High virological failure rate in HIV patients after switching to a regimen with two nucleoside reverse transcriptase inhibitors plus tenofovir

BACKGROUND

Regimens with two nucleoside analogue reverse transcriptase inhibitors (NRTI) plus tenofovir DF have been associated with a high failure rate when administered as first line therapy. Little is known about patients with undetectable viral loads who are switched to these regimens.

METHODS

A post-hoc review of the virological outcomes at 24 weeks of patients who switched from a successful (< 50 copies/ml) highly active antiretroviral therapy regimen to a tenofovir plus two NRTI combination.

RESULTS

Fifty-five patients started a two NRTI plus tenofovir regimen mostly because of previous toxicity/intolerance of the original drugs (74%). After 24 weeks, only 17 patients (31%) remained virologically suppressed. Patients with a regimen including a didanosine plus tenofovir-based regimen had significantly poorer outcomes than those on other combinations (success rate 5 versus 47.1%, P = 0.001). In contrast, patients on a regimen including zidovudine plus tenofovir showed a trend towards a better outcome (75 versus 27%, P = 0.083). Multivariate analysis confirmed the combination of didanosine plus tenofovir as the only variable associated with a higher rate of failure (odds ratio 17.7; 95% confidence interval 2.1-147; P = 0.007). Patients with previous reverse transcriptase mutations presented virological failure in all cases. At failure a new pattern, including the K65R mutation with M184V or thymidine analogue mutations, was observed.

CONCLUSIONS

Even in patients with suppressed viraemia, a two NRTI plus tenofovir regimen is associated with a high virological failure rate, but significant variations are found depending on the nucleosides included.

Clifford algebra approach to the coincidence problem for planar lattices

The problem of coincidences of planar lattices is analyzed using Clifford algebra. It is shown that an arbitrary coincidence isometry can be decomposed as a product of coincidence reflections and this allows planar coincidence lattices to be characterized algebraically. The cases of square, rectangular and rhombic lattices are worked out in detail. One of the aims of this work is to show the potential usefulness of Clifford algebra in crystallography. The power of Clifford algebra for expressing geometric ideas is exploited here and the procedure presented can be generalized to higher dimensions.

Distribution of galanin-like immunoreactivity in the brain of the Siberian sturgeon (Acipenser baeri)

Galanin is a 29-amino acid peptide widely distributed in the central nervous system of vertebrates. The organization of galaninergic systems is well known in teleosts, the most advanced actinopterygians, but no data are available on primitive bony fish. To extend the evolutionary analysis of galaninergic systems we studied the distribution of galanin-like immunoreactive (GAL-ir) cells and fibers in the sturgeon brain, since chondrosteans are among the most primitive extant actinopterygians. Double-immunolabeling experiments were performed to compare the distribution of galanin with that of neurophysin, tyrosine hydroxylase, and serotonin. Numerous GAL-ir cells of cerebrospinal fluid-contacting (CSF-C) type were found in the ventral telencephalon, preoptic area, and in the tuberal and caudal hypothalamus. The distribution of GAL-ir elements in the sturgeon brain shows many similarities to that observed in other vertebrates, but also important differences, such as the abundance of GAL-ir CSF-C cells, which appear to be a primitive characteristic. GAL-ir neurons observed in the sturgeon telencephalic hemispheres perhaps represent the basic organization of common ancestors of bony fishes and tetrapods. In the preoptic-hypophyseal system, GAL-ir cells appeared to be related not only with neurophysin-expressing neurons (in the tuberal hypothalamus) but also with serotoninergic and catecholamines-synthesizing neurons (in preoptic and tuberal nuclei). Numerous GAL-ir fibers were observed in the median eminence and neural lobe of the hypophysis, indicating that galanin may play a role in the modulation of hypophyseal secretion. GAL-ir neurons were absent from the sturgeon brainstem, suggesting that their presence in other vertebrates could represent an evolutionary recent acquisition.

Rapid detection of cows' milk in sheeps' and goats' milk by a species-specific polymerase chain reaction technique

A polymerase chain reaction (PCR) assay was developed for the specific identification of cows' milk in sheep's and goats' milk by using primers targeting the mitochondrial 12S rRNA gene. The use of a forward primer complementary to a conserved DNA sequence, along with a reverse primer specific for cow, yielded a 223-bp fragment from cows' milk DNA, whereas no amplification signal was obtained in sheep's and goats' milk DNA. The technique was applied to raw, pasteurized, and sterilized milk binary mixtures of cow-sheep and cow-goat, enabling the specific detection of cows' milk with a good sensitivity threshold (0.1%). The proposed PCR assay represents a rapid and straightforward method applicable to the authentication of milk and other dairy products in routine analysis.

Histopathology of Sclerotinia sclerotiorum attack on flower parts of Helianthus annuus heads in tolerant and susceptible varieties

Sunflower head rot is a major disease caused by Sclerotinia sclerotiorum. Sunflower varieties which are tolerant to the fungus have been developed. The changes occurring in flower parts at different times after inoculation with pathogen ascospores were studied for two sunflower varieties (tolerant HA 302 and susceptible HA 89). In variety HA 302 there was cell collapse, changes in cell wall composition, and an increase in phenolic compounds in the tissues of corolla and style, which prevented the pathogen from advancing. This response was weaker in susceptible variety HA 89, and occurred only in the style, so did not stop the pathogen from developing and reaching the ovary. Phenolic compounds were found in HA 302 corolla and style tissues only when the pathogen was present, constituted an induced response that prevented further development of the fungus. Principal component analysis (PCA) showed that at the beginning of the infection there was no difference in behavior between the two varieties. The difference arose during the final observation times, when in variety HA 89, the pathogen colonized ovary, style and base of filaments and produced noticeable colonization of the corolla.

Ultrasonic flaw detection in NDE of highly scattering materials using wavelet and Wigner-Ville transform processing

In ultrasonic non-destructive evaluation of highly scattering materials the backscattering noise may attain peak values greater than the searched flaw pulse and the mean value of noise spectrum is very similar to the searched echo spectrum. Several specific methods have been proposed for the reduction of this type of noise, but the comparison of the performance of different methods is still an open problem. In this paper, we make a comparison among some methods based on simultaneous representations in time and frequency/scale domains of the ultrasonic traces. Synthetic and experimental traces are de-noised using a discrete wavelet processor with decomposition level-dependent threshold selection and a method that combines Wigner-Ville transform and filtering in the time-frequency domain. The results are comparatively evaluated in terms of signal to noise ratio and probability of detection.

