Pharmacokinetic comparison of two albendazole dosage regimens in patients with neurocysticercosis

To evaluate two different dosage regimens for albendazole (7.5 mg/kg twice a day or 5.0 mg/kg three times a day), a study was performed in 10 patients with a diagnosis of parenchymal brain cysticercosis. Each patient received both regimens sequentially according to a randomized, crossover design. Blood and urine samples were taken once the drug steady state had been reached. Plasma levels of albendazole sulfoxide at steady state were determined using a HPLC method. In spite of a great intersubject variability observed with both regimens in the area under the curve (AUC) and in the minimum steady-state plasma concentration (Cp min ss), no statistically significant differences were found in these parameters. We suggest that a regimen of 7.5 mg/kg every 12 h can favorably replace the currently used regimen of 5 mg/kg every 8 h.

[Ectopic ascites secondary to the implantation of a LeVeen shunt]

Insertion of a peritoneovenous shunt is an effective method of treatment of refractory ascites although not free of complications. The incidence of them varies between 20-50%, being obstruction, infection and disseminated intravascular coagulation the more frequent. We report a case of a patient that presented with ectopic ascites in cellular subcutaneous tissue one year after the placement of the shunt. This complication was due to an increase of ascites. Treated with paracentesis the ascites decreased and the ectopic ascites resolved.

The effect of industrial pollution on mercury levels in water, soil, and sludge in the coastal area of Motril, southeast Spain

The total concentration of mercury was determined in samples of water, soil and sludge from the Mediterranean coastal area of Southeast Spain (Motril), where Hg contamination is produced primarily by a local paper mill. Samples were taken at surface level in a 5 Km radius from the factory. The total Hg concentrations varied from 0.117 to 0.760 microgram/g in soil and sludge, and from ND to 2.088 micrograms/L in water. A negative correlation was observed between the distance of the sampling station from the mill and the concentration of Hg in the soil and sludge samples. Similarly, an increase in Hg concentration was observed in the freshwater and wastewater after passing close to the factory.

A reorganized Candida albicans DNA sequence promoting homologous non-integrative genetic transformation

In order to develop plasmids adequate for non-integrative genetic transformation of Candida albicans, a DNA fragment of 15.3 kb was cloned from this organism on the basis of its capacity to convert the integrative Saccharomyces cerevisiae vector YIp5 into a non-integrative one. Southern hybridization analysis, carried out with a labelled DNA probe of 3.6 kb derived from the cloned fragment, showed that it consisted of C. albicans DNA, the hybridization pattern indicating that the corresponding sequences were homologous to several chromosomal regions. The size of the C. albicans DNA promoting autonomous replication in S. cerevisiae was substantially reduced by subcloning. A 5.1 kb subfragment, defined by BamHI and SalI restriction sites, retained autonomous replication sequences (ARS) functional in the heterologous S. cerevisiae system and in C. albicans, when inserted in plasmid constructions that carried a S. cerevisiae trichodermin-resistance gene (tcm1) as selection marker. C. albicans transformants were both of the integrative and the non-integrative type and the plasmids recovered from the latter very often carried a reorganized ARS, indicating that recombination of the inserted ARS DNA had occurred in the homologous host. Successive reorganizations of the ARS insert in C. albicans eventually led to a more stable and much smaller fragment of 687 bp that was subsequently recovered unchanged from transformants. Sequence analysis of the 687 bp fragment revealed four 11-base blocks, rich in A+T, that carried the essential consensus sequence considered relevant for yeast ARS elements in addition to other features also described as characteristic of yeast replication origins.

[Application of bidimensional echocardiography in the diagnosis of ventricular septal defect]

Between 1985-1990 we studied by means of two-dimensional echocardiography 286 patients with isolated ventricular septal defect (VSD). A hundred and sixty three being male and 123 female, as a mean age of 5 +/- 3 months. Sixty two cases (22.3%) reveales associated anomalies and in other 63 (22.4%) there was in the evolution an aneurysm of the septum membranous. The projections used were apical 4-chamber, with or without aortic root; parasternal long-short axis of great arterias or at ventricular level; subcostal 4-chamber; right oblique outlet right outflow tract and left oblique outlet left and right outflow tracts. Patients with VSD smaller than 3 mm were excluded. Perimembranous defects, 189 cases (66%), were more frequent than muscular, 91 31.8%), and subarterial defects, 6 (2.1%). Only 19 (9 apical muscular, 6 perimembranous outlet and 4 perimembranous trabecular) were initially misclassified. The diameter of the VSD was large in subarterial (0.85 +/- 0.1 cm) and perimembranous outlet VSD (0.75 +/- 0.5 cm) compared with the rest. Each group of defects was more easily shown by one particular projection except trabecular muscular defect. In conclusion, we are able to state that two-dimensional echocardiography enables us to discover the size and situation of isolated ventricular defects.

