Measurement of blood acetoacetate and beta-hydroxybutyrate in an automatic analyser

beta-hydroxybutyrate and acetoacetate as well as lactate and pyruvate are intermediary metabolites normally present in blood. The beta-hydroxybutyrate/acetoacetate ratio is an expression of the mitochondrial oxido-reduction state. This ketone body ratio can provide a clue to diagnosis and metabolic status in congenital errors of the electron transport chain and pyruvate metabolism. The standardization of these analytical procedures improves the interpretation of the results helping in the difficult diagnosis of mitochondrial diseases in children. This study describes an adaptation to a Dimension R 2 L (Dade Behring, Newark, Delaware, USA) automatic analyser for a method to measure blood ketone bodies (beta-hydroxybutyrate and acetoacetate). The method allows the metabolites to be measured directly in nondeproteinized plasma (fluoride/ethylenediaminetetraacetic acid). This adaptation simplifies the analytical procedure and limits the turnaround time to 20 minutes. With a sample volume of 200 mu l metabolite concentrations ranging from 12 to 1300 micromol L(-1) of g-hydroxybutyrate and from 10 to 450 micromol L(-1) of acetoacetate may be measured with a reliable analytical response.

[Cristóbal de Vega (1510-1573), physician to prince Don Carlos (1545-1568)]

This paper represents biographical aspects concerning the always-delicate health of Prince Don Carlos (1545-1568), first-born son of the King Felipe II of Spain (1527-1598). The main conditions and circumstances of his pathobiography were drawn from interesting data offered by one of his royal doctors, the former professor of the University of Alcalá, Cristóbal de Vega (1510-1573), throughout his significant medical career. In particular, the report on the quartan fevers suffered by Don Carlos in Doctor Vega's Commentaria in librum Aphorismorum (1568), provides considerable and previously unknown clinical data on the disease.

Nitric oxide and inducible nitric oxide synthase expression are downregulated in acute cholestasis in the rat accompanied by liver ischemia

Hepatic blood flow decreases under cholestasis and there is evidence that NO regulates liver microvascular perfusion. Thus, the aim of the present study was to evaluate NO synthesis in cholestasis. Cholestasis was induced by bile-duct ligation (BDL) in male Wistar rats. Bilirubins and enzyme activities were measured in serum. Lipid peroxidation, GSH, GSSG and glycogen were determined in liver. Histopathological analysis was performed. Serum NO2- + NO3- concentration was measured by the Gries reaction. iNOS immunoblot analysis was carried out using an iNOS polyclonal antibody. After 7 days of BDL lipid peroxidation increased while GSH/GSSG ratio decreased. Serum NO2- + NO3- and liver iNOS protein were reduced, accompanied by ischemia as revealed by the histopathological analysis. GSH upregulates NO synthesis by increasing iNOS mRNA levels and iNOS activity, thus the reduction of GSH/GSSG ratio may be responsible for the downregulation of iNOS protein and NO synthesis, which in turn may explain the observed ischemia and the decreased hepatic blood perfusion in cholestasis reported by others.

Correlation between cytogenetic abnormalities and disease characteristics in multiple myeloma: monosomy of chromosome 13 and structural abnormalities of 11q are associated with a high percentage of S-phase plasma cells

BACKGROUND AND OBJECTIVES

Cytogenetic studies in multiple myleoma (MM) are limited by the difficulties in obtaining metaphases that can be investigated and few studies have analyzed the relationship between cytogenetics and clinical disease characteristics. The aim of our study was to analyze the recurrent cytogenetic changes in MM and to correlate them with clinical and biological characteristics including the percentage of S-phase plasma cells (PCs).

DESIGN AND METHODS

Chromosomal abnormalities were analyzed in 86 patients with MM. In all patients, two types of cultures (5 d culture with interleukin-4 and unstimulated 72 h culture) were used for cytogenetic analysis. DNA content analysis (ploidy and cell cycle analysis) together with the most relevant clinical and biological disease features were studied.

RESULTS

Cytogenetic analysis was successful in 72 of the 86 patients (84%). Forty-seven patients (65%) had an abnormal karyotype. The most frequent trisomies involved chromosomes 3, 5, 9, 11, 15, 19, 22, 1, 7, 17, 18, and 21, and monosomies affected chromosomes 13 and 8, while structural changes involved chromosomes 1, 11, 14q32, 4p16 and 16q22-23. Patients with abnormal karyotype displayed a poor performance status, advanced stage, anemia and a high percentage of bone marrow plasma cells. In addition, MM patients with -13/13q- and 11q abnormalities showed a significantly higher proportion of S-phase PCs (p=0.02).

INTERPRETATION AND CONCLUSIONS

In summary, our study shows a relationship between unfavorable cytogenetics (-13/13q-/11q abnormalities) and a high percentage of S-phase PCs, a well-known adverse prognostic factor.

The effect of pig farming on copper and zinc accumulation in cattle in Galicia (north-western Spain)

Copper and zinc are frequently added at high concentrations to pig diets as growth promoters. Livestock grazing pasture contaminated with pig slurry may, therefore, be at risk from excessive intake of these elements. High liver copper concentrations have been detected in cattle from the agricultural region of Galicia (NW Spain), especially where there is intensive pig farming. The aim of this study was to evaluate whether pig farming does affect accumulation of copper and zinc in cattle in Galicia. Hepatic copper and zinc concentrations in calves were elevated in areas with naturally high levels of these elements in the soil. The densities of young pigs (piglets and growing-finishing pigs), but not reproductive sows, also influenced copper accumulation in calves. Liver copper levels in calves were significantly and positively related to the density of young pigs in the region. In areas with the highest pig densities, more than 20% of the cattle analysed had hepatic copper concentrations that exceeded the potentially toxic concentration of 150 mg/kg fresh weight. There was no evidence that zinc accumulation in calves was affected by pig density.

[Minimally invasive parathyroid surgery with 99mTc-sestamibi scintigraphy and probe-radioguided surgery: preliminary results]

OBJECTIVE

The most common pathological finding in patients with sporadic primary hyperparathyroidism is a single adenoma. The success of parathyroid surgery is determined by the identification and removal of the responsible adenoma. The aim of our study was to minimize interventional techniques, hospital stay and overall costs of patients with parathyroid adenoma who do not require a complete neck examination.

METHODS

Seven patients with biochemically confirmed hyperparathyroidism were included in our study. All the patients underwent 99mTc-Tetrofosmin and 99mTc-Pertecnetate neck scans in the days prior to the surgery. On the day of the operation, we administrated a dose of 740-925 MBq 99mTc-sestamibi. The scintigraphy study and radioguided surgery examination were performed with a 10 mm hand-held gamma probe at 2-3 hours of the administration. The counts were measured in the four neck quadrants.

RESULTS

We identified seven adenomas and six were removed with a 2 cm incision. The removal of the adenoma resulted in a decline in radioactivity in that quadrant, these being comparable in all the neck quadrants. Ex vivo counts identified parathyroid tissue from fat and lymph node. The histopathologic exam and a decrease of the intact PTHi levels at 30 and 60 minutes after removal of the adenoma confirmed the correct surgery.

