[Importance of n-3 polyunsaturated fatty acids (n-3 PUFA) in nutritional recovery]

Severe protein deprivation at weaning, may cause a stop in cellular proliferation and absolute number of T cells W3/13+ in the thymus of growing rats. The administration of a 20 g/100 casein recovery diet supplemented with 24 mg of n-3 PUFA during 9 days, counteracted this effect suggesting for these essential nutrients a dose-dependent response. No changes were observed in hemostastic factors such as protrombine time (QUICK) and partial active tromboplastine time (KPTT). Even though total plasma lipids showed no changes, the LDL-cholesterol fraction presented a low increment in agreement with international data. Daily administration of this supplemented diet did not show an increase in hepatic lipid peroxidation in the experimental group, suggesting that natural antioxidants and vitamin E provided by the diet might be playing a protective role.

[Possible factors associated with epidemic neuropathy in Cuba]

Of the 115 patients who suffered from epidemic neuropathy and received attention from March 16 de April 30, 1993, at the Center for Medical and Surgical Research (CMSR), in Havana City, 114 controls were selected at random in the community. In the univariate analysis it was found a significant association mainly with the smoking habit (odds ratio = 3.45 [95% confidence interval 1.85 to 6.35)] and with the consumption of edible fat of uncertified procedence (odds ratio = 2.77 [95% confidence interval 1.34 to 5.8]). All were ratified in the multivariate logistical regression analysis. Association (odds ratio = 8.8 [95% confidence interval 2.58 to 30.55] with the presence of antibodies against the Coxsackie virus A-9 strain 47 was also found among the 182 individuals who had serological test. It seems that the toxic factor derived from the smoking habit, together with the deficiency of some nutrients due to the changes occurred in the diet, as well as the contact with the isolated virus in one of the patients facilitated the clinical expression of this disease and therefore in the origin of the epidemics.

Enantiomerically Pure alpha-Alkylidene beta-Amino Esters from Asymmetric Addition of Metal Dienolates to N-Sulfinylimines

Lithium dienolate of 3-butenoic methyl ester was reacted with enantiomerically pure N-arylsulfinyl phenylimines (1 and 2) under different conditions. The reactions were completely regioselective-the C-C coupling occurs at the 2-position of dienolate-and highly stereoselective at the iminic carbon. In the presence of different Lewis acids (ZnCl(2), ZnBr(2), and ScTf(3)) mixtures of two alpha-vinyl, beta-arylsulfinylamino esters (epimers at C-alpha) were obtained, being the stereoselectivity depending on the nature of the aryl sulfinyl moiety and the Lewis acid used. Desulfinylation of these mixtures followed by isomerization of the double bond with Na(2)CO(3) allowed the synthesis of the optically pure (E)-alpha-ethylidene-beta-amino ester 10 in quite high overall yield. The addition of the lithium dienolate to sulfinylimines in the absence of the Lewis catalysts yielded mixtures containing important amounts of the optically pure N-arylsulfinyl alpha-ethylidene-beta-amino esters, which became the exclusive product of the reaction when N-2-methoxynaphthylsulfinyl phenylimine 2 was used as starting product.

Lipoprotein changes in patients with chronic hepatitis C treated with interferon-alpha

OBJECTIVE

The aim of this study was to evaluate the effects of interferon-alpha therapy on the lipid profile of patients with chronic hepatitis C.

METHODS

In 36 consecutive patients with chronic hepatitis C, fasting lipoproteins were evaluated prospectively at baseline, 1, 3 and 6 months during interferon-alpha therapy and 3 months after the end of treatment.

RESULTS

During interferon-alpha therapy, there was a progressive increase in total and very low density lipoprotein (VLDL)-triglycerides, VLDL-cholesterol and a sustained raise in apolipoprotein (apo) B. In parallel, there was a reduction in high density lipoprotein (HDL)-cholesterol and apo A1 levels. In contrast, total and low density lipoprotein (LDL)-cholesterol and lipoprotein (a) levels remained essentially unchanged during interferon-alpha therapy. Three patients developed chylomicronemia, two of them with severe hypertriglyceridemia, although none of them presented with pancreatitis. Chylomicronemia and severe hypertriglyceridemia were more common in patients with basal triglycerides above 200 mg/dl. Nineteen patients responded to interferon-alpha therapy, but their lipid profile did nor differ from that of nonresponders. Three months after the end of interferon-alpha therapy lipid changes subsided, although VLDL and HDL-cholesterol and apo B did not reach basal levels.