Chronic alcohol intake induces reversible disturbances on cellular Na+ metabolism in humans: its relationship with changes in blood pressure

The effect of chronic alcohol consumption on Na(+)-K+ ATPase, Na(+)-Li+ countertransport, outward Na(+)-K(+)-Cl- cotransport system and the Na+ leak was investigated in red blood cells from 18 normotensive subjects with a daily alcohol intake of more than 150 g. The study was repeated after 3 months of alcohol withdrawal, and results were compared with a group of 20 healthy normotensive teetotalers. Maximal efflux rate (Vmax) and apparent dissociation constant for internal Na+ (KNa) of the Na(+)-K+ pump and the Na(+)-Li+ countertransport were significantly higher in alcohol consumers. A positive correlation between daily alcohol intake and Vmax of both transport systems (p less than 0.05) was observed. These values significantly decreased after alcohol withdrawal. A simultaneous stimulation of the Na(+)-K(+)-Cl- cotransport system after alcohol withdrawal was also observed. Blood pressure values were higher in alcoholics (133.7/82.3) than in abstainers (121.4/75 mmHg) and significantly decreased (128.5/76.9 mmHg) after withdrawal. A positive correlation between the stimulation of the Na(+)-K(+)-Cl- cotransport and the decrease of blood pressure after withdrawal was observed. In conclusion, chronic alcohol intake induces disturbances on red blood cell Na+ metabolism that dissipate with the cessation of drinking. Similar abnormalities also reported in humans and animals with primary hypertension have been associated in the pathogenesis of essential hypertension. Therefore, the pressor effect of chronic alcohol intake could be mediated through these changes in cellular Na+ metabolism.

[The value of ADA in peritoneal tuberculosis]

The aim of this study was to confirm that ascitic fluid determination of adenosine deaminase activity (ADA) is useful for the diagnosis of tuberculous peritonitis. 109 patients with ascites have been studied; 4 had tuberculous peritonitis and 105 nontuberculous ascites. The mean value of ascitic fluid AQDA was 0.587 +/- 0.2 uKat/l in tuberculous peritonitis and 0.11 +/- 0.1 uKat/l in nontuberculous ascites (p less than 0.001). An ADA value upper than 0.40 uKat/l has a sensitivity of 100% and a specificity of 99% for diagnosing tuberculous peritonitis. Ascitic fluid determination of ADA is simple, cheap and has a good diagnostic accuracy. In countries with high incidence of tuberculosis, measurement of ADA in ascitic fluid should be used as screening test for tuberculosis.

Poroid hidradenoma: a light microscopic and immunohistochemical study

Poroid hidradenoma is a recently described variant of the eccrine poroma group of tumors. This neoplasm shows architectural characteristics of hidradenoma (tumor cells confined entirely within the dermis in both solid and cystic components) and cytologic characteristics of poroid neoplasm (poroid and cuticular cells, the latter showing ductal differentiation). Therefore the term "poroid hidradenoma" seems to be the most appropriate. We document herein a case of poroid hidradenoma studied by immunoperoxidase techniques. Our immunohistochemical results are similar to those of other poroid neoplasms. These also support the inclusion of this tumor as the fourth variant within the eccrine poroma group of tumors.