CONCLUSIONS

Radioguided parathyroid surgery allows for a minimally invasive unilateral neck examination with a small scar and better cosmetic results, reduces operative and anesthetic times, requires minimal times spent in the hospital and achieves a reduction in overall cost.

Effect of sex on arsenic, cadmium, lead, copper and zinc accumulation in calves

This study evaluated the effect of sex on the accumulation of arsenic, cadmium, lead, copper and zinc in calves. Samples of liver, kidney, muscle and blood of 312 animals (127 females and 185 males) were analysed after acid digestion using atomic absorption spectrophotometry (AAS). Arsenic was determined by AAS interfaced with continuous flow hydride generation, cadmium and lead by graphite furnace, and copper and zinc by flame. Females accumulated more cadmium, copper and zinc in kidneys than did males. The zinc blood levels in females were higher than in males, whereas copper in liver was higher in males than in females. In the case of arsenic and lead, no significant statistical differences between males and females were found.

[Changes in brain serotonin biosynthesis in rats with diabetes mellitus induced by streptozocin: effect of insulin treatment]

OBJECTIVE

To investigate if the changes in the activity of the tryptophan-5-hydroxylase and in brain serotonin synthesis provoked by diabetes mellitus persist or return to normal in the diabetic rats submitted to treatment with insulin.

METHODS

Diabetes induced by the administration of streptozotocin in rats and their treatment with insulin was the paradigm used. At days 7, 14 and 21 of evolution, the brain serotonergic biosynthetic activity was evaluated.

RESULTS

The diabetic rats showed a significant decrease of body weight. Also, they showed a low concentration of I-tryptophan, as well as a diminution in the activity of the key enzyme tryptophan-5-hydroxylase and its product serotonin in the cerebral cortex and brainstem. Interestingly, the activity of the enzyme was higher in the brainstem from day 14, accompanied with an elevation of the neurotransmitter. The diabetic rats submitted to treatment with insulin showed a complete physical recovery and a return to normal of plasma and brain I-tryptophan. The activity of the enzyme not only normalized but was elevated and with an increase of serotonin in the brainstem and cerebral cortex.

CONCLUSION

The present findings confirm that diabetes mellitus produced a chronic anabolic deficit and a decrease in some brain regions of serotonin synthesis. Also, demonstrate that the diabetic rats under specific treatment with insulin had a complete physical recovery and a return to normal of the serotonin precursor in the blood and brain. However, the activity of the limiting enzyme TrpOH case was elevated with an increase of the neurotransmitter in all regions studied. Since the diabetic animal, insulin treated, does recover metabolically, the mechanism of activation of the serotonin biosynthetic path in the brain may not be dependent on the decreased availability of its precursor the free plasma I-tryptophan. Instead, it might be due to a change in the kinetics of tryptophan-5-hydroxylase, since its activity remains significantly increased in spite of plasma and brain normalization of its substrate. Altogether these changes in the biosynthesis of an important brain neurotransmitter may be of relevance in the pathophysiology of the psychoneurological complications in diabetic patients.

Small-diameter mesocaval shunts: a 10-year evaluation

The use of small-diameter portosystemic shunts for the treatment of bleeding esophageal varices caused by portal hypertension has emerged as an outgrowth of the development of polytetrafluoroethylene vascular grafts, which allow the use of a narrow lumen. We report our experience with this type of graft over a 10-year period. Thirty-three patients with good liver function (Child-Pugh class A) were electively operated. The average age of these patients was 45 years (range 17 to 71 years). Twenty-nine patients had liver cirrhosis, one had portal fibrosis, and three had idiopathic portal hypertension. Operative mortality was 3%, and the rebleeding rate was 15%. Postoperative encephalopathy was observed in 14 patients (11%), three of whom had grade III to IV encephalopathy. The remaining 11 patients, had mild encephalopathy that was easily controlled. Postoperative angiography showed shunt patency in 81% of the patients, reduction in portal vein diameter in 33% of the patients, and portal vein thrombosis in 6%. Good postoperative quality of life was observed in 63% of the patients. Survival according to the Kaplan-Meier actuarial method was 81% at 12 months, 56% at 60 months, and 36% at 10 years. These shunts are a good alternative for patients being considered for surgery in whom other portal blood flow preserving procedures (i.e., elective shunts, devascularization with esophageal transection) are not feasible.

Altered central nervous system cytokine-growth factor expression profiles and angiogenesis in metallothionein-I+II deficient mice

To study the importance of metallothionein-I and -II (MT-I+II) for brain inflammation and regeneration, the authors examined normal and MT-I+II knock-out (MT-KO) mice subjected to a cortical freeze injury. Normal mice showed profound neurodegeneration, inflammation, and gliosis around the injury, which was repaired by 20 days postlesion (dpl). However, in MT-KO mice the lesion-associated inflammation was still present as late as 90 dpl. Scanning electron microscopy demonstrated that the number of capillaries was lower, and ultrastructural preservation of the lesioned parenchyma was poorer in MT-KO mice, suggesting an altered angiogenesis. To gain insight into the mechanisms involved, a number of cytokines and growth factors were evaluated. The number of cells expressing the proinflammatory cytokines IL-1beta, IL-6, and TNF-alpha was higher in MT-KO mice than in normal mice, which was confirmed by RNase protection analysis, whereas the number of cells expressing the growth factors bFGF, TGFbeta1, VEGF, and NT-3 was lower. Increased expression of proinflammatory cytokines could be involved in the sustained recruitment of CD-14+ and CD-34+ inflammatory cells and their altered functions observed in MT-KO mice. Decreases in trophic factors bFGF, TGFbeta1, and VEGF could mediate the decreased angiogenesis and regeneration observed in MT-KO mice after the freeze lesion. A role for MT-I+II in angiogenesis was also observed in transgenic mice expressing IL-6 under the control of the promoter of glial fibrillary acidic protein gene (GFAP-IL6 mice) because MT-I+II deficiency dramatically decreased the IL-6-induced angiogenesis of the GFAP-IL6 mice. In situ hybridization analysis indicated that the MT-III expression was not altered by MT-I+II deficiency. These results suggest that the MT-I+II isoforms have major regulatory functions in the brain inflammatory response to injury, especially in the angiogenesis process.

Differential expression of sialic acid on porcine organs during the maturation process

Sialylated structures play important roles in cell communication, and change in a regulated manner during development and differentiation. In this work, we report the main glycosidic modifications that occur during the maturation of porcine tissues, involving the sialylation process as determined with lectins. Sialic acids were identified at several levels in a broad range of cell types of nervous, respiratory, genitourinary and lymphoid origin. Nevertheless, the most contrasting was the type of glycosidic linkage between 5-N-acetyl-neuraminic acid (Neu5Ac) and galactose (Gal) expressed in central nervous system (CNS). Newborn CNS abundantly expressed Neu5Acalpha2,3Gal, but weakly or scarcely expressed Neu5Acalpha2,6Gal/GalNAc. Maturation of CNS induced drastic changes in sialic acid expression. These changes include decrease or complete loss of NeuAcalpha2,3Gal residues, mainly in olfactory structures and brain cortex, which were replaced by their isomers Neu5Acalpha2,6Gal/GalNAc. In the brain cortex and cerebellum, the increase of Neu5Acalpha2,6Gal/GalNAc molecules was paralleled by an increase of 5-N-acetyl-9-O-acetyl-neuraminic acid (Neu5,9Ac2). In addition, terminal Gal and N-acetyl-D-galactosamine (GalNAc) residues also increased their expression in adult CNS tissues, but this was more significant in structures forming the encephalic trunk. Our results show that sialylation of porcine CNS is finely modulated throughout the maturation process.