Development of galanin-like immunoreactivity in the brain of the brown trout (Salmo trutta fario), with some observations on sexual dimorphism

The development of galanin-like immunoreactive (GAL-ir) cells and fibers was investigated in the brain of brown trout embryos, alevins, juveniles, and adults (some spontaneously releasing their gametes). The earliest GAL-ir neurons appeared in the preoptic region and the primordial hypothalamic lobe of 12-mm embryos. After hatching, new GAL-ir neurons appeared in the lateral, anterior, and posterior tuberal nuclei, and in late alevins, GAL-ir neurons appeared in the area postrema. In juveniles, further GAL-ir populations appeared in the nucleus subglomerulosus and magnocellular preoptic nucleus. The GAL-ir neuronal groups present in juveniles were also observed in sexually mature adults, although the area postrema of males lacked immunoreactive neurons. Moreover, spawning males exhibited GAL-ir somata in the olfactory bulb and habenula, which were never observed in adult females or in developing stages. In adults, numerous GAL-ir fibers were observed in the ventral telencephalon, preoptic area, hypothalamus, neurohypophysis, mesencephalic tegmentum, ventral rhombencephalon, and area postrema. Moderate to low GAL-ir innervation was seen in the olfactory bulbs, dorsomedial telencephalon, epithalamus, medial thalamus, optic tectum, cerebellum, and rhombencephalic alar plate. There were large differences among regions in the GAL-ir innervation establishment time. In embryos, GAL-ir fibers appeared in the preoptic area and hypothalamus, indicating early expression of galanin in hypophysiotrophic centers. The presence of galanin immunoreactivity in the olfactory, reproductive, visual, and sensory-motor centers of the brain suggest that galanin is involved in many other brain functions. Furthermore, the distribution of GAL-ir elements observed throughout trout development indicates that galaninergic system maturation continues until sexual maturity.

Salivary and serum beta2-microglobulin and gamma-glutamyl-transferase in patients with primary Sjögren syndrome and Sjögren syndrome secondary to systemic lupus erythematosus

BACKGROUND

Sialochemistry has been proposed as a simple and useful tool for the diagnosis of Sjögren syndrome (SS). Although many changes have been detected in several constituents of saliva from patients with SS, none are individually sensitive or specific enough for diagnosing SS. The aim of this study was to assess the value of the combined determination of beta2-microglobulin (beta2m) and gamma-glutamyl-transferase (GGT) activity in serum and saliva as a diagnostic instrument for differentiating primary and secondary [to systemic lupus erythematosus (SLE)] SS patients from normal subjects.

METHODS

Nineteen primary SS (pSS) patients, 15 patients with SS secondary to SLE, and 25 SLE patients without SS were studied. Thirty healthy subjects were included in the study as control group.

RESULTS

By means of a mathematical model, (a) 84.1%, (b) 85.7%, and (c) 87.0% of patients were correctly classified as SS or normal when (a) salivary beta2m and GGT values, (b) serum beta2m and salivary GGT values, and (c) salivary beta2m and GGT along with serum beta2m values, respectively, were considered. To differentiate between pSS and sSS by means of the mathematical model, the combination of serum beta2m and salivary GGT values achieved that 81.8% of the patients were correctly classified.

CONCLUSION

Since sialochemistry is an easy, safe and reliable test, the combined determination of beta2m and GGT in saliva and serum was useful for differentiating SS patients from normal subjects, but not excessively good for differentiating pSS from sSS patients.

Optimisation of a solid-phase microextraction procedure for the determination of triazines in water with gas chromatography-mass spectrometry detection

A procedure based on solid-phase microextraction (SPME) and gas chromatography-mass spectrometry, operating in the chemical ionisation mode, was developed and optimised in order to determine 10 triazines in water samples. Five different SPME fibers available for analysis [polydimethylsiloxane (PDMS) 100 microm, polyacrylate (PA) 80 microm, PDMS-divinylbenzene (DVB) 65 microm, Carbowax (CW)-DVB 65 microm, and Carboxen (CAR)-PDMS 75 microm] were tested, and PDMS-DVB was selected. To enhance the sensitivity of the SPME, variables affecting adsorption and desorption steps such as temperature, time, pH and ionic strength of the solution were optimised. Detection limits obtained were ranged between 2 and 17 ng l(-1), and precision values were below 8% for the selected PDMS-DVB fiber. The optimised method was applied to real water samples and no triazines were detected.

Ehp53, an Entamoeba histolytica protein, ancestor of the mammalian tumour suppressor p53

This paper reports the identification of Ehp53, a p53-like Entamoeba histolytica protein, which binds to the human p53 DNA consensus sequence (oli-p53). Monoclonal antibodies against p53 (Ab-1 and Ab-2) recognized a single 53 kDa spot in two-dimensional gels and inhibited the formation of complexes produced by E. histolytica nuclear extracts and oli-p53. Additionally, E. histolytica gene promoter sequences with high homology to oli-p53 formed complexes with nuclear proteins that were abolished by oli-p53. Ehp53 protein levels increased in UV-irradiated trophozoites. This protein was also detected in Entamoeba moshkovskii and Entamoeba invadens. By confocal microscopy, Ehp53 was located in the nuclei, EhkO organelles and cytoplasm. The Ehp53-encoding gene was cloned and its predicted amino acid sequence showed 30-54 % and 50-57 % homology with important domains of the human and the Drosophila melanogaster p53 proteins, respectively. This homology included the tetramerization domain, the nuclear export signal and a nuclear localization signal. Ehp53 also contains seven of the eight DNA-binding residues and two of the four Zn(2+)-binding sites described for p53. A recombinant Ehp53 was recognized by Ab-2. Ehp53 is believed to be the first p53-like protein found in protozoa and may be the evolutionary ancestor of the mammalian p53.