Complex adnexal tumor of the primary epithelial germ with distinct patterns of superficial epithelioma with sebaceous differentiation, immature trichoepithelioma, and apocrine adenocarcinoma

A 60-year-old man came for treatment of a sharply outlined erythematous plaque on the gluteal area (45 x 20 mm) of 20 years' duration. Eccentrically located on the plaque was a nodule, 20 mm in diameter. Histological study of the plaque showed a superficial platelike tumor with basaloid bland cytology and sebaceous gland differentiation. Histologic study of the nodule found an undifferentiated adenocarcinoma whose ductlike glandular structures opened to the skin surface and infiltrated the whole depth of the dermis. Study of other areas of the lesion detected two more neoplasms. A nodule of squamous cell carcinoma was found within the superficial band of the benign sebaceous tumor. The fourth neoplastic pattern consisted of epithelial islands composed of basaloid cells within a fibroblastic stroma. There was prominent palisading of epithelial cell nuclei at the periphery of the islands, which usually were surrounded by a sheath of mesenchymal cells. In this complex adnexal tumor of the primary epithelial germ, sebaceous and follicular differentiation both simulate neoplastic patterns recently described as separate entities: superficial epithelioma with sebaceous differentiation and immature trichoepithelioma. The undifferentiated adenocarcinoma may represent differentiation toward the third component of the germ, that is, the apocrine gland.

Determination of arsenic in fish by hydride generation atomic absorption spectrometry

A method utilizing microwave dissolution in a closed Teflon bomb followed by hydride generation atomic absorption spectrometry has been used for the routine analysis of arsenic in fish species from the coast of the province of Granada, Spain. The technique was evaluated for decomposing biological standard reference material (BCR mussel tissue) for arsenic analyses. The precision of the results ranged from 2.78 to 6.99%. The recovery percentages ranged from 96.33 to 100.00%. The values determined in the samples indicated slight contamination by this element in the zone. The concentrations of arsenic in fish ranged from 0.396 to 45.716 micrograms/g.

[Prevalence of lipid disorders and their course after blood pressure control in essential arterial hypertension]

BACKGROUND

Arterial hypertension and hyperlipidemia are the principal factors of cardiovascular risk with an association which appears to obey common pathogenic bonds. In the present study the initial prevalence of hypercholesterolemia and hypertriglyceridemia was determined in a sample of essential hypertensives and the long term effect of different antihypertensive treatments on lipid metabolism has been analyzed.

METHODS

Total cholesterol, its LDL and HDL fractions and plasmatic triglycerides were determined in a sample of 158 hypertensive patients prior to the initiation of antihypertensive treatment and following one year of normotension.

RESULTS

The initial prevalence of lipid disturbances was of 47% (isolated hypercholesterolemia 17%, isolated hypertriglyceridemia 14% and mixed anomalies 16%). After one year of tension control the initial prevalence was not modified. In the patients controlled with a low sodium diet a decrease in total cholesterol and an increase in cholesterol-HDL were observed in those treated with atenolol, and a decrease in cholesterol-LDL was seen in those receiving captopril. The group treated with nifedipin presented no significant variations of the lipid profile.

CONCLUSIONS

The prevalence of lipid disturbances is greater among the hypertensive patient than in the general population. The rational treatment of a hypertensive patient must not only regard blood pressure figures but also control the other risk factors since the drugs commonly used in the treatment of arterial hypertension generally demonstrate a neutral effect on lipid metabolism.

Blood eosinophilia in Hodgkin's disease. A follow-up of 25 cases in Venezuela

Twenty-five patients with Hodgkin's disease and high eosinophil counts were observed for an average of 90 months. Fluctuations in the levels of eosinophils were important in the course of observation. No relation with stages, histologic type, or evolution was noticed. Steroid-containing regimens and severe premortem conditions seemed to lower the counts. Relapse-free survival was shorter in our 25 patients than in a control group of 50 patients with Hodgkin's disease and no eosinophilia who had approximately the same stage, histologic type, and treatment of disease. However, the overall survival was somewhat better for the eosinophilic patients with stages IIIB and IV (0.1 greater than P greater than 0.05).

An amino-proximal domain required for the localization of FtsQ in the cytoplasmic membrane, and for its biological function in Escherichia coli

The location of FtsQ, an Escherichia coli protein essential for cell division, is, under physiological conditions, in the cytoplasmic membrane facing towards the periplasmic space. An amino-proximal hydrophobic domain is required for FtsQ to reach its location and for its activity in the cell. Overexpression of modified forms of FtsQ is deleterious for the cell.