Metallothionein induction by restraint stress: role of glucocorticoids and IL-6

Restraint stress increased liver metallothionein-I (MT-I) mRNA and MT-I+II protein levels. The glucocorticoid receptor antagonist RU 486 decreased this response. In contrast, adrenalectomy only decreased MT-I+II protein levels. Moreover, corticosterone or progesterone did not reverse the effect of RU 486. These results suggest that glucocorticoids are important for MT-I+II protein synthesis but not for MT-I mRNA accumulation during restraint stress, and that other factors must be involved in this process. Interleukin-6 (IL-6) deficient mice showed a significant decrease of restraint stress-induced liver MT-I mRNA levels (approximately 30% of IL-6+/+ mice) up to approximately 4-5 hours after the onset of stress. Western blotting of hepatic nuclear proteins showed that the IL-6 responsive transcription factor Stat3, which has been shown to mediate MT induction by inflammation, was also activated by restraint stress. Results after extended periods of restraint stress indicate that IL-6 participates early and transiently in the process. The analysis of the expression of the acute phase plasma protein serum amyloid A suggests that restraint stress elicits an acute phase response similar to that caused by inflammation.

Toxic and trace elements in liver, kidney and meat from cattle slaughtered in Galicia (NW Spain)

The aims of this study were to determine the levels of some toxic and trace metals in cattle meat in Spain and to compare them with concentrations in cattle elsewhere and to maximum acceptable levels. Arsenic, cadmium, lead, copper and zinc concentrations in the liver, kidney and muscle (meat) from 438 calves (6-10 months old) and 56 cows (2-16 years old) slaughtered in Galicia (NW Spain) in 1996 were quantified. The arithmetic mean fresh weight concentrations in calf liver, kidney and muscle respectively were 0.043, 0.055, 0.004 mg/kg for arsenic, 0.032, 0.070, 0.001 mg/kg for cadmium, 0.053, 0.052, 0.009 mg/kg for lead, 64.6, 4.91, 0.677 mg/kg for copper and 47.7, 14.4, 47.8 mg/kg for zinc. In cows, these concentrations were 0.046, 0.068, 0.005 mg/kg (arsenic), 0.097, 0.458, 0.001 mg/kg (cadmium), 0.057, 0.066, 0.017 mg/kg (lead), 60.3, 3.67, 1.26 mg/kg (copper) and 59.8, 20.0, 52.7 mg/kg (zinc). Except for copper levels in the liver which were high, metal concentrations in cattle were generally low in Galicia and broadly similar to those in the rest of Europe, Australia and Canada. Arsenic, cadmium and lead concentrations in Galician cattle rarely exceeded acceptable maximum concentrations that have been adopted by many countries. Copper and zinc concentrations in Galician cattle did exceed acceptable maximum concentrations but the frequency with which this occurred depended upon which acceptable maximum concentration was used; regulatory values differ markedly between countries.

The safety of olanzapine compared with other antipsychotic drugs: results of an observational prospective study in patients with schizophrenia (EFESO Study). Pharmacoepidemiologic Study of Olanzapine in Schizophrenia

INTRODUCTION

Results of controlled clinical trials should be confirmed through safety and effectiveness studies in nonselected patient cohorts treated according to routine clinical practice.

METHOD

Outpatients with schizophrenia (ICD-10 criteria) entered this prospective, naturalistic study when they received a new prescription for an antipsychotic drug. Treatment assignment was based on purely clinical criteria, as the study did not include any experimental intervention. Safety was evaluated through the collection of spontaneous adverse events and a specific questionnaire for extrapyramidal symptoms. Global clinical status was measured through the Clinical Global Impressions-Severity (CGI-S) and the Global Assessment of Functioning (GAF) scales.

RESULTS

From the 2967 patients included, 2128 patients were treated with olanzapine as monotherapy or combined with other drugs (olanzapine group), and 821 were treated with other antipsychotic drugs as monotherapy or combined with other drugs (control group). There were no statistical differences between treatment groups at baseline regarding age, gender, disease duration, or severity of symptoms. Olanzapine was well tolerated and effective in this study. Overall incidence of adverse events was significantly lower in the olanzapine group compared with the control group (p < .001). Somnolence and weight gain were significantly more frequent in the olanzapine group, and akathisia, dystonia, extrapyramidal syndrome, hypertonia, hypokinesia, and tremor were significantly higher in the control group. Clinical improvement at endpoint, measured through the mean change in the CGI-S and the GAF, was significantly higher in the olanzapine group compared with the control group (p = .004).

CONCLUSION

These results show that olanzapine is safe and effective in nonselected schizophrenic outpatients and are consistent with the efficacy and safety profile that olanzapine has shown in previous controlled clinical trials.

Arsenic, cadmium, lead, copper and zinc in cattle from Galicia, NW Spain

Knowledge of trace and toxic metal concentrations in livestock is important for assessing the effects of pollutants on domestic animals and contaminant intakes by humans. Metal levels in cattle have been measured in various countries but not in Spain. In this study, the (wet wt.) concentrations of three toxic elements (arsenic, cadmium, lead) and two trace elements (copper, zinc) were quantified in the liver (Li), kidney (Ki), muscle (M) and blood (Bl) of calves (males and females between 6 and 10 months old) and cows (2-16 years old) from Galicia, NW Spain. For the toxic elements, geometric mean concentrations of arsenic in calves (sexes combined) and cows were 10.8 and 10.2 microg/kg (Li), 11.3 and 15.2 microg/kg (Ki), 3.75 and 4.25 microg/kg (M), 3.23 and 2.92 microg/l (Bl). The corresponding cadmium concentrations were 7.78 and 83.3 microg/kg (Li), 54.3 and 388 microg/kg (Ki), 0.839 and 0.944 microg/kg (M), 0.373 and 0.449 microg/l (Bl). Geometric mean concentrations of lead in calves and cows were similarly low and were 33.0 and 47.5 microg/kg (Li), 38.9 and 58.3 microg/kg (Ki), 6.37 and 12.5 microg/kg (M), 5.47 and 12.2 microg/l (Bl). Sex had almost no effect on the amount of toxic metal accumulated except that kidney cadmium concentrations were significantly higher in females than males. Age did influence accumulation; cadmium and lead (but not arsenic) concentrations in most tissues were significantly greater in cows than female calves. For the trace elements, geometric mean copper levels in calf and cow tissues were 49.9 and 36.6 mg/kg (Li), 4.27 and 3.63 mg/kg (Ki), 0.649 and 1.68 mg/kg (M) and 0.878 and 0.890 mg/l (Bl). The corresponding zinc concentrations were 46.3 and 52.5 mg/kg (Li), 14.2 and 20.7 mg/kg (Ki), 47.3 and 52.5 mg/kg (M) and 2.80 and 2.22 mg/l (Bl). Female calves had significantly higher levels than males of muscle zinc and blood copper and zinc. Female calves accumulated more copper but less zinc in the liver and kidneys compared with cows; this may have been associated with the chronic, low-level cadmium accumulation observed in cows. Overall, the levels of arsenic, cadmium, lead and zinc in cattle in Galicia do not constitute a risk for animal health. However, up to 20% of cattle in some regions in Galicia had levels of copper in the liver that exceeded 150 mg/kg wet wt. These animals may be at risk from copper poisoning.