Epidemiological assessment of the influence of socio-family factors in adolescent pregnancy

Pregnancy in adolescence constitutes a serious public health problem at these ages. It de-stabilizes family homeostasis; family and affective support received by the adolescent is recognized to be a factor of influence in the problem. The objective of the research presented is the empirical study in Cádiz, SW Spain, of the socio-family support received by a group of adolescent mothers, and the influence of this on the development of the pregnancy and the infant, in comparison with a group of adult mothers. A descriptive study of 305 adolescent mothers and 285 adult mothers who gave birth in 1996 and attended the family planning centers of the Primary Health Care District of Cádiz, Spain, in 1997. The variables used included socio-demographic data of the adolescents, information on the pregnancy and birth, on the health of the baby, and on social and family support (by means of the Duke-Inc and Apgar family questionnaires). In the statistical study of the data, frequencies, statistical association, and disequalities of prevalence in the variables were determined. Of the totals, 81.6% (77-86) of the adolescent mothers were unmarried, compared with 22% (17-26) of the adult mothers; 82.3% (78-87) of the adolescents were living with their parents, compared with 39.3% (34-45) of the adults. Family support received is greater among the adolescents (p < 0.01). In this group, in line with increasing family support, there is improvement in--the decision to continue the pregnancy (p < 0.0001), frequency of check-ups (p < 0.0001), less problems in the pregnancy (p < 0.01), differences in the anthropometric values of the baby at birth (p < 0.0001), and breast-feeding (p < 0.001). The conclusion is reached that juvenile pregnancy is not synonymous with more risky pregnancy. There is a positive correlation between the socio-family support received and the general success of the pregnancy and better health in the mother and baby.

[Results of C1-C2 transarticular screw fixation in a series of 20 patients]

OBJECTIVE

C1-C2 transarticular fixation is an increasingly used surgical method of treating atlantoaxial instability. When properly performed, it can safely provide fusion rates near 100%, but techniques of fixation in this region allow only a small margin of error. We here report the results of C1-C2 transarticular fixation in a series of 20 patients in which different procedures were selected according to the presenting disorder in each case.

METHODS

The study group included 9 men and 11 women with a mean age of 48 years (range 17 to 68 years). The causes of instabilities were rheumatoid arthritis in nine patients, type II and III Hangman's fracture of traumatic origin in nine (in association with other lesions in three cases), pseudoarthrosis after type II odontoid fracture in one, and type III complex C1 fracture in a patient with ankylosing spondylitis. Preoperative assessment included flexion and extension plain radiographs and computed tomography (CT) and magnetic resonance imaging (MRI) scans. Operations included transarticular screw fixation in all cases; in patients with rheumatoid arthritis it was associated with sublaminar fixation and bone grafting following Sonntag's technique in all but two cases. Postoperative results were evaluated in relation to the biomechanical stability and fusion was studied by flexion and extension radiographs and CT scans. Pain relief in patients with rheumatoid arthritis patients was assessed using a 0-10 visual analogic scale (V.A.S.).

RESULTS

In the traumatic group, a consolidation of the fracture and radiologic stability was achieved in all cases. In patients with rheumatoid arthritis, pain improved in all but not the neurological deficit, and in all cases a C1-C2 biomechanical stability was reached despite interlaminar graft resorption in two (25%) cases. With respect to complications, a lesion of the vertebral artery occurred in one case, deviation of the screw in two cases, and breakage of the screw without clinical repercussion in two other cases.

CONCLUSION

C1-C2 transarticular screw fixation was a useful technique to achieve satisfacory biomechanical stability in patients with atlatoaxial instability of both inflammatory and traumatic origin with a low rate of complications.

[Specific markers of myocardial injury in acute stroke]

INTRODUCTION

It is thought that any acute damage to the central nervous system and, more particularly, acute cerebrovascular disease (ACVD) can give rise to a myocardial lesion. Our aim is to apply the latest biochemical markers (troponin T, troponin I and myoglobin) to the study of this problem.

PATIENTS AND METHODS

We conducted a retrospective study of 42 patients who were consecutively admitted to hospital with ACVD. The pathological antecedents and the clinical and electrocardiographic variables were considered in each case. A single determination of CK, CK MB, myoglobin, troponin T and troponin I was performed for each patient.

RESULTS

The determination of the new biochemical markers was positive in a higher number of cases than CK and its MB fraction, or electrocardiographic alterations. This positivity, together with the troponin T and troponin I values correlate with mortality.

CONCLUSIONS

We present the first research work to be published in Spanish that studies the new biochemical markers of myocardial damage in ACVD. We urge researchers to carry out further analyses on more extensive series in order to determine the influence myocardial damage has on mortality and to establish suitable therapeutic measures. This will also allow us to find out whether a certain location or size of the lesion can give rise to a higher predisposition to this kind of damage

[Right primary iliac artery rupture during transurethral resection of bladder tumor]

Injury to a large-caliber artery transurethral resection of a bladder tumor is a rare but serious complication. It is important that an anesthesiologist be able to detect such an injury, in order to include it among the many differential etiological diagnoses for shock. A 75-years-old man reported hematuria. An ultrasound image of the bladder showed many neoformations consistent with a diagnosis of multiple bladder neoplasms, and transurethral endoscopy was performed under subarachnoid anesthesia. Acute hypotension, bradycardia and shock developed 30 minutes into the procedure. The diagnosis was hypovolemic shock due to acute intraoperative hemorrhage, and exploratory laparotomy revealed an opening in the common iliac artery. The rupture was sutured. In spite of administration of crystalloids, colloids, blood products and vasoactive agents, a second operation was required due to hemodynamic instability. The patient died in the intensive care unit.

Anomalous roughening of Hele-Shaw flows with quenched disorder

The kinetic roughening of a stable oil-air interface moving in a Hele-Shaw cell that contains a quenched columnar disorder (tracks) has been studied. A capillary effect is responsible for the dynamic evolution of the resulting rough interface, which exhibits anomalous scaling. The three independent exponents needed to characterize the anomalous scaling are determined experimentally. The anomalous scaling is explained in terms of the initial acceleration and subsequent deceleration of the interface tips in the tracks coupled by mass conservation. A phenomenological model that reproduces the measured global and local exponents is introduced.