CONCLUSION

In patients with chronic hepatitis C, interferon-alpha therapy is associated with an increase of total and VLDL-triglycerides, VLDL-cholesterol and apo B, and a decline of HDL-cholesterol and apo A1. The development of chylomicronemia and severe hypertriglyceridemia in some cases makes mandatory a close monitoring of triglycerides during interferon-alpha therapy, particularly among patients with increased triglycerides at baseline.

[Factors associated with the incurability of epidemic neuropathy in Cuba]

56 patients were surveyed and reexamined at the Center for Medical and Surgical Research (CMSR) a year after the onset of the neuropathy epidemic. The possible factors associated with the occurrence were investigated to be studied together with the disease persistence, including the antibody titre of 33 of them, who had a previous serology against the biological agent (strain 47/IPK) isolated from the cerebrospinal fluid of a sick patient. A fourth of the patients (15 cases) were still ill. The loss of weight and the smoking habit were stressed as the factors most associated with the persistence of the clinical manifestations of epidemic neuropathy. In spite of the fact that the small number of patients who underwent the checkup limited the study, this is a basic document about the existent situation a year after the problem happened.

[Investigation of a water-borne Salmonella ohio outbreak]

BACKGROUND

The genus Salmonella is one of the main causes of foodborne and waterborne illness worldwide. It is a major public health concern almost entirely due to S. enteritidis. However, outbreaks caused by Salmonella ohio are rare. We have not found any reference about salmonellosis by S. ohio whose origin was water of a drinking fountain.

METHODS

An epidemiological survey was carried out to investigate the origin of the outbreak, and information was sought on personal details, symptoms, contact with others who had ill as well as a history of eating. Fecal specimens and water samples were cultured for bacterial pathogens including Salmonella. Salmonella isolates obtained were characterized by stereotyping.

RESULTS

A total of 101 persons were exposed. 87 of these were interviewed, but only 59 of these were affected (attack rate: 67.8%), including 56 children and 3 adults. Syndrome was not severe, in general, persisting for a period of 2 days, in average. S. ohio was isolated from the water and from 2 of the 13 stool specimens analysed.

CONCLUSIONS

The outbreak was caused by consumption of water from a drinking fountain which was contaminated by S. ohio. This fountain had not a chlorination system. An outbreak due to S. ohio whose origin is the consumption of water from a drinking fountain is described for the first time in this paper. It can be concluded the importance of keeping a good epidemiological control system to investigate and prevent outbreaks. The control of drinking fountains is also important, to prevent its contamination.

Dietary nucleotides correct plasma and liver microsomal fatty acid alterations in rats with liver cirrhosis induced by oral intake of thioacetamide

BACKGROUND/AIMS

Dietary nucleotides modulate a number of metabolic processes, including long-chain polyunsaturated fatty acid metabolism. In this study, we evaluated the effect of dietary nucleotides on plasma and liver microsomal fatty acid profiles in a rat model of liver cirrhosis induced by oral intake of thioacetamide.

METHODS

Fifty-four female Wistar rats were assigned to one of the following groups: rats in the thioacetamide group (n=45) were given 300 mg thioacetamide/l in their drinking water for 4 months, and rats in the control group (n=9) received water during the same period. After 4 months of treatment, 9 rats in each group were killed. The remaining rats in the thioacetamide group were divided into two new groups, and the animals in each were allowed to recover for 1 or 2 weeks on either a nucleotide-free diet or the same diet supplemented with 50 mg of each of the following: AMP, GMP, CMP, IMP and UMP per 100 g diet.

RESULTS

Saturated (mainly stearic acid), monounsaturated, and n-6 long-chain polyunsaturated fatty acids (mainly arachidonic acid), and also the unsaturation index decreased in plasma of rats with experimental cirrhosis. Administration of the diet supplemented with nucleotides to thioacetamide-treated rats corrected plasma levels of saturated, n-6 long-chain polyunsaturated fatty acids and the unsaturation index. In liver microsomes, the cirrhotic rats showed lower levels of protein and higher levels of palmitic, oleic, linoleic and arachidonic acids. Protein concentrations and levels of all the above-mentioned fatty acids were corrected with the nucleotide-enriched diet.

CONCLUSIONS

Dietary nucleotides contribute to correcting plasma and liver microsomal fatty acid alterations in rats with liver cirrhosis induced by chronic oral administration of thioacetamide.