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.

Beta,gamma-methylene ATP but not alpha,beta-methylene ATP mimics the inhibitory effect of ATP on ventricular automaticity

The effects of alpha,beta- and beta,gamma-methylene ATP on ventricular automaticity induced by local injury in the right ventricle of rats pretreated with reserpine, were investigated and compared with the effects of ATP and adenosine. Beta,gamma-methylene ATP but not alpha,beta-methylene ATP mimicked the inhibitory effect of both ATP and adenosine on the spontaneous automaticity In low concentrations, adenosine was more effective than ATP. Alpha,beta-methylene ATP caused little or no effect on ventricular automaticity. The results suggest that the effect of ATP might depend on its hydrolysis into AMP/adenosine.

The use of HLA A2.1/p53 peptide tetramers to visualize the impact of self tolerance on the TCR repertoire

p53 is an attractive target for cancer immunotherapy since it is overexpressed in half of all tumors. However, it is also expressed in normal lymphoid tissue, and self tolerance leaves a p53-specific repertoire purged of high avidity CTL. To better understand the mechanism of tolerance and the basis for such low avidity interaction, p53-specific CTL from p53 deficient (p53-) and sufficient (p53+) A2.1/Kb transgenic mice were compared with respect to their ability to bind HLA-A2.1 tetramers containing cognate murine p53 peptide Ag, p53 261-269. Since the murine CD8 molecule cannot interact with human HLA-A2.1, this tests the ability of the TCR to bind the A2.1/peptide complex tetramer. CTL from p53- mice demonstrated strong binding of such A2.1/p53 261-269 tetramers; however, the CTL from tolerant p53+ mice were devoid of tetramer-binding CD8+ T cells. Examination of TCR expression at the clonal level revealed that CTL from p53+ and p53- mice each expressed comparable levels of the p53-specific TCR. These results indicate that normal expression of p53 promotes elimination of T cells expressing TCRs with sufficient affinity to achieve stable binding of the A2.1/p53 261-269 tetramers.

[Changes in cerebra serotonin synthesis induced by insulin-dependent diabetes mellitus]

OBJECTIVE

Evaluate if the rats with diabetes mellitus insulin-dependent have a minor activity of the serotonergic biosynthetic pathway through the decrease of the free fraction of L-tryptophan in plasma.

METHODS

Diabetes mellitus was induced in rats, and the brain serotonergic biosynthetic activity was evaluated at 7, 14, and 21 days after streptozotocin administration.

RESULTS

The diabetic animals showed a general decrease in body weight. In plasma they had a decrease in the free fraction of L-tryptophan. Also, in the brain they show low levels of the amino acid, as well as decrease of the activity of the limiting enzyme tryptophan-5-hydroxylase and its product serotonin. Interestingly, the activity of the enzyme was higher in the brainstem from day 14, accompanied with an elevation of the neurotransmitter.

CONCLUSIONS

The results confirm that diabetes mellitus insulin-depend induce chronic undernourishment. The low levels of L-tryptophan in blood of the diabetic animals suggest a minor transport of the amino acid to the brain and a decrease in serotonin synthesis, in cerebral cortex and hypothalamus. Besides, during the evolution of the disease, the activity of tryptophan hydroxylase was elevated, independently of L-tryptophan concentration in the brainstem of diabetic animals, suggesting a different response according to the brain region and possibly a different functional change, accompanied by an increase in the synthesis of the neurotransmitter.

Purification and characterization of the hemagglutinin-neuraminidase of Porcine rubulavirus LPMV

The Hemagglutinin-Neuraminidase (HN) from the LPMV strain of Porcine rubulavirus was purified from virions by ultracentrifugation in a continuous 20-60% sucrose gradient and by ion exchange chromatography. The HN is a glycoprotein of 66 kDa constituted by 50.5, 13.3 and 13.6% of non polar, uncharged polar, and charged polar amino acids, respectively. The HN contains 4% of carbohydrates, its glycannic portion is constituted by Man, Gal, GlcNAc, GalNAc, and Neu5Ac in 3:3:4:1:1 molar ratios. The HN possesses hemagglutinating activity in the presence of erythrocytes from several animal species, including human ABO, and treating the erythrocytes with neuraminidase or pronase abolishes this activity. The binding specificity of the purified HN was determined by hapten inhibition assays, indicating that the hemagglutinating activity of the HN is specific for sialic acid and Neu5Acalpha2,3Gal-containing structures.

Diazepam reduces action potential duration in guinea-pig papillary muscle by a cAMP-dependent mechanism

In this study, we have analyzed the role of cyclic AMP (cAMP) as the mediator of the decrease in action potential duration induced by diazepam. Diazepam (1-100 microM) reduced, in a dose-dependent manner, the duration of intracellular action potential recorded in the papillary muscle obtained from the right ventricle of the guinea pig heart. This effect was mimicked by the analog of cyclic AMP, 8-Br-cAMP (100 microM), but not by gamma-amino-butyric acid (GABA). Also, the selective antagonist of the benzodiazepine receptors, flumazenil did not modify the effect of diazepam. The diazepam-induced shortening of action potential duration was partially antagonized by the inhibitor of cAMP synthesis carbachol (1 microM) or the blocker of the cAMP-dependent protein kinase A, Rp-cAMP[S] (1 microM). These results indicate that cyclic AMP is involved in the diazepam-induced shortening of the action potential duration of the guinea pig papillary muscle.

Proportion of S-phase tumor cells measured by flow cytometry is an independent prognostic factor in meningioma tumors

Meningiomas are tumors in arachnoid cells which represent up to one fifth of all intracranial tumors and up to a quarter of spinal neoplasias. Although meningiomas have classically been considered to be benign tumors, it has also been well-established that they show a heterogeneous clinical outcome. To the best of our knowledge no study has yet been performed in which the independent prognostic value of both DNA ploidy and cell cycle has been simultaneously assessed in a large series of meningioma tumors. The aim of the present study was to prospectively explore the prognostic value of DNA ploidy status and the proliferative rate of tumor cells in a series of 105 consecutive meningioma patients studied at diagnosis. Both the presence of DNA aneuploidy and the proportion of S-phase tumor cells were analyzed in all cases in fresh tumors obtained during diagnostic surgery. From the technical point of view, we followed the recommendations of the Consensus Conference on Flow Cytometry DNA Analysis held in October 1992. Our results show that meningioma tumors display a relatively low incidence of DNA aneuploidy (14%), and they usually show a low proliferative rate (mean percentage of S-phase cells of 1.3 +/- 0.3%). The presence of DNA aneuploidy was associated with a higher incidence of aggressive histopathologic subtypes (P = 0.045), a greater age (P = 0.009), location at the cerebral convexity (P = 0.004), and a greater proportion of S-phase cells (P = 0.005). In contrast, no significant association between the DNA ploidy status of meningioma patients and their disease-free survival was found (P = 0. 1). Regarding the proliferative activity of neoplastic cells, we found that a high proportion of S-phase cells (>1.8%) was associated with a significantly lower mean age (P = 0.007), aggressive histopathologic subtypes (P = 0.03), a higher incidence of DNA aneuploidy (P = 0.004), and a significantly shorter disease-free survival (P < 0.004). Multivariate analysis of prognostic factors showed that the proportion of S-phase tumor cells was the most powerful independent prognostic factor in meningioma patients (P = 0.02). In summary, we conclude that the proportion of S-phase tumor cells represents the individual parameter with the highest value for predicting disease-free survival in meningioma patients.