Entamoeba histolytica: DNA carrier vesicles in nuclei and kinetoplast-like organelles (EhkOs)

Entamoeba histolytica, the protozoan responsible for human amoebiasis, has a complex genome, whose linear chromosomes and DNA circles have so far eluded detailed analysis. We report the detection by transmission electron microscopy of nuclear vesicles (0.05-0.3 microm in diameter) carrying DNA in E. histolytica trophozoites. In late anaphase many of these nuclear vesicles were found to be organized in structures of approximately 2.5 x 1 microm, in association with chromosomes and microtubules. In glutaraldehyde-fixed and detergent-treated trophozoites, nuclear vesicles displayed a non-membranous envelope. Binding of phosphotungstate stain and recognition by serum from patients with systemic lupus erythematosus indicated that these vesicles contain DNA. Similar DNA carrier vesicles were found in the cytoplasm and in the E. histolytica kinetoplast-like organelle (EhkO). By Feulgen staining, we detected DNA carrier vesicles entering or leaving the nuclei, suggesting a structural relationship between the nuclear vesicles and the vesicles present in the EhkOs.

Fungal populations on sunflower (Helianthus annuus) anthosphere and their relation to susceptibility or tolerance to Sclerotinia sclerotiorum attack

Analysis of the fungal flora from different floret parts of various sunflower (Helianthus annuus) varieties showed that there are differences in both fungal species and frequency, depending on whether the sunflower variety is susceptible (SV) or tolerant (TV) to attack of the flower heads by the ascomycete pathogen Sclerotinia sclerotiorum. The sunflower varieties analyzed were SV: HA 300 and Z 20028, and TV: HA 302, Z AV 8410 and Z 30629. The isolates showed different "in vitro" behavior as biocontrol agents. The most common types of interaction with Sclerotinia sclerotiorum were D2 and D2+ (hyphal contact) for isolates from SV and TV, while some of the isolates from TV displayed antibiosis. The microorganisms that colonize TV florets play a part in an indirect mechanism that protects flowers from ascospore germination and pathogen growth.

Two new HLA class I alleles recognised by PCR sequence-specific primer and sequencing based typing: B*3805 and Cw*0408

Two new HLA class I alleles have been recognised by molecular-based typing. B*3805 was initially identified by polymerase chain reaction using sequence-specific primers (PCR-SSP) and afterwards confirmed by sequencing based typing (SBT) studies in a Spanish Caucasian blood cord unit. A unique nucleotide change throughout exons 2, 3 and 4, leading to the amino acid replacement Ser11Ala, differentiates B*3801 and *3805. This position behaves as a dimorphic residue in HLA-B and -C loci, and seems to be structurally unrelated to peptide and TcR recognition. Cw*0408 was first detected by SBT in two African American bone marrow donors in combination with its most structurally related allele, Cw*04011. The single amino acid change found between Cw*04011 and Cw*0408 was Thr163Leu, a residue involved in pocket A of the peptide-binding cleft. This new allele could be the result of a gene conversion event between Cw*04011 and any of the Cw*03 alleles.

N-Cyclopropylimine-1-pyrroline rearrangement. A novel photochemical reaction

[reaction: see text] A novel aza-(vinylcyclopropane-cyclopentene) photochemical rearrangement is reported. 1-Pyrrolines are easily synthesized in good yields from N-cyclopropylimines. Hydrogen, alkyl, and aryl groups can be placed anywhere within the system, and the reaction proceeds regiospecifically.

Interface depinning in the absence of an external driving force

We study the pinning-depinning phase transition of interfaces in the quenched Kardar-Parisi-Zhang model as the external driving force F goes towards zero. For a fixed value of the driving force, we induce depinning by increasing the nonlinear term coefficient lambda, which is related to lateral growth, up to a critical threshold. We focus on the case in which there is no external force applied (F=0) and find that, contrary to a simple scaling prediction, there is a finite value of lambda that makes the interface to become depinned. The critical exponents at the transition are consistent with directed percolation depinning.

Use of cholinesterase activity in monitoring organophosphate pesticide exposure of cattle produced in tropical areas

The use of cholinesterase activity as a biochemical method for monitoring organophosphate pesticide exposure in cattle is described herein. Determination of cholinesterase activity of whole blood, erythrocyte, and plasma was carried out according to the Ellman modified kinetic method. The mean baseline acetylcholinesterase activities of 9.549 +/- 3.619 IU/mL in whole blood, 9.444 +/- 3.006 IU/mL in erythrocytes, and 0.149 +/- 0.063 IU/mL in plasma were estimated for steers from the control group. Results of multivariate analysis showed that the general responses between the control and experimental groups (in vivo, monitoring and case studies) treated with Coumaphos and Fenthion were statistically different, and the general responses of these experimental groups were statistically different over time as well. Among the fractions that were analyzed, the erythrocyte acetylcholinesterase activity could be adequate for the diagnosis of exposure or acute poisoning in cattle as it showed a good within-run and between-run precision with CVs <10% better than those in plasma.

[Feeding habits of raccoon (Procyon lotor) (Carnivora: Procyonidae) in a coastal, tropical wet forest of Costa Rica]

Raccoon (Procyon lotor) food habits were studied at Manuel Antonio National Park, a tropical rain forest in the Pacific coast of Costa Rica from May to December 1987, from September to December 1989 and from January to April 1990. A 134 feces sample size was used to assess the most important items in raccoon diet: two crab species (Gecarcinus quadratus and Cardisoma crassum) with a relative frequency of 0.94 in the rainy season of 1987, 0.76 in the rainy season of 1989 and 0.65 in the dry season of 1990. Fruits were the second category in importance, with relative frequencies of 0.09 for 1987, 0.32 for 1989 and 0.44 for 1990.

Acute Synovitis, Fever and Rash Possibly Caused by Metallic Debris from a Loosened Knee Prosthesis in a Patient with Rheumatoid Arthritis

A 39-year-old woman with long-standing seropositive rheumatoid arthritis who had a total replacement of her left knee with a modular prosthesis in 1994 presented with fever, pruritic rash, and acute synovitis of that joint following local trauma. Synovial fluid showed a charcoal-like color, and contained abundant phagocytes laden with metal particles. In patients with rheumatoid arthritis who have undergone total joint replacement, metal particle reactions and possible hyper-sensitivity should be added to the list of potential causes of superimposed acute synovitis and systemic manifestations.

Mandatory reporting of domestic violence injuries to the police: what do emergency department patients think?

CONTEXT

Laws requiring mandatory reporting of domestic violence to police exist in 4 states. Controversy exists about the risks and benefits of such laws.

OBJECTIVE

To examine attitudes of female emergency department patients toward mandatory reporting of domestic violence injuries to police and how these attitudes may differ by abuse status.