G proteins are involved in the suppression of collagen alpha 1 (I) gene expression in cultured rat hepatic stellate cells

We analyse the role of the G proteins in regulating collagen gene expression by measuring collagen alpha 1(I) mRNA levels in cultured hepatic stellate cells in basal conditions and after stimulating or inhibiting the major intracellular signalling pathways. Stimulation of Gs protein and adenylyl cyclase or the addition of 8Br-cAMP to the cells led to a decrease in collagen alpha 1(I) mRNA levels, while blocking protein kinase A abolished this effect. Blocking Gi protein, phospholipase A2 and C, calcium channels and calmodulin resulted in a significant increase in collagen mRNA levels. PKC stimulation led to a marked decrease in these levels. These results suggest that collagen gene expression is inhibited by a number of intracellular pathways. A Gs and a pertussis toxin-sensitive G protein seem to initiate cellular response. Transcription factors, acting in these pathways, must be identified. However, it seems that they do not need to be synthesised.

Autologous peripheral blood progenitor cell transplantation mobilized with high-dose cytarabine in acute myeloid leukemia in first complete remission

BACKGROUND

The aim of this study was to increase disease-free survival (DFS) in AML in CR1 using a high-dose cytarabine consolidation plus G-CSF as in vivo purging and mobilization of CD34+ cells before ablative therapy and peripheral blood autograft.

PATIENTS AND METHODS

Fifty-six consecutive AML patients (pts) (including 11 children < 15 years), with a median age of 32 years, were analyzed. After achievement of CR with cytarabine-mitoxantrone (7 + 3) in adults and a BFM-like protocol in children, pts were intensified with cytarabine 2 g/m2 x six doses plus mitoxantrone for adults, or, 3 g/m2 x six doses plus etoposide for children, followed by G-CSF 5 micrograms/kg SC daily. The ablative regimens used were busulfan and cyclophosphamide (Bu/Cy) in standard-risk pts plus etoposide (2400 mg/m2) for high-risk pts.

RESULTS

For the 54 pts who underwent autologous transplant, the median time to reach > 1.0 x 10(9)/l neutrophils was 13 days (8-48), and to reach platelets > 25 x 10(9)/l 32 days (8-364), and the median numbers of red blood cell and platelet units transfused were 3 and 5, respectively. Six pts had treatment-related deaths (11%). The disease-free survival and overall survival at 30 months (mos) for the 56 eligible pts were 61% and 62%, respectively. Only two relapses were observed after 21 mos, while there were 12 relapses within 12 mos.

CONCLUSIONS

The above treatment results in a similar DFS rate as does rescue with bone marrow cells, with faster neutrophil and platelet recovery.

[Effect of n-3 PUFA polyunsaturated fatty acids on the thymus of rats with severe protein depletion]

Severe protein deprivation at weaning provokes an arrest of cellular proliferation and maturation, and an increase of ADA and PNP activities in the thymus of growing rats. A 20% casein diet fed during 9 days was enough to reverse the effect on ADA and PNP. The supplementation with 24 mg/d of n-3 PUFA, was able to recover thymus' cellular proliferation and maturation.

Morfología polínica de Veronica L. (Scrophulariaceae) en el Suroeste de España

Se estudia la morfología polínica, al microscopio óptico y electónico de barrido, de 13 taxones de Veronica L.: V. scutellata, V. anagallis-aquatica, V. anagalloides, V. thriphyllos, V. praecox, V. arvensis, V. peregrina, V. polita, V. agrestis, V. persica, V. cymbalaria, V. hederifolia subsp. hederifolia y V. hedertfolia subsp. triloba. Los resultados confirman el carácter euripolínico del género. Se establecen dos tipos polínicos basados en el modelo de ornamentación. Por último, se discuten los resultados obtenidos y la relación entre los datos palinológicos y otros datos morfológicos.

[Frequency of human trichinosis in Concepción and Arauco, Chile: study in autopsied persons at the Concepción Medico-Legal Service. June 1996-March 1997]

The frequency of trichinosis was determined in 300 dead persons, residents in the provinces of Concepción and Arauco, and requiring necropsy at the Servicio Medico Legal of Concepción. Diaphragm muscle samples were taken from June 1996 to March 1997. The diagnosis was made by trichinoscopy and artificial digestion techniques. Five samples (1.67%) were positive. There was not differences between sexes. Positive cases were found mainly among 30 to 49 years old people belonging to middle-lower class. Both diagnostic techniques showed different sensitivity as a consequence of the parasitic load and on the contrary, the artificial digestion was less sensitive when the cyts were fully calcified.