A rapid procedure for the isolation of plasmid DNA from environmental bacteria

The INSTA-MINI-PREP method, a rapid protocol for plasmid DNA extraction, was originally developed to prepare plasmid DNA from 1 to 3 ml miniprep Escherichia coli cultures. Direct extraction of plasmid DNA is achieved by a two-phase solution which is separated by centrifugation in the presence of the INSTA-PREP gel barrier material. This method has been successfully tested on various environmental Salmonella strains, although it was not suitable for Pseudomonas aeruginosa and enterococci strains. The INSTA-MINI-PREP method is a new alternative procedure to screen plasmid contents of Salmonella and E. coli strains rapidly and easily.

[The pediatric prescription according to its origin and the motive for the consultation in a basic rural health area]

OBJECTIVE

To describe the paediatric prescription in a rural health district in terms of the origin and reason for consultation.

DESIGN

Cross-sectional descriptive study.

SETTING

Garraf Rural Health District, Barcelona.

PARTICIPANTS

The 3 basic care paediatrics units in the district.

MEASUREMENTS AND MAIN RESULTS

1068 attendances of children of both sexes under 15 were collected. Recorded on each visit to the paediatrics clinic were: age, sex, reason for consultation (RC), and, if medicine was given, the product prescribed and the origin of the prescription. The number of children receiving treatment increased progressively with age. 87% +/- 2.8% of prescriptions originated with the paediatrician. Therapeutic groups of respiratory apparatus and systemic anti-infection drugs accounted for 69% +/- 2.9% of all prescriptions. Only 2.3% +/- 0.5% had fixed-dose associations. The most common RC was upper-tract respiratory infection, mainly treated with a single therapy (76.6% +/- 6.1%). In the case of the second most common RC, acute bronchitis, 94.6% +/- 4.2% of all cases received drugs treatment with single therapy or two simultaneous treatments. Acute tonsillitis was mainly treated with antibiotics (86.4% +/- 6.6%).

CONCLUSIONS

The frequencies of the pathology groups detected in the Health District correlate with other studies' findings. Analysis of the origin of prescriptions shows the high decision-making capacity of the Health District's paediatricians. The pharmacological profile employed is good, though it could be improved.

Morphology and amplitude values of the P and T waves in the electrocardiograms of Spanish-bred horses of different ages

This investigation was undertaken to determine values of electrocardiographic parameters in Spanish-bred horses at different stages of growth. The study was carried out on 179 healthy Spanish-bred (Andalusian) horses (98 females and 81 males), which were aged between 1 month and 17 years. The ECGs showed P waves of different configurations. The bifid shape deflection of the P wave was generally more frequent than the simple one in animals from 6 months of age. The first component of bifid P waves (P1) did not vary in a statistically significant way with increasing age, showing a mean value of 0.105 mV. The amplitudes of the P2 (the second component of the bifid P waves) and simple P waves showed statistically significant differences between the age groups. The highest values were found in animals up to 3 months and over 2 years of age. Several configurations of the T wave were observed in the different age groups: a negative shape was generally present for the youngest animals (foals up to 2 years old); the biphasic (/+) pattern became more frequent in animals 3 and 4 years old. In adult horses the positive configuration was the most frequent. No statistically significant differences according to age were found for the amplitude values of the different T-wave configurations.

Comparison of the efficacy and safety of two preseasonal regimens of glutaraldehyde modified, tyrosine-adsorbed parietaria pollen extract over a period of three years in monosensitive patients

The purpose of this study was to evaluate the clinical efficacy over a period of three years (1988-90) of two preseasonal dosage regimens of a Parietaria allergoid (Bencard Tyrosine Parietaria) in patients who were only sensitive to this pollen. Fifty patients were included (14 men and 36 women, age: mean, 28 years; range, 14-47 years). Twenty five patients (group A) were treated each january with the basic course of Bencard Tyrosine Parietaria. This consisted of injecting subcutaneously 0.5 ml from each of three vials, with one week between each injection. A further injection using the vial with the highest dose was given one week later. Each january and february, twenty five patients (group B) were treated with the basic course of Bencard Tyrosine Parietaria, repeating the last dose five times, with one week between each injection. Immunotherapy with a tyrosine-adsorbed Parietaria judaica allergoid is an effective method for mitigating nasal (p < 0.0001), bronchial (p < 0.005), conjunctival (p < 0.001) and palatal itching symptoms (p < 0.0001) in patients who are sensitive to this pollen. Sensitivity to Parietaria pollen, as verified by skin test and nasal challenge, decreased during immunotherapy (p < 0.001). Histamine release by peripheral blood basophils decreased during the course of the study, falling from 43.5 ng/ml to 12.3 ng/ml in group A and from 42.9 ng/ml to 10.0 ng/ml in group B; during the second and third years, IgG levels were increased one and four months after starting treatment with the extract, while this was not the case after ten months; IgE levels were also increased. Finally, overall tolerance to this immunotherapy product was good in almost all patients.

Results of surgical treatment (modified Sugiura-Futagawa operation) of portal hypertension associated to complete splenomesoportal thrombosis and cirrhosis

BACKGROUND

Hemorrhagic portal hypertension, secondary to both intrahepatic and extrahepatic portal hypertension, is an uncommon entity. In this condition, the extrahepatic and the intrahepatic obstruction of the portal vein, due to chronic liver disease, produce a more severe form of hemorrhagic portal hypertension that is more difficult to control. The results of surgical treatment (modified Sugiura-Futagawa operation) in this subset of patients is analyzed.

METHODS

Among 714 patients with a history of hemorrhagic portal hypertension, 14 cases were found with histologically proven liver cirrhosis and complete splenomesoportal thrombosis demonstrated by means of preoperative angiography. Patients with incomplete (partial) splenomesoportal thrombosis were excluded. There were nine males and 5 females with a mean age of 51 years. Alcoholic cirrhosis was demonstrated in 50% of the cases, post hepatitic cirrhosis in 28%, primary biliary cirrhosis in 7%, and cryptogenic cirrhosis in 14%. There were nine Child-Pugh A and 5 B cases. All cases were treated by means of our modified Sugiura-Futagawa procedure.

RESULTS

Bleeding recurrence from esophagogastric varices was shown in one case, colonic varices in one case and hypertensive gastropathy in another of the survivors. Post operative encephalopathy was shown in 3 of the cases. The thirty-six month survival rate was 30% (Kaplan-Meier).

CONCLUSIONS

The combination of intrahepatic plus extrahepatic portal hypertension has a worse prognosis. Treatment options are limited (sclerotherapy and/or devascularization), because shunt surgery, TIPS and liver transplantation have a very restricted role and postoperative outcome is poor.