DESIGN, SETTING, AND PARTICIPANTS

Cross-sectional survey conducted in 1996 of 1218 women patients (72.8% response rate) in 12 emergency departments in California (a state with a mandatory reporting law) and Pennsylvania (without such a law).

MAIN OUTCOME MEASURES

Opposition to mandatory reporting to police and the characteristics associated with this belief.

RESULTS

Twelve percent of respondents (n = 140) reported physical or sexual abuse within the past year by a current or former partner. Of abused women, 55.7% supported mandatory reporting and 44.3% opposed mandatory reporting (7.9% preferred that physicians never report abuse to police and 36.4% preferred physicians report only with patient consent). Among nonabused women, 70.7% (n = 728) supported mandatory reporting and 29.3% opposed mandatory reporting. Patients currently seeing/living with partners (odds ratio [OR], 1.5; 95% confidence interval [CI], 1.1-2.0), non-English speakers (OR, 2.1; 95% CI, 1.4-3.0), and those who had experienced physical or sexual abuse within the last year (OR, 2.2; 95% CI, 1.6-2.9) had higher odds of opposing mandatory reporting of domestic violence injuries. There were no differences in attitudes by location (California vs Pennsylvania).

CONCLUSIONS

The efficacy of mandatory reporting of domestic violence to police should be further assessed, and policymakers should consider options that include consent of patients before wider implementation.

Pre-infarction angina elicits greater myocardial viability on reperfusion after myocardial infarction: a dobutamine stress echocardiographic study

OBJECTIVES

We sought to evaluate myocardial viability (inotropic reserve) after myocardial infarction (MI) and its relationship with the presence of unstable pre-infarction angina (PIA).

BACKGROUND

Several studies have suggested that PIA can limit infarct size, but it is not known whether PIA can elicit myocardial viability after an acute MI, with left ventricular function improvement.

METHODS

Before discharge from the hospital, 91 patients with a reperfused MI (either fibrinolysis or primary coronary angioplasty) had low-dose dobutamine echocardiography performed to assess the myocardial inotropic reserve of the infarct-related area.

RESULTS

Twenty-nine patients (31.9%) had PIA in the 24-h period before the onset of MI. Nine patients were treated with primary coronary angioplasty: five (8.1%) in the group with PIA and four (13.8%) in the group without PIA. There were no other significant differences in the baseline characteristics of the patients. There were more viable segments in patients with PIA (44.9% vs. 30.7%, p = 0.007), and the number of patients with significant viability was higher in the PIA group (73.9% vs. 46.3%, p = 0.026). This occurred despite a similar number of segments with segmental wall abnormalities at baseline in both groups (46.1% vs. 46.9%, p = NS).

CONCLUSIONS

The presence of previous unstable PIA induces greater myocardial viability of the infarct-related area upon reperfusion and, as such, could have considerable therapeutic and clinical implications.

[Splenectomy in a patient with beta thalassemia intermedia and severe hemolytic anemia]

A 36-year-old woman with beta thalassemia intermedia suffered a hemolytic crisis secondary to Epstein-Barr virus infection. She was given a transfusion of phenotypically compatible blood. However, severe hemolysis persisted (with hemoglobin levels around 4 g/dl) in spite of gamma globulin and corticosteroid administration. Emergency therapeutic splenectomy was performed. We discuss intraoperative management in situations of severe anemia, concluding that it is possible to survive significant decreases in hemoglobin concentration with cardiocirculatory reserve and respiration intact, maintaining normal volume.

Identification of goose (Anser anser) and mule duck (Anasplatyrhynchos x Cairina moschata) foie gras by multiplex polymerase chain reaction amplification of the 5S RDNA gene

Polymerase chain reaction (PCR) amplification of the nuclear 5S rDNA gene has been used for the identification of goose and mule duck foie gras. Two species-specific reverse primers were designed and used in a multiplex reaction, together with a forward universal primer, to amplify specific fragments of the 5S rDNA in each species. The different sizes of the species-specific amplicons, separated by agarose gel electrophoresis, allowed clear identification of goose and mule duck foie gras samples. This genetic marker can be useful for detecting fraudulent substitution of the duck liver for the more expensive goose liver.

Identification of Nile perch (Lates niloticus), grouper (Epinephelus guaza), and wreck fish (Polyprion americanus) fillets by PCR amplification of the 5S rDNA gene

Nile perch (Lates niloticus), grouper (Epinephelus guaza), and wreck fish (Polyprion americanus) were differentiated by polymerase chain reaction (PCR) amplification of the nuclear 5S rDNA gene. The design of 3 species-specific primers complementary to the nontranscribed intergenic spacer region from the 5S rDNA molecule allowed amplification of clearly distinguishable gene fragments in each fish species. This approach is rapid and reliable and offers the potential to detect fraudulent or unintentional mislabeling of these species in routine seafood authentication analysis.

The factors associated with disclosure of intimate partner abuse to clinicians

OBJECTIVE

Our goal was to identify the prevalence, determinants of, and barriers to clinician-patient communication about intimate partner abuse.

STUDY DESIGN

We conducted telephone interviews with a random sample of ethnically diverse abused women.

POPULATION

We included a total of 375 African American, Latina, and non-Latina white women aged 18 to 46 years with histories of intimate partner abuse who attended 1 of 3 primary care clinics in San Francisco, California, in 1997.

OUTCOMES MEASURED

We measured the relevance and determinants of past communication with clinicians about abuse and barriers to communication.

RESULTS

Forty-two percent (159) of the patients reported having communicated with a clinician about abuse. Significant independent predictors of communication were direct clinician questioning about abuse (odds ratio [OR]=4.6; 95% confidence interval [CI] 3.2-6.6), and African American ethnicity (OR=1.8; 95% CI, 1.1-2.9). Factors associated with lack of communication about abuse included immigrant status (OR=0.6; 95% CI, 0.3-1.0) and patient concerns about confidentiality (OR=0.7; 95% CI, 0.5-0.9). Barriers significantly associated with lack of communication were patients' perceptions that clinicians did not ask directly about abuse, beliefs that clinicians lack time and interest in discussing abuse, fears about involving police and courts, and concerns about confidentiality.

CONCLUSIONS

Clinician inquiry appears to be one of the strongest determinants of communication with patients about partner abuse. Other factors that need to be addressed include patient perceptions regarding clinicians' time and interest in discussing abuse, fear of police or court involvement, and patient concerns about confidentiality.