3D structure of kaliotoxin: is residue 34 a key for channel selectivity?

Kaliotoxin (KTX) is a natural peptide blocker of voltage-dependent K+ channels. The 3D structure of a truncated analogue of KTX (Fernandez et al. (1994) Biochemistry 33, 14256-14263) was determined by NMR spectroscopy and showed significant differences from structures established for other related scorpion toxins. A recent publication with the structure of the complete toxin (Aiyar et al. (1995) Neuron 15, 1169-1181) did not confirm these differences. In this communication we report NMR data for KTX at pH 3.0, 5.5 and 7.2 and the 3D structure obtained from data at pH = 5.5. Complete KTX displays a folding similar to that of other toxins with an alpha-helix and a beta-sheet linked by two disulphide bonds. The pKa of His 34 is anomalously low (4.7-5.2 depending on the buffer) owing to its interaction with two Lys residues (including the essential Lys 27), the charged N-terminus and the side chain of Met 29. Charged residues are placed symmetrically with respect to an axis that approximately coincides with one of the principal components of the moment of inertia of the toxin. His 34, which occupies a well-defined position between two conserved Cys, is located on the centre of a layer of charged groups. Positively and negatively charged residues are found at the same position in related toxins. It is suggested that electrostatic effects modulate the distances between positive charges in flexible side chains, contributing to the fine tuning of the selectivity toward different channel subclasses and that the approximate coincidence between the moment of inertia and the charge axis facilitate the approach of the toxin to the channel. The very low pKa of His 34 implies that it will be completely unprotonated at physiological pH.

[Clinico-pathological correlation in the main types of dementia]

INTRODUCTION

Dementia has became a serious health problem in developed countries. The objective of this study was to establish the possible correlation between the initial clinical diagnosis and the anatomopathological criteria. Pathological confirmation of the cases clinically diagnosed as Alzheimer disease/senile dementia Alzheimer type (AD/SDAT) and multi-infarct dementia (MID) was carried out.

MATERIAL AND METHODS

Twelve brains from demented patients were studied. Brains were removed at post-mortem intervals of 1-3 hours to guarantee an adequate conservation of the tissue. The brains were weighed, fixed for 4 weeks in 10% buffered neutral formalin and coronally sectioned at intervals of approximately 1 cm. Bilateral sections of neocortex from frontal, temporal, parietal lobes, cingulate gyrus, amygdala, hippocampus, thalamus, cerebellum and unilateral sections of locus ceruleus and substantia nigra were taken. Five micrometer sections of the paraffin embedded material were stained by the following methods: hematoxylin-floxine, Congo red and Bielschowsky silver impregnation.

RESULTS

Our neuropathological results showed a high correlation with the initial clinical classification and confirmed the diagnosis of AD/ SDAT in 6 cases, MID in 3 cases and mixed dementia in 1 case. Two cases did not exhibited morphological evidence of dementia.

CONCLUSIONS

We concluded that the methodology applied for the morphologic diagnosis of dementia was feasible, useful and reproducible. Further studies will be necessary using a larger number of sample.

General Method for Asymmetric Synthesis of alpha-Methylsulfinyl Ketones: Application to the Synthesis of Optically Pure Oxisuran and Bioisosteres

The first asymmetric synthesis of oxisuran [1, (methylsulfinyl)methyl 2-pyridyl ketone], a synthetic immunosuppressive drug, is described. Both enantiomers were efficiently synthesized, in optically pure form, using DAG methodology for the key condensation step. Attempts to couple metal enolates of aryl methyl ketones with chiral sulfinyl compounds led to some epimerization at sulfur. This loss of chirality was circumvented by reacting the alpha-lithio derivatives of the N,N-dimethylhydrazones derived from these ketones with either the (R)- or the (S)-methanesulfinate of diacetone D-glucose, to yield the corresponding alpha-(methylsulfinyl)methylhydrazones, with complete inversion of chirality at sulfur. Hydrolysis of the resulting hydrazones with copper(II) chloride gave 1 in optically pure form. The generality of the method was demonstrated by the preparation of the optically active oxisuran analogs, 2-4, in which the pyridyl moiety was replaced by phenyl, furyl, and thienyl moieties, respectively. The optical purities of these products were determined by proton NMR spectroscopy, using chiral shift reagents, following conditions established by the study of racemic mixtures of the beta-keto sulfoxides.