[Cervico-dorsal intramedullary lipoma of neonatal presentation]

INTRODUCTION AND CLINICAL CASE

We present the case of a ten day old boy with cervicodorsal intramedullary lipoma. The initial clinical presentation was of rapidly progressing unilateral brachial paralysis. Neurological examination at birth was completely normal apart from a cutaneous port wine stain on the shoulder homolateral to the paralysis thought to be due to an angiolipoma. On clinical suspicion of an intradural space-occupying lesion at cervical level, a magnetic resonance study was done which showed an intramedullary tumour at cervicodorsal level extending from C3 to T3, which disappeared with the fat suppression technique, a finding characteristic of lipomas. The anatomo-pathological report was that the mass was a tumour made up of mature fat cells in a connective tissue stroma, with no malignant formation or granulomatous components. Lipomas are the second most common spinal tumors in infancy after neuroblastoma. This type of tumour is usually found at lumbosacral level and is considered to be congenital.

CONCLUSIONS

This lipoma was unusual in being cervicodorsal (a common site in adults but not in infancy), being intramedullary (most are extramedullary even when they are intradural), presentation being so early during the neonatal period, rapidly progressive and relapsing after surgical removal.

Impaired inflammatory response to glial cell death in genetically metallothionein-I- and -II-deficient mice

Metallothionein I+II (MT-I+II) are acute-phase proteins which are upregulated during pathological conditions in the brain. To elucidate the neuropathological importance of MT-I+II, we have examined MT-I+II-deficient mice following ip injection with 6-aminonicotinamide (6-AN). 6-AN is antimetabolic and toxic for bone marrow cells and grey matter astrocytes. In MT+/+ mice, injection with 6-AN resulted in breakdown of the blood-brain barrier (BBB) and absence of GFAP-positive astrocytes in specific grey matter areas of the brain stem. Reactive astrocytosis encircled the damaged grey matter areas, which were heavily infiltrated by microglia/macrophages. The recruitment of hematogenous macrophages was accompanied by leakage of the BBB. The immunoreactivity (ir) of granulocyte-macrophage-colony-stimulating factor (GM-CSF) and the receptor for GM-CSF (GM-CSFrec) was significantly upregulated in astrocytes and microglia/macrophages, respectively. MT-I+IIir was also clearly increased in astrocytes surrounding the damaged areas, while that of the CNS-specific MT isoform, MT-III, was mildly increased in both astrocytes and microglia/macrophages. In MT-/- mice injected with 6-AN, the BBB remained almost intact. The damage to specific grey matter areas was similar to that observed in MT+/+ mice, but reactive astrocytosis, microglia/macrophages infiltration, and GM-CSFir and GM-CSFrecir were clearly reduced in MT-/- mice. In contrast, MT-IIIir was dramatically increased in MT-/- mice. Total zinc decreased and histochemically detectable zinc increased in the brain stem after 6-AN similarly in MT+/+ and MT-/- mice. Bone marrow myeloid monocytes and macrophages were increased as a reaction to 6-AN only in MT+/+ mice. The results demonstrate that the capability of MT-/- mice to mount a normal inflammatory response in the brain is severely attenuated, at least in part because of 6-AN-induced bone marrow affectation, involving MT-I+II for the first time as major factors during CNS tissue damage.

Prognostic value of immunophenotypic detection of minimal residual disease in acute lymphoblastic leukemia

PURPOSE

The identification of immunophenotypic aberrancies through multiparametric flow cytometry makes the differentiation between normal and leukemic cells relatively simple and quick, and is therefore an attractive method for the investigation of minimal residual disease (MRD). In this report, we have analyzed the impact on relapse and relapse-free survival (RFS) of detecting immunophenotypical aberrant cells in acute lymphoblastic leukemia (ALL) patients in cytomorphologic complete remission (CR).

MATERIALS AND METHODS

Two hundred eleven bone marrow (BM) samples from 53 consecutive ALL (37 precursor B-ALL and 16 T-ALL) patients were analyzed. The only selection criteria were to have at least one aberrant immunophenotypic feature at diagosis and to have achieved cytomorphologic CR after induction therapy. For MRD detection, all follow-up samples were analyzed with triple labelings using a two-step acquisition procedure, in which 106 cells were screened for the possible persistence of residual leukemic cells with the same phenotypic aberrancy as that identified diagnosis.

RESULTS

Patients who displayed a gradual increase in MRD levels showed a higher relapse rate (90% v22%; P < .00001) and shorter median RFS (12 months v not reached; P < .0001) than those with stable or decreasing MRD levels. This adverse prognostic influence also was observed when children and adults, as well as B-ALL and T-ALL patients, were analyzed separately. An MRD level > or = or greater than 10(-3) discriminated two risk groups of ALL patients with significantly different relapse rates and RFS at all treatment phases (end of induction, consolidation, maintenance, and out of treatment).

CONCLUSION

Multiparametric flow cytometry of MRD in ALL patients is a valuable tool for relapse prediction and for the identification of a cohort of patients with very poor prognosis.

[Ribotypes of strains of Pseudomonas aeruginosa in a patient with cystic fibrosis]

BACKGROUND

Pseudomonas aeruginosa is the major causative agent of respiratory infection in cystic fibrosis (CF) patients, and its presence in sputum is related with important deterioration of lung function in affected patients, thus a methodical monitorization and control of such a microorganism is decisive in the clinical status of the patient. Due to the limited effectiveness of phenotypic subtyping techniques, it is necessary to use molecular characterization methods.

MATERIAL AND METHODS

We have studied the respiratory secretions periodically obtained over a period of time of 19 months, screening for total bacterial counts, P. aeruginosa load and genomic analysis of isolates using a ribotyping protocol.

RESULTS

This study has showed the chronical and transitory carriage of different strains and the relation of increased bacterial counts with clinical deterioration periods.

CONCLUSIONS

We consider that the use of molecular markers can be of great interest in the epidemiological surveillance of P. aeruginosa in CF patients.

IL-6 deficiency leads to increased emotionality in mice: evidence in transgenic mice carrying a null mutation for IL-6

The role of interleukin-6 (IL-6) on emotional behavior was studied in two experiments using transgenic mice carrying a null mutation for IL-6 (IL-6(-/-)). In the first experiment, IL-6(-/-) mice were compared with the two wild-type strains contributing to the genetic background of the transgenic mice, namely C57BL/6J and 129/SvJ, as well as with the F2 offspring of C57BL/6J x 129/SvJ mice. The two parental strains differed substantially in terms of emotional reactivity, suggesting that the F2 offspring were more appropriated for analyzing the effect of the null mutation. IL-6(-/-) mice showed lower levels of ambulation in the holeboard, and lower levels of exploration of the open arms of the plus-maze, than the wild-type F2 C57BL/6J x 129/SvJ mice. In the second experiment, IL-6(-/-) mice were backcrossed for 10 generations to C57BL/6J mice to decrease the uncertainty of the effect of the genetic background, and when compared with wild-type C57BL/6J mice in the holeboard and the plus-maze, the same results were obtained. Therefore, IL-6(-/-) mice seem to be more emotional than their appropriate controls, suggesting that the major cytokine IL-6 is involved in the control of emotionality.