PCR-SSCP: a simple method for the authentication of grouper (Epinephelus guaza), wreck fish (Polyprion americanus), and Nile perch (Lates niloticus) fillets

A method of DNA analysis has been developed to verify the authenticity of grouper (Epinephelus guaza), wreck fish (Polyprion americanus), and Nile perch (Lates niloticus) fillets. A short fragment (208 bp) of the mitochondrial 12S rRNA gene was amplified by the polymerase chain reaction and analyzed by single-strand conformation polymorphism to get species-specific patterns of single-stranded DNA (ssDNA). DNA strands were separated by native polyacrylamide gel electrophoresis and visualized by silver staining. Discrimination among the three fish species studied was possible, because each one expressed a specific ssDNA pattern.

[New High Andes species VII (Lepidoptera: Noctuidae)]

Four new species of Scriptania Hampson (Hadeninae) (3 spp.) and Pseudoleucania Staudinger (1 sp.) (Noctuinae), are described. Female Scriptania lucens Köhler are described and a new geographical record for the species is added; Strigania demerodes (Dyar) n. comb. is reexamined, and the synonymy and morphological variation of male genitalia of Strigania lithophilus (Butler) are given.

Cluster analysis of antinuclear autoantibodies in the prognosis of SLE nephropathy: are anti-extractable nuclear antibodies protective?

To investigate the possible role of anti-ENA autoantibodies in the pathogenesis of SLE nephropathy, we performed a cross sectional clustering study of 91 SLE patients using 75 clinical and laboratory variables examining the presence of anti-dsDNA and ENA autoantibodies by ELISA and Western blot. We applied principal component, hierarchical cluster, multiple correspondence and logistical regression analysis. Two polar forms of SLE nephropathy and five clinical groups were identified: group 1 without overt nephropathy (n = 37), group 2 with nephropathy and only proteinuria (n = 19), group 3 nephropathy and only hematuria (n = 11), group 4 with hematuria and proteinuria (n = 14) and group 5 on renal failure (n = 10). When analyzed individually, levels of anti-dsDNA and single anti-ENA antibodies did not allow us to differentiate between renal and non-renal groups. However, when the anti-ENA autoantibodies were analyzed as a cluster, a high predictive value for clinical nephropathy was obtained. Thus, the absence of ENA antibodies (ENA ve or Venezuelan cluster) increased eleven-fold the odds ratio to develop SLE nephropathy. We suggested that the ENA ve cluster may predict development of the most severe forms of renal lupus while the ENA Sm/RNP and the ENA Ro/La/Sm/RNP clusters could be associated with the absence and the most benign form of SLE nephropathy. It must be interesting to apply similar cluster methodology in an SLE population with different ethnic background.

Prevalence and determinants of intimate partner abuse among public hospital primary care patients

OBJECTIVE

To determine the prevalence, sociodemographic determinants, and depression correlates of intimate partner abuse among an ethnically diverse population of women patients.

DESIGN

Cross-sectional telephone survey in English and Spanish of a random sample of women patients aged 18 to 46 years.

SETTING

Three public hospital primary care clinics (general internal medicine, family medicine, and obstetrics/gynecology) in San Francisco, Calif.

PARTICIPANTS

We interviewed 734 (74%) of the 992 eligible participants. Thirty-one percent were non-Latina white, 31% African American, and 36% Latina.

MEASUREMENTS AND MAIN RESULTS

Using questions adapted from the Abuse Assessment Screen, we determined recent and lifetime history of physical, sexual, and psychological abuse. Overall, 15% reported recent abuse by an intimate partner (in the preceding 12 months); lifetime prevalence was 51%. Recent abuse was more common among women aged 18 to 29 years (adjusted odds ratio [OR] 2.1; 95% confidence interval [CI], 1.2 to 3.7), non-Latinas (adjusted OR, 1.7; 95% CI, 1.0 to 2.9), and unmarried women (adjusted OR, 1.65; 95% CI, 1.0 to 2.7). The prevalence of abuse did not differ by education, employment, or medical insurance status of the women. Compared with women with no history of abuse, a greater proportion of recently abused women reported symptoms of depression (adjusted OR, 3.5; 95% CI, 2.2 to 5.5).

CONCLUSIONS

Because a substantial proportion of women patients in primary care settings are abused, screening for partner abuse and depression is indicated. In contrast to other studies, lower socioeconomic status was not associated with partner abuse history.

Identification of the clam species Ruditapes decussatus (Grooved carpet shell), Venerupis pullastra (Pullet carpet shell), and Ruditapes philippinarum (Japanese carpet shell)by PCR-RFLP

PCR-RFLP analysis has been applied to the identification of three clam species: Ruditapes decussatus (grooved carpet shell), Venerupis pullastra (pullet carpet shell), and Ruditapes philippinarum (Japanese carpet shell). PCR amplification was carried out using a set of primers designed from the DNA nucleotide sequences reported for alpha-actins from humans and various animals. Restriction endonuclease analysis based on sequence data of the PCR products of each clam species revealed the presence of species-specific polymorphic sites for MaeIII and RsaI endonucleases. Electrophoretic analysis of the amplicons digested with MaeIII and RsaI produced species-specific profiles that allowed the genetic identification of the three clam species.

[Hemorrhagic syndrome caused by exposure to a rodenticide. Report of a case]

We report a 22 years old male, admitted to the emergency room due to a life threatening coagulation disorder, with prothrombin times fluctuation between 5 and 37% and very low activity of factors II, VII, IX and X. In the month prior to the admission, the patient had used the rodenticide difethialone, without any precaution to avoid accidental exposure. The patient was maintained with fresh frozen plasma until oral vitamin K1 was obtained. This medication corrected the coagulation disorder.