A protein kinase gene complements the lytic phenotype of Saccharomyces cerevisiae lyt2 mutants

By genetic analysis of a thermosensitive autolytic mutant whose phenotype was complemented by osmotic stabilization with sorbitol, we identified gene LYT2 of Saccharomyces cerevisiae, which is probably involved in cell wall formation. A yeast gene complementing lyt2 strains was cloned and shown to carry an open reading frame coding for a 484-amino-acid protein exhibiting all the characteristic domains of serine/threonine protein kinases and highly homologous to other yeast protein kinases involved in control of the mitotic cycle. Mutants disrupted in the cloned gene also displayed an autolytic phenotype complemented by osmotic stabilization with sorbitol. However, genetic comparison of lyt2 mutants and disruptants of the protein kinase gene revealed that the cloned gene is not the structural gene LYT2 but a suppressor of the lytic phenotype, named gene SLT2, that was mapped to chromosome V. The product of gene SLT2 is the first protein kinase to be described in relation to the yeast cell-wall functions.

An unusual benign neural tumour with stellate-cell morphology

We report a stellate-cell dermal tumour which was studied by immunohistochemistry and electron microscopy. The stellate morphology of the tumour cells appeared to be due to retraction of their cytoplasm resulting in the emergence of intercellular spaces. Results of the immunohistochemical investigations were consistent with a neural tumour, but we could not assign it to any particular category of the known neural tumours. Therefore we have designated this tumour as an unusual, benign, neural-tumour with stellate-cell morphology.

Therapeutic response may be predicted by some clinical parameters in essential hypertensive patients

Several clinical parameters have been studied in a sample of 211 essential hypertensives in order to determine their usefulness as predictors of therapeutic response. One hundred and twenty-four patients (58.8%) achieved normotension with monotherapy, whereas 87 hypertensives (41.2%) needed two or more drugs to control their BP values. Patients who required a combination of drugs exhibited higher levels of systolic and diastolic BP, higher frequency of acute severe hypertension before the beginning of treatment, a more advanced stage of hypertension, and higher plasma aldosterone levels when they were compared with those controlled with a single drug. Likewise, previous cardiovascular complications related to hypertension, enlargement of cardiac silhouette on chest x-ray films and left ventricular hypertrophy were more frequent in the former. By means of a logistic regression analysis, these last three parameters showed a significant relationship with the number of required drugs. We conclude that hypertensives exhibiting this clinical profile have a higher probability of requiring a combination of drugs in the pharmacological treatment of essential hypertension.

Clear cell squamous cell carcinoma. A histologic, immunohistologic, and ultrastructural study

Squamous cell carcinomas (SCCs) usually show a standard histopathologic picture only varying with regard to their degree of differentiation. The authors describe a case of clear cell SCC that was studied by light and electron microscopy. The clear cells showed an empty cytoplasm that was periodic acid-Schiff and alcian blue negative. By electron microscopy these cytoplasms consisted of empty spaces and were not surrounded by membranes, which would be consistent with lipid vacuoles. The differential diagnosis of this uncommon variant of SCC requires consideration of other clear cell tumors.

Preferential cytoplasmic location of FtsZ, a protein essential for Escherichia coli septation

An ftsZ thermonull mutant has been constructed in which the ftsZ gene has been deleted from the Escherichia coli chromosome while maintaining a wild-type copy of the gene in a thermosensitive plasmid. Under conditions in which the ftsZ+ allele is unable to be replicated at the same pace as the chromosome, the cells become non-viable and grow as filaments, indicating that, contrary to other reports, FtsZ performs a function essential for cell survival. Antibodies raised against FtsZ have been used to detect the cellular location of FtsZ and its contents per cell. Fractionation experiments indicate that most of the total FtsZ present in the cell stays in the cytoplasm.

Choriocarcinoma of the testis metastatic to the skin

A case of choriocarcinoma of the testis metastatic to the skin is reported. In this case report the primary tumor was first diagnosed by the histopathologic findings in the cutaneous biopsy of a single nodule that appeared on the chest, with both syncytiotrophoblastic and cytotrophoblastic cells in the metastatic solid tumor islands. Using peroxidase-antiperoxidase techniques, beta-human chorionic gonadotropin (beta-HCG) was positive within the cytoplasm of syncytiotrophoblastic cells. The patient was treated with orchiectomy, chemotherapy, and radiotherapy. With these measures there was a decrease of chorionic gonadotropin serum levels to normal limits and 2 years after this treatment there is no evidence of recurrence.