Influence of viral genotype and level of viremia on the severity of liver injury and the response to interferon therapy in Spanish patients with chronic C infection

BACKGROUND

We wanted to investigate the influence of viral genotype on the severity of liver injury and response to interferon and whether the level of viremia differs in accordance with genotype, severity of liver disease, and response to interferon in patients with hepatitis C virus (HCV) infection.

METHODS

We studied 118 patients with HCV-related liver disease. HCV genotypes were determined with a line probe assay, and serum HCV RNA levels with a competitive reverse transcription polymerase chain reaction assay.

RESULTS

HCV type 1b was the most prevalent genotype (88%). It was present in 100% of cirrhotic patients, with or without hepatocellular carcinoma (HCC), but only in 78% of patients with chronic hepatitis (P < 0.001). The response to interferon was better in patients infected with non-1b HCV genotypes (P = 0.002). In a multivariate analysis non-1b HCV genotypes and a low hepatic fibrosis correlated with a favorable response to interferon. Among patients with chronic hepatitis those infected with HCV type 1b were older (P < 0.001), and age was the only independent factor associated with HCV type 1b. Viremia levels differed neither between genotypes nor in response to interferon and was significantly lower in patients with cirrhosis and HCC.

CONCLUSIONS

HCV 1b was associated with more severe liver disease and a worse response to interferon therapy. Non-1b genotypes and a lower liver fibrosis were the only independent predictors of a favorable response to interferon. Levels of HCV viremia differed neither among different genotypes nor in response to interferon and decreased with advanced liver disease.

Involvement of sphingolipids in the endothelin-1 signal transduction mechanism in rat brain

In cerebral cortex, endothelin-1 (ET-1) evoked a decrease of 40% in sphingomyelin (SM) levels together with an increase in both ceramide and glycosphingolipid (GSL) levels (100 and 56% respectively). These facts indicate that ET-1 increases sphingomyelinase activity and, possibly, activates the synthesis of GSL. By contrast, in cerebellum ET-1 seems to activate the hydrolysis of both SM and GSL, since the peptide evoked a decrease (near 30%) of their levels concomitantly with an increased production of ceramides (200%). These ceramides are clearly different from those produced in cerebral cortex which come from the SM hydrolysis only. It is suggested that ETB receptor subtype is involved in these responses.

[Direct percutaneous endoscopic jejunostomy, variation of the technique of gastrostomy]

Percutaneous endoscopic gastrojejunostomy is a percutaneous endoscopic gastrostomy derived technique, that is widely employed. However it has a high incidence of mechanic complications. Percutaneous endoscopic jejunostomy direct access, improves these problems and allows to apply this technique in patients with previous gastric resection or with other gastric diseases that contraindicate percutaneous endoscopic gastrostomy. We describe, for the first time in our country, a direct percutaneous endoscopic jejunostomy placement.

Multivariate analyses of prognostic factors associated with hematopoietic recovery in autograft patients with different sources of progenitor cells. A GATMO experience. Argintine Group of Bone Marrow Transplant

OBJECTIVE

To evaluate in a multivariate analysis the prognostic factors associated with hematopoietic recovery and the supportive care requirements after autotransplant of progenitor cells (PC) from various sources: bone marrow (BMPC), BMPC & peripheral blood (PBPC), and PBPC alone.

PATIENTS AND METHODS

A total of 570 patients with hematological malignancies and solid tumors underwent high-dose therapy followed by autotransplant. PBPC were obtained after mobilization with chemotherapy and/or cytokines. One-hundred five patients received BMPC, 217 received BMPC & PBPC and 248 PBPC alone; all of the patients received G-CSF or GM-CSF after infusion.

RESULTS

In a multivariate analysis the recovery of neutrophils was adversely associated with low numbers of nucleated cells infused (P < 0.13), bone marrow progenitor cell source, and diagnosis of multiple myeloma and acute leukemia (P < 0.001). The factors that adversely affected platelet recovery were low number of nucleated cells and diagnosis of multiple myeloma and acute leukemia (P < 0.001).

CONCLUSIONS

We conclude that BMPC adversely affect neutrophil recovery while low numbers of nucleated cells and diagnosis of multiple myeloma and acute leukemia adversely affect both neutrophil and platelet recovery.