall paintings and building materials: molecular monitoring and cultivation

Several moderately halophilic gram-positive, spore-forming bacteria have been isolated by conventional enrichment cultures from damaged medieval wall paintings and building materials. Enrichment and isolation were monitored by denaturing gradient gel electrophoresis and fluorescent in situ hybridization. 16S ribosomal DNA analysis showed that the bacteria are most closely related to Halobacillus litoralis. DNA-DNA reassociation experiments identified the isolates as a population of hitherto unknown Halobacillus species.

Pyogenic hepatic abscess: clues for diagnosis in the emergency room

The objective of this paper is to describe the clinical and diagnostic characteristics of patients with pyogenic hepatic abscesses evaluated in the emergency room, and to know whether it is feasible to make an early diagnosis based on any of these characteristics. The setting was an urban, tertiary-care teaching hospital. This was a retrospective study of 63 adult patients admitted to our institution because of pyogenic liver abscesses from January 1991 to December 1998.

A maternal inherited translocation t(1;22)(q11;p11) in two infertile brothers

We report two infertile brothers presenting with azoospermia and oligozoospermia. Cytogenetic studies using G-banding and FISH analysis on lymphocyte cultures revealed an autosomal balanced reciprocal translocation t(1;22)(q11;p11) in both males. The same translocation was found in their mother, but not in a third fertile brother and maternal uncle suggesting that this translocation might compromise the male but not the female gametogenesis in this family.

Fibroblasts from idiopathic pulmonary fibrosis and normal lungs differ in growth rate, apoptosis, and tissue inhibitor of metalloproteinases expression

Idiopathic pulmonary fibrosis (IPF) is a chronic lung disorder characterized by fibroblast proliferation and extracellular matrix accumulation. However, studies on fibroblast growth rate and collagen synthesis have given contradictory results. Here we analyzed fibroblast growth rate by a formazan-based chromogenic assay; fibroblast apoptosis by in situ end labeling (ISEL) and propidium iodide staining; percent of alpha-smooth muscle actin (alpha-SMA) positive cells by fluorescence-activated cell sorter; and alpha1-(I) collagen, transforming growth factor (TGF)-beta1, collagenase-1, gelatinases A and B, and tissue inhibitor of metalloproteinase (TIMP)-1, -2, -3, and -4 expression by reverse transcriptase/polymerase chain reaction in fibroblasts derived from IPF and control lungs. Growth rate was significantly lower in IPF fibroblasts compared with controls (13.3 +/- 38.5% versus 294.6 +/- 57%, P < 0.0001 at 13 d). Conversely, a significantly higher percentage of apoptotic cells was observed in IPF-derived fibroblasts (ISEL: 31.9 +/- 7.0% versus 15.5 +/- 7.6% from controls; P < 0.008). alpha-SMA analysis revealed a significantly higher percentage of myofibroblasts in IPF samples (62.8 +/- 25.2% versus 14.8 +/- 11.7% from controls; P < 0.01). IPF fibroblasts were characterized by an increase in pro-alpha1-(I) collagen, TGF-beta1, gelatinase B, and all TIMPs' gene expression, whereas collagenase-1 and gelatinase A expression showed no differences. These results suggest that fibroblasts from IPF exhibit a profibrotic secretory phenotype, with lower growth rate and increased spontaneous apoptosis.