Epidemiological aspects of Mendelian syndromes in a Spanish population sample: I. Autosomal dominant malformation syndromes

Using a sample of 710,815 liveborn infants throughout Spain, monitored from April, 1976, to December, 1988, by the Spanish Collaborative Study of Congenital Malformations (ECEMC), we estimated the prevalence of each recognized autosomal dominant malformation syndrome for a total prevalence figure of 12.1 per 100,000 live births, including all detected autosomal dominant malformations syndromes. We estimated that the mutation rate for those syndromes was 48.5 per 1,000,000 gametes. The geographical distribution of these syndromes was homogeneous in the Spanish Regions.

Epidemiological aspects of Mendelian syndromes in a Spanish population sample: II. Autosomal recessive malformation syndromes

From April, 1976, to December, 1988, the Spanish Collaborative Study of Congenital Malformations (ECEMC) monitored a total population of 710,815 liveborn infants in 16 of 17 Spanish Regions and identified 14,439 (2.0%) with congenital defects. Among the malformed children, we identified 73 with well recognized autosomal recessive syndromes, for an overall prevalence rate of 10.3 per 100,000 livebirths and a total carrier frequency of 1/49. Considering the Spanish Regions (Comunidades Autónomas), we analyzed the geographical distributions of these syndromes that were homogeneous. We studied the place of birth of the grandparents to determine the distribution of the gene as well as the gene flow.

[Do clinical parameters exist that permit predicting the need to combine a diuretic with captopril in the initial treatment of essential arterial hypertension?]

In the present work the clinical, biological, radiological, electrocardiographic and hormonal characteristics are analyzed in 51 patients suffering mild essential hypertension, in whom treatment with captopril in monotherapy or associated to chlortalidone managed to normalize arterial pressure and maintained the pressure control during a period of one year. Captopril in monotherapy at a dose of 50 to 150 mg/day normalized blood pressure in 34 patients (66.7%) while in the remaining 17 patients (33.3%) the association of 25 mg of Chlortalidone was required. When comparing the subgroup of patients whose blood pressure levels were controlled with captopril as the only used drug (Group A) against those who required the association with diuretics (Group B), we could only observe significant differences regarding the blood pressure level and cardiothoracic index, being these higher in the group of patients who required pharmacologic association. We conclude that only the severity of hypertension allows to predict the necessity of associating a diuretic to captopril in order to obtain the control of blood pressure levels.

Papillary eccrine adenoma--a light-microscopic and immunohistochemical study

We report a case of papillary eccrine adenoma. This benign cutaneous tumour had a diagnostic microscopic appearance that consisted of multiple dilated ducts lined by two or more layers of cells. The inner layer often formed intraluminal papillary projections of variable complexity. The lumina were filled by eosinophilic amorphous material. Immunoperoxidase studies showed carcino-embryonic antigen in the luminal border of the ducts, but S-100 protein was absent for tumoral ducts. We discuss the eccrine and apocrine differentiation of this neoplasm on the basis of the immunoperoxidase results. The differential diagnosis includes other cutaneous neoplasms with intraductal papillary proliferation.

Angioleiomyoma within a histiocytoma

We report an angioleiomyoma developed within a cellular histiocytoma on the calf of a 77-year-old man. The lesion consisted of a spherical nodule with two well-defined concentric areas. The outer circular area was a cellular histiocytoma and the inner central area consisted of an angioleiomyoma. Immunoperoxidase investigations for desmin demonstrated positivity in the angio-leiomyoma, whereas the histiocytoma remained negative. Serial sections of the lesion failed to demonstrate a connection between the angioleiomyoma and a normal vein which could have been trapped by the histiocytoma. The angioleiomyoma may have originated from a vessel in the histiocytoma.

[The clinical profile of hypertensive patients can predict the need for combining a second or third drug with atenolol in the initial treatment of light and moderate essential arterial hypertension]