Immunity to porcine rubulavirus infection in adult swine

The immune response against the porcine rubulavirus was analyzed in experimentally infected adult pigs. High titers of virus neutralizing and hemagglutinating inhibitory antibodies were identified in infected animals. The antibody specificity was directed towards HN, M, and NP rubula virion proteins; immunodominance of HN proteins was demonstrated. Peripheral blood mononuclear cells from infected, but not from non-infected pigs proliferated in vitro in response to virus antigenic stimuli, showing a bell-shaped plot with the highest peak at 5 weeks post-infection. Virus-induced lymphoblasts expressed CD4+ CD8+ phenotype, whereas lectin-induced lymphoblasts were mainly identified as CD4+ CD8- cells. Phenotype analysis of freshly prepared PBMC revealed increased number of both monocytes (PoM1+) and total T lymphocytes (CD2+) early during infection, with reduced values of B lymphocytes at 4 weeks post-infection. Decrease in CD4+ CD8- blood cells was observed at 3 weeks post-infection, whereas both CD4- CD8+ and CD4+ CD8+ cells increased 1 and 4 weeks post-infection, respectively. This work discusses the relevance of CD4+ CD8+ T cells in the control of porcine rubulavirus infection.

The influence of reproductive stage on the selenium status of sheep in a low-selenium region

The selenium status of sheep was evaluated during the reproductive stage in a region of low selenium level. Serum selenium concentration, whole blood glutathione peroxidase activity (GSH-Px), which is a good indicator of protection against oxidative damage, as well as the activities of creatine kinase (CK) and aspartate aminotransferase (AST), the plasma indicators of muscle damage, were evaluated in a group of ewes during gestation and lactation and in their lambs. The selenium requirements of ewes were found to increase during lactation. There were no differences in GSH-Px activity between the experimental and the control groups throughout the reproductive stage. In the second half of pregnancy GSH-Px activity was subnormal. In spite of this, no evidence of existing pathologic conditions associated with selenium deficiency was found, since the muscle markers CK and AST were within the normal range. In the same way, no distinct symptoms of nutritional myopathy were observed in the lambs, suggesting that the low selenium level found in the ewes did not cause alterations in their development.

Effect of seasonal acclimatization on the expression of the carp transcription factor Pit-1

We isolated a clone comprising four exons of the carp Pit-1 gene. Using synthetic oligonucleotide probes derived from the carp Pit-1 sequence Pit-1 expression was assessed by in situ hybridization in pituitary sections from summer- and winter-acclimatized carp. Semiquantitative analyses of the hybridization signals revealed a significant higher Pit-1 expression in the proximal pars distalis (PPD) and pars intermedia (PI) of the pituitary glands from summer-acclimatized carp, compared to the winter-acclimatized fish. In both adaptive states, relative to the PPD and PI, only a basal Pit-1 expression was detected in the rostral pars distalis. Thus, during seasonal acclimatization of an eurythermal fish, Pit-1 seems to be involved in the mechanisms that underlie the compensatory response.

Modifications of the form and amplitude of the electrocardiographic QRS complex during growth in the Spanish-bred Horse

Configuration and amplitude values of the QRS complex of the electrocardiogram were studied with standard Einthoven leads in 173 healthy Spanish-bred (Andalusian) horses, aged between 1 month and 17 years. Animals which were 1 month old had a predominantly negative QRS complex, whereas a predominantly positive complex direction was found in the rest of the animals. Statistically significant variations were found for the Q-wave and QRS main vector between the different age groups, with highest values for the Q-wave and most negative values for the direction of the QRS main vector in animals up to 2 months of age. The effect of age on the form and amplitude values of the QRS complex could be related to the changes in size and position of the heart in the thorax during growth. This study provides standard electrocardiographic values for the Andalusian horse at different ages.

Immunophenotypic characterization of plasma cells from monoclonal gammopathy of undetermined significance patients. Implications for the differential diagnosis between MGUS and multiple myeloma

Although the immunophenotype of plasma cells (PCs) from multiple myeloma (MM) patients has been extensively explored, information on the phenotypic characteristics of PCs in monoclonal gammopathy of undetermined significance (MGUS) patients is scanty and frequently controversial. Thus, the question of whether or not PCs are phenotypically different in the two disorders and whether this criteria could be useful for the differential diagnosis between MGUS and MM remains to be explored. In the present study, the immunophenotypic profile of bone marrow PCs (BMPCs) from a group of 76 MGUS patients has been analyzed by flow cytometry and compared with that of BMPCs present in both MM patients (n = 65) and control subjects (n = 10). For that purpose, a large panel of monoclonal antibodies against PC-related antigens was used together with a sensitive methodology in which a minimum of 10(3) PCs were studied. In all MGUS cases studied, two clearly defined and distinct PC subpopulations could be identified. One PC subpopulation, population A (33 +/- 31% of total PCs), constantly displayed a high CD38 expression with low forward light scatter (FSC)/side light scatter (SSC) and was positive for CD19 and negative for CD56 (only a small proportion of these PCs were weakly positive for CD56). The other PC subpopulation, population B (67 +/- 31% of total PCs), showed the opposite pattern; the antigen CD56 was strongly positive and CD19 was constantly negative, and it showed a lower CD38 expression and higher FSC/SSC values than population A. Clonality studies (cytoplasmic light chain restriction, DNA content studies, and polymerase chain reaction assessment) confirmed the clonal nature of PCs from population B and the polyclonal origin of PCs from population A. Moreover, the polyclonal PCs from MGUS displayed a phenotypic profile identical to that found in PCs from healthy individuals. By contrast, clonal PCs from all MGUS patients displayed a similar antigenic profile to myelomatous PCs, with clear phenotypic differences with respect to normal PCs: lower intensity of CD38 expression and a variable reactivity for markers that were not expressed in normal PCs, such as CD28, CD117, and sIg. Although the presence of residual polyclonal PCs was a constant finding in MGUS patients, it was a rare event in MM and, when present (only 22% of MM cases), its frequency was significantly lower than that observed in MGUS (0.25% versus 32.9%, respectively; P < 0.0001). Only 1.5% of patients with MM had more than 3% of normal PCs, whereas 98% of patients with MGUS had more than 3%. Moreover, as shown by multivariate analysis, the number of residual polyclonal PCs was the most powerful single parameter for the discrimination between MGUS and MM patients at diagnosis, even when only stage I MM cases were considered.

[Prospective 3-month study of intravascular catheter complications in HIV-infected patients: relation between phlebitis and infection]

BACKGROUND

The aim of this study was to evaluate the etiology of phlebitis (chemical or infectious) and the prevalence of infections related to intravascular catheters (IRIC) in patients with HIV infection admitted to a 22-bed Infectious Disease Unit with a high rate of HIV infection.

MATERIAL AND METHODS

A 3-month prospective study from November 1, 1994 to January 31, 1995 was carried out following a formula for data collection of all the intravenous catheters used during that time period. Cultures of the catheters withdrawn on Wednesdays and those with signs of phlebitis were performed.