Self-disturbance as a source of spatiotemporal heterogeneity: the case of the tallgrass prairie

Tallgrass prairies are characterized by high levels of litter production, which has a profound effect on live biomass. Litter introduces a delayed inhibition of biomass growth, generating nonlinear dynamics and chaos. In this paper, we study a model of biomass-litter interaction, and focus on the litter persistence rate. The observed dynamics depends largely on this rate of year-to-year persistence. Different scenarios are explored and discussed. A spatially extended counterpart of such a model is later on introduced to account for the effects of space. Temporal chaos introduces spatial heterogeneity in terms of gaps where the current year biomass is almost zero. Such gaps can be colonized by fugitive species. The inhibitory effect of litter on biomass is thus an important source of intrinsic, small-scale heterogeneities that may promote diversity. On the other hand, the huge amounts of litter produced by the competitive dominants in tallgrass prairies enhance the probability of fires. Fires benefit, rather than depress, the superior competitive species. This fact explains why the intermediate disturbance hypothesis (IDH) stating that the highest diversity levels should be observed at intermediate disturbance frequencies, does not work in these communities. We define self-disturbances as small-scale disturbances affecting the growth and survival of the individuals that have generated them (e.g. due to the effects of the litter mass they produce). In the absence of other disturbances, self-disturbances can induce high heterogeneity and diversity levels in tallgrass prairies. We discuss the general implications of self-generated disturbances for landscape heterogeneity and diversity of communities in which the main external perturbations benefit the dominant species.

An Entamoeba histolytica rab-like encoding gene and protein: function and cellular location

We identified here a 576 bp rab-like gene (EhrabB) in Entamoeba histolytica. EhrabB is located 332 bp upstream from the start codon of the Ehcp112 encoding gene, but is transcribed from the complementary strand. The EhrabB open reading frame predicts a 192 amino acid polypeptide (EhRabB) with 40-42% identity to Rab proteins, involved in vesicle docking regulation in endo and exocytic pathways of eukaryotic cells. Transcripts of 0.6 and 0.97 kb were detected by the EhrabB probe in northern blot assays. Using specific antibodies, EhRabB was located in small cytoplasmic vesicles by confocal microscopy. During phagocytosis, EhRabB was initially translocated to the plasma membrane and to the phagocytic mouths. The protein diminished after 10 min phagocytosis, suggesting that EhRabB could be participating in the regulation of the endocytosis process.

Molecular response assessed by PCR is the most important factor predicting failure-free survival in indolent follicular lymphoma: update of the MDACC series

BACKGROUND

We have observed that molecular response, as defined by a PCR-negative status during the first year of therapy, along with beta 2-microglobulin (beta 2M), was the most important variable associated with failure-free survival (FFS) in follicular lymphoma (FL). Herein, we present an update of the previously published MDACC series.

PATIENTS AND METHODS

A total of 116 patients (male:female ratio 64:52; median age: 52 years) with indolent FL and BCL-2 rearrangement (at MBR or mcr breakpoints) assessable in peripheral blood (pb) by PCR prior to treatment, and with two or more PCR determinations during the first year, were selected for the present study.

RESULTS

Of the 116 patients, 4 who presented with progression and 1 who died of unrelated causes during the first year were excluded from the landmark analysis. One hundred patients (86%) achieved clinical CR and 80 (69%) achieved a negative PCR status within first year. Median FFS was 6.4 years. Five-year FFS was 73% and 28% for molecular responders and nonresponders, respectively (P = 0.001). In spite of this strikingly higher FFS favoring molecular responders, no clearcut plateau was evident in this group. Molecular response assessed in pb (P = 0.001) and serum beta 2M (P < 0.001) were the most important factors to predict FFS in the multivariate analysis. In the subset of patients with normal beta 2M and molecular CR, there was a trend for a plateau in the FFS curve. No significant difference between the groups has been observed so far in terms of survival.

CONCLUSIONS

Molecular response assessed in pb using a PCR technique is, along with beta 2M, the most important factor to predict FFS in FL.

Changes in Trypanosoma cruzi phospholipid turnover induced by parasite contact with cell membranes

To investigate the possibility that cell contact could initiate a series of signals in both the host cell and the flagellate protozoan Trypanosoma cruzi, we studied [32P]-phospholipid turnover during parasite interaction with cellular membranes in vitro. Lipid alterations were produced in the parasite during the initial period of contact with the plasma membranes of human erythrocytes. In the presence of calcium an increment in phosphatidylethanolamine was observed with a concomitant decrease in phosphatidic acid fractions, whereas these modifications were not observed in the absence of calcium. There was an evident decrease in phosphatidylcholine and a shift in the phosphatidylinositol/lysophosphatidylethanolamine fraction among the phospholipids of major turnover in the absence or presence of calcium. Among the minor labeled species, lysophosphatidylcholine reached levels that duplicated control values, whereas the amounts of lysophosphatidylinositol, phosphatidylinositol 4-phosphate, and phosphatidylinositol 4,5-bisphosphate diminished by over 50%. All of these variations indicate that the parasite's contact with plasma membranes induces changes involving T. cruzi phospholipids and suggest the participation of these compounds in the activation of intracellular mechanisms that might be important during the life cycle of this parasite.

Interpretation of electrospray/ion trap mass spectra of bile acids and other surfactants

Electrospray spectra of various bile acids and other surfactants were obtained using an ion trap instrument. Bile acids and bile acid derivatives such as 3-[(3-cholamidopropyl)dimethylammonio]-1-propanesulfonate (CHAPS) self associate to form micelles in a stepwise process. Their spectra show a distinct pattern of aggregation, with ions evenly separated in the m/z space. A new parameter, n/z, can be used to characterize such ions, where n is the number of molecules and z is the charge of the aggregate. The values of z were determined using multi-stage mass spectrometry (MS(n)) and high resolution in the ion trap.

Diminished levels of T cell receptor zeta chains in peripheral blood T lymphocytes from patients with systemic lupus erythematosus

OBJECTIVE

To examine the expression of molecules known to participate in early T cell receptor (TCR)/CD3 signaling in peripheral blood (PB) T lymphocytes from patients with systemic lupus erythematosus (SLE).

METHODS

Signaling molecules were analyzed by immunoprecipitation and Western blotting of unstimulated PB T lymphocyte cell lysates from SLE patients, non-SLE disease controls, and healthy controls. Flow cytometry was used for analysis of the expression of membrane markers in intact cells.

RESULTS

PB T lymphocytes from SLE patients showed diminished levels of TCRzeta chains. This was not due to trapping of these molecules in the cytoskeleton, nor was it dependent on the presence of monocyte/macrophages. There was normal expression of CD3epsilon chains and normal assembly of TCR/CD3 complexes in membranes. We observed a lack of expression of TCRzeta chains in in vitro cultures of SLE T cells, and reversal of the defective expression in some patients by culturing T cells in the presence of NH4Cl.