In this study the clinical, biological, radiologic, electrocardiographic, and hormonal characteristics of 80 patients with slight or moderate essential arterial hypertension in whom the treatment with atenolol alone or associated with chlorthalidone or with a third agent normalized the arterial pressure during a period of one year, are revised. Atenolol given alone at the dose of 50 to 100 mg per day normalized the blood tension in 44 (55%) patients, in 26 cases (32.5%) the association of chlorthalidone 25 mg/day was required, and in the remaining 10 patients (12.5%) a third pharmacologic agent was needed. Patients who required the association of three agents (group C) had systolic arterial pressures significantly higher than those observed in patients treated with atenolol alone (group A) (176.6 +/- 14.3 vs 161.4 +/- 12.9 mmHg, p less than 0.01) and higher to those measured in patients who required the association of chlorthalidone (group B) (176.6 +/- 14.3 vs 162.8 +/- 15 mmHg, p less than 0.05). On the other hand the 44 hypertensive patients controlled with monotherapy showed a lower incidence of cardiovascular complications (6.8% in group A, 38.5% in group B, and 30% in group C, p = 0.0042), they required acute treatment for hypertensive crisis (34.1% in group A, 73.1% in group B, and 66.7% in group C, p = 0.0041), and they showed electrocardiographic signs of left ventricular hypertrophy or overload (26.2% in group A, 60% in group B, and 42.9% in group C, p = 0.0228).(ABSTRACT TRUNCATED AT 250 WORDS)

Nocturnal growth hormone surges in type 1 diabetes mellitus are both sleep- and glycemia-dependent: assessment under continuous sleep monitoring

Our work has studied the relationship between nocturnal growth hormone (GH) surges, sleep and glycemia in seven conventionally treated type 1 diabetic patients under continuous sleep monitoring and the results were compared to those found in five age-matched healthy controls. On the experimental day, sleep was monitored from 24.00 to 07.00. Blood glucose levels and GH were assayed in both groups. As a group the diabetics had nocturnal GH responses higher than those in controls. However, the sleep-related GH release is not abnormally high in patients who maintain strict normoglycemia. Early-night hypoglycemia and/or rapidly decreasing blood glucose concentrations enhance sleep-related GH secretion in diabetics, whereas hypoglycemia not associated with slow-wave sleep (SWS) causes a moderate increase in GH. Late-onset nocturnal hypoglycemia is not potent enough to stimulate GH. It is proposed that in diabetics sleep-related GH production is probably not abnormally elevated within a wide range of stable glucose levels, but when these thresholds are crossed or when there is a rapid decrease in blood glucose, then GH secretion is inversely related to the changing blood glucose. Therefore, our study supports the conclusion that sleep-related GH secretion is finely modulated by the actual glycemic fluctuations in diabetic patients.

Aggressive keratoacanthoma of the eyelid: "malignant" keratoacanthoma or squamous cell carcinoma?

We report an aggressive keratoacanthoma of the upper eyelid that recurred at the site of a previously excised keratoacanthoma. The diagnosis was confirmed by biopsy. Because the surgery required would be extensive, medical therapy was tried first. The tumor was treated with intralesional injections of 5-fluorouracil and radiotherapy. Despite this therapy, the orbital computed tomogram showed tumor extension into the orbit, and an orbital exenteration was performed. Histopathology of the excised tumor was consistent with squamous cell carcinoma. We discuss the topic of malignant transformation of the keratoacanthoma.

Trichogenic trichoblastoma. An unusual neoplasm of hair germ

Tumors of hair germ are a very rare group of primary cutaneous neoplasms that have been divided into two groups: epithelial and mesenchymal. Epithelial neoplasms of hair germ are further subdivided into those that are purely epithelial (trichoblastomas) and into epithelial neoplasms with mesenchymal components that may cause inductive changes toward the earliest phase of hair follicle differentiation (trichoblastic fibroma) or a more advanced and complete hair follicle formation (trichogenic trichoblastoma). We herein report an ulcerated trichogenic trichoblastoma whose epithelial and mesenchymal components recapitulated the formation of numerous primitive dermal papillae of the hair bulb because there were numerous strands of small polygonal epithelial cells that delimited areas of a dense and abundantly cellular connective tissue in a hair papilla-like pattern.

Follicular lymphomatoid papulosis

A case of follicular lymphomatoid papulosis was studied by light- and electron-microscopic methods. The nature of atypical cells was analyzed with monoclonal antibodies. This case proved to be mainly a type B lymphomatoid papulosis with a predominance of T-helper markers in atypical lymphoid cells. All previously reported cases of this rare variant corresponded to type A lymphomatoid papulosis. Therefore we believe this to be the first case report of type B follicular lymphomatoid papulosis.