RESULTS

One hundred fifty-two intravenous catheters in 71 patients with HIV infection with a mean age of 37 years (range: 21-73) and mean hospital stay of 10.2 days were reported. During the study period 42 phlebitis were produced, of which 37 catheters (7 central and 30 peripheral) were processed. Of the 37 phlebitis processed, 29 (78.9%) were considered to be of physiochemical origin. Of the 21 catheters withdrawn Wednesday, 18 were processed, 8 with phlogotic signs, 2 with IRCI, equivalent to 1.9 IRCI/100 days of catheterization. During the study period no local or severe systemic infections related to the catheter were reported. Staphylococcus epidermidis was the organism involved in all the cases of IRCI.

CONCLUSIONS

Despite the high number of immunosuppressed patients in related to HIV infection, a greater incidence of IRCI was not found in these patients. The most frequent cause of phlebitis by catheter was of chemical origin.

Secondary structure prediction of the hemagglutinin-neuraminidase from a porcine rubulavirus

The Hemagglutinin-Neuraminidase (HN) from 'La Piedad, Michoacan' porcine rubulavirus (LPMV) interacts specifically with NeuAc alpha 2,3 lactose residues on the target cell. In this work we report the secondary structure of this protein, determined with five different theoretical algorithms. Results indicate that the HN protein is organized in: an intracellular region (from amino acid 1 to 25); in a beta-strand transmembrane region (residue 26 to 47), typically hydrophobic, rigid and solvent inaccessible; and extracellular region (48 to 576), which possesses hemagglutinating and neuraminidase activity. The secondary structure in this region is organized in a beta-loop-beta alternated with few alpha-helices. Regions with structural and functional implications were determined by pattern search and multiple alignment of the HN from LPM with 12 rubulaviruses and paramyxoviruses HN sequences. The low diversity observed among the HN sequences evaluated indicates that in general the structural organization of the protein, and in particular its sugar binding domain, is closely related among both genera, thus suggesting that the sugar binding domain is well preserved through evolution.

Characterization of Lactobacillus sake isolates from dry-cured sausages by restriction fragment length polymorphism analysis of the 16S rRNA gene

Lactobacillus sake strains originally isolated from dry-fermented sausages were characterized by phenotypic and genotypic methods, including DNA-DNA hybridization, restriction fragment length polymorphism (RFLP), and 16S rDNA sequencing analysis, in order to establish their taxonomic position and relation to well defined reference species. Initially, isolates of Lact. sake showing a characteristic phenotype (melibiose-positive, maltose- and arabinose-negative) were identified by DNA-DNA hybridization. Subsequently, RFLP studies using EcoRI and HindIII as restriction enzymes, and cDNA from Escherichia coli or 16S rDNA from Lact. sake strains as probes, showed distinct polymorphism levels. Thus, EcoRI-digested DNA probed with cDNA from E. coli disclosed the presence of a unique cluster for the meat isolates tested, allowing their differentiation from the reference type strain. When HindIII-digested DNA was hybridized with the cDNA probe, strain-specific patterns were obtained, showing a higher discrimination power. Considerable strain differentiation was also observed when EcoRI and HindIII digests were hybridized with 16S rDNA probes. Finally, sequence analysis of the 16S rDNA from one isolate also revealed a certain degree of genetic variability with respect to the reference strain of Lact. sake.

Endotoxin and intracerebroventricular injection of IL-1 and IL-6 induce rat brain metallothionein-I and -II

Metallothioneins (MTs) are a family of proteins which in mammals is comprised of four isoforms (MT-I-IV). MT-I and MT-II are expressed in many tissues, whereas MT-III is expressed exclusively in the central nervous system (CNS). In contrast to the liver, the knowledge of the regulation of the different MT isoforms in the brain is scarce. A number of cytokines have been shown to be important regulators of MT synthesis in vivo and in vitro. In accordance with this concept, the i.p. administration of endotoxin, which elicits the release of cytokines not only in peripheral tissues but also in the brain, caused an overall increase of MT-I + II levels in the rat brain which was very significant in medulla + pons and cerebellum. Among the putative cytokines involved in endotoxin-elicited brain MT-I+II induction, interleukin-1 (IL-1) and interleukin-6 (IL-6) are likely candidates. These cytokines have a variety of effects in the brain, and they are major regulators of MT-I+II synthesis in tissues such as the liver. Here we show the administration of IL-1 and IL-6 into the third ventricle increased MT-I+II protein levels in specific brain areas in the rat. IL-1 tended to increase MT-I+II levels in all brain areas studied, but significantly in the striatum, hypothalamus, medulla + pons and cerebellum. The effect of IL-6 was more restricted, but a significant increase of MT-I+II levels was still observed in frontal cortex, hypothalamus and cerebellum. The results suggest that IL-1 and IL-6 are important regulators of brain MT-I+II and that these cytokines could mediate MT-I+II induction after an immunological insult.

Functional and biochemical evidence for diazepam as a cyclic nucleotide phosphodiesterase type 4 inhibitor

1. The responses of the electrically-driven right ventricle strip of the guinea-pig heart to diazepam were recorded in the absence and in the presence of different selective cyclic nucleotide phosphodiesterase (PDE) inhibitors. 2. Diazepam, at concentrations ranging from 1 microM to 100 microM, was devoid of effect on the contractile force in this preparation. 3. Conversely, diazepam (5 microM-100 microM) produced a consistent positive inotropic response in the presence of a concentration (1 microM), that was without effect in the absence of diazepam, of either of the selective PDE 3 inhibitors milrinone or SK&F 94120, but not in the presence of the selective PDE 4 inhibitor rolipram. 4. This effect of diazepam was not gamma-aminobutyric acid (GABA)-dependent, since it was neither mimicked nor potentiated by GABA, and was not affected by either a high concentration (5 microM) of the antagonists of the benzodiazepine/GABA/channel chloride receptor complex, picrotoxin, flumazenil and beta-carboline-3-carboxylic acid methyl ester (betaCCMe), or by the inverse agonists, beta-carboline-3-carboxylic acid N-methylamide (betaCCMa) and methyl 6,7-dimethoxy-4-ethyl-beta-carboline-3-carboxylate (DMCM, 0.1 microM). Furthermore, a specific antagonist of the peripheral benzodiazepine receptors, PK 11195 (5 microM), did not influence the effect of diazepam. 5. Biochemical studies with isolated PDEs, confirmed that diazepam selectively inhibits type 4 PDE from guinea-pig right ventricle rather than the other PDEs present in that tissue. The compound inhibited this enzyme in a non-competitive manner. Diazepam was also able to inhibit PDE 5, the cyclic GMP specific PDE absent from cardiac muscle, with a potency close to that shown for PDE 4. 6. Diazepam displaced the selective type 4 PDE inhibitor, rolipram from its high affinity binding site in rat brain cortex membranes, and also potentiated the rise in cyclic AMP levels induced by isoprenaline in guinea-pig eosinophils, where only type 4 PDE is present. 7. The PDE inhibitory properties of diazepam were shared, although with lower potency, by other structurally-related benzodiazepines, that also displaced [3H]-rolipram from its high affinity binding site. The order of potency found for these compounds in these assays was not related to their potencies as modulators of the GABA receptor through its benzodiazepine binding site. 8. The pharmacological and biochemical data presented in this study indicate that diazepam behaves as a selective type 4 PDE inhibitor in cardiac tissue and this effect seems neither to be mediated by the benzodiazepine/GABA/channel chloride receptor complex nor by peripheral type benzodiazepine receptors.