Periungual porocarcinoma

We describe a patient who developed a porocarcinoma in the nail bed. His profession had exposed him to X-rays for many years, resulting in chronic radiodermatitis of several digits on both hands. He displayed an ulcer in the lateral nail fold of the right third digit which extended into the nail bed. The histology of the lesion was consistent with malignant eccrine poroma. Porocarcinoma has not been previously published in this location and this tumor must be considered in differential diagnosis of subungual malignant tumors.

[Right aortic arch with retro-esophageal aorta. Diagnosis by computerized axial tomography]

The case of a patient with right aortic arch and retro-esophageal aorta associated with a perimembranous ventricular septal defect with a mild fibrous subaortic stenosis is presented. The existence of the retro-esophageal segment of the aorta was confirmed by left ventriculography and computerized axial tomography. This patient is the first to be diagnosed by axial tomography in our country.

Simultaneous occurrence of junctional nevus and seborrheic keratosis

A 45-year-old man presented with a pigmented lesion on his face. A clinical diagnosis of melanocytic nevus was made and the lesion was excised. Histopathologic examination showed a reticular seborrheic keratosis associated with a junctional nevus. We discuss the relation of nevocellular nevi with epidermal and adnexal tumors.

Ultrasonic patterns observed in hepatic metastases from breast carcinoma: diagnosis and evolution

A retrospective analysis was made of 78 patients presenting breast neoplasm with hepatic metastases confirmed by ultrasound. Clinical hepatomegaly was present in 61%. The serum glutamic-oxaloacetic transaminase (SGOT) was elevated in 72%, the serum glutamic-pyruvic transaminase (SGPT) in 56%, the serum alkaline phosphatase (Aph) in 86%, and the gamma-glutamil transpeptidase (GGT) in 76%. A hypoechogenic multiple nodular pattern (HMN) was observed in 69%, a diffuse hypoechogenic pattern (DH) in 15%, and a mixed multiple nodular pattern (MMN) in 11%. No single nodular pattern was presented in any patient. The univariate analysis showed a better survival rate in patients with a mixed pattern (mean 11 months, range 1-29 months) (p = 0.027). No significant differences were observed regarding the remaining patterns, age, presence or not of hepatomegaly, or altered enzymatic values.

Interactions between oxytocin- and calcium-modifying agents in the rat testicular capsule in vitro

We have studied the effect of drugs which affect the movement of calcium on the contractions induced by 50 and 200 nM oxytocin in the isolated testicular capsule of the rat. The ED50 for oxytocin in this preparation was 188 (+/- 66 S.E.) nM and the maximal contraction induced by oxytocin was smaller than that obtained with 10 microM of the calcium ionophore, A23187. Lanthanum (10 mM), cobalt (2 mM), EGTA (3.5 and 5 nM, 30 s exposure) and a decrease in the calcium concentration of the medium reduced the oxytocin response. The response was completely abolished after prolonged incubation with EGTA (2 mM) in a calcium-free medium. The calcium blocking agents, nifedipine and flunarizine, and the agonist, Bay K 8644, did not modify the responses to oxytocin. Verapamil, at possibly non-specific doses (10 microM), reduced the contractions while diltiazem (0.1 mM), in a prazosin (10 microM)-resistant way, and nickel (0.1 mM) increased them. Both modifiers of intracellular calcium that were used namely TMB-8 (10 microM), in a calcium-free medium, and dantrolene sodium (10 and 30 microM), with and without calcium in the medium, decreased the oxytocin response. On the whole, it seems as if both intra- and extracellular calcium were involved in the contractile effect of oxytocin, although extracellular calcium does not seem to gain access to the cell through voltage-dependent calcium channels sensitive to selective calcium entry blockers.

Chemical warfare. Cutaneous lesions from mustard gas

Cutaneous lesions of eight patients evacuated from the Iran-Iraq war zone are reported. The patients were exposed to mustard gas, and there was a spectrum of dermatologic lesions. In the mild cases only there was a sunburnlike erythema, but in the most severe cases this erythema was followed by large and disseminated bullae, which histologically showed a subepidermal location with full-thickness epidermal necrosis. The resorption of these blisters was followed by hyperpigmentation, which was more evident in the intertriginous areas. In these last cases there also were ocular, respiratory, and gastrointestinal manifestations. In the skin this mustard gas seems to act through a primary irritant mechanism and without allergic contact sensitization.