CONCLUSION

Blood lymphocytes from SLE patients have a diminished expression of TCRzeta chains that may be related to enhanced degradation in the lysosomal compartment. The defective expression of these molecules may alter signal transduction via the CD3 pathway and contribute to abnormal T cell responses in T lymphocytes from SLE patients.

Entamoeba histolytica : a novel cysteine protease and an adhesin form the 112 kDa surface protein

Here, we present evidence that a cysteine protease (EhCP112) and a protein with an adherence domain (EhADH112) form the Entamoeba histolytica 112 kDa adhesin. Immunoelectron microscopy and immunofluorescence assays using monoclonal antibodies (mAbAdh) revealed that, during phagocytosis, the adhesin is translocated from the plasma membrane to phagocytic vacuoles. mAbAdh inhibited 54% adherence, 41% phagocytosis, and 35% and 62% destruction of MDCK cell monolayers by live trophozoites and their extracts respectively. We cloned a 3587 bp DNA fragment (Eh112 ) with two open reading frames (ORFs) separated by a 188 bp non-coding region. The ORF at the 5' end (Ehcp112 ) encodes a protein with a cysteine protease active site, a transmembranal segment and an RGD motif. The second ORF (Ehadh112 ) encodes a protein recognized by mAbAdh with three putative transmembranal segments and four glycosylation sites. Northern blot, primer extension and Southern blot experiments revealed that Ehcp112 and Ehadh112 are two adjacent genes in DNA. Ehcp112 and Ehadh112 genes were expressed in bacteria. The recombinant peptides presented protease activity and inhibited adherence and phagocytosis, respectively, and both were recognized by mAbAdh. The EhCP112 and EhADH112 peptides could be joined by covalent or strong electrostatic forces, which are not broken during phagocytosis.

Translation to Spanish, reproducibility, and cross-cultural adaptation of the Miller-Rahe Recent Life Change Questionnaire in Venezuela

OBJECTIVE

To translate into Spanish a version of the Miller-Rahe Recent Life Change Questionnaire and to adapt it to Venezuelan cultural values.

METHODS

The Spanish version and cross-cultural adaptation of the Miller-Rahe Recent Life Change Questionnaire was done following recently proposed guidelines to preserve semantic, idiomatic, and conceptual equivalence in translations of health assessment instruments. We performed one or more translations into the new language, as well as back-translation, test-retest reliability, and weighting score for the translated instrument.

RESULTS

A Spanish version of the Recent Life Change Questionnaire was obtained. Validity of translations was demonstrated with a significant agreement for the nonliteral translations (kappa value = 0.97, P < 0.05). The conceptual equivalence was demonstrated by significant agreement in the back-translations (kappa value = 0.84, P < 0.05). The translated instrument met acceptable levels of reliability, as assessed by Spearman's rank correlation coefficients (> 0.60 for all categories of the questionnaire). The cross-cultural adaptation of the translated instrument required addition and exclusion of items as well as changes of the ranking and scaling of life units in the original questionnaire.

CONCLUSION

A valid and reliable Spanish version of the Miller-Rahe Recent Life Change Questionnaire was produced and adapted to Venezuelan cultural values.

Correlation of bcl-2 rearrangement with clinical characteristics and outcome in indolent follicular lymphoma

The t(14;18) translocation, which involves the bcl-2 oncogene, occurs in follicular lymphomas (FL) at two common sites: the major breakpoint region (MBR) and the minor cluster region (mcr). The biological and clinical significance of these breakpoints is unknown. The bcl-2 breakpoint site was determined in 247 previously untreated patients (49% men; median age 52 years) with indolent FL (155 grade I, 83 grade II, and 8 grade III) to correlate it with pretreatment characteristics, response, and outcome. The bcl-2 breakpoint site was determined by a polymerase chain reaction method of peripheral blood (all cases), bone marrows (149 cases), and fresh lymph node biopsy specimens (68 cases). The breakpoint site occurred at MBR in 175 cases (71%) and at mcr in 27 (11%). In 45 cases (18%), no breakpoint was detected (germline). No significant relationship was found between the rearrangements and the expression of BLC-2 and BAX proteins. Patients' germline for MBR and mcr tended to present more frequently with stage IV disease and higher beta2-microglobulin (beta2M) levels, whereas mcr-rearranged patients presented more frequently with early stage and normal beta2M. The complete response rate of germline patients was significantly lower than that of MBR and mcr patients. An estimated 3-year failure-free survival (FFS) for mcr, MBR, and germline cases was 95%, 76%, and 57%, respectively (P <.001). The bcl-2 breakpoint site was independent of serum beta2M and lactate dehydrogenase in its correlation with FFS. In conclusion, the bcl-2 rearrangement site is an important prognostic factor in indolent FL, useful to identify patients who may require different treatment.

[Primary Sjögren syndrome. Study of a population of patients at the Hospital Universitario de Caracas, Venezuela]

Sjögren's syndrome is an autoimmune exocrinopathy of unknown etiology. It is characterized by a chronic inflammatory process that leads to functional impairment and destruction of lachrymal and salivary glands. There is a primary and a secondary form of the disease; the latter accompanies a well defined connective tissue disease. As far as we know, there are no previous reports of primary Sjögren's syndrome in Venezuela. The main purpose of this study was to present the clinical findings and outcome of a population of patients diagnosed and followed in our hospital. A population of fifty-four patients predominantly females (96%) with a mean age of 42 (range 24 to 84) was studied. The presence of articular symptoms was the most common extraglandular manifestation (87%), followed by enlargement of parotideal glands (52%). Parotid enlargement and renal disease were observed with a higher frequency than previously reported in the literature. Recurrent enlargement of parotideal glands has been related to lymphoid malignant transformation in these patients. Our findings seem to suggest that the pattern of clinical expression of primary Sjögren's syndrome may be influenced by the genetic make-up of the population under study, and possibly by local environmental influences. Two of our cases developed pseudolymphoma, a transitional stage between the benign lymphoproliferation of primary Sjögren's syndrome and lymphoma. Furthermore, in this relatively small sample six patients have died during a short follow-up period, suggesting a potentially more aggressive course of the disease in our patients.

The pyruvate:ferredoxin oxidoreductase enzyme is located in the plasma membrane and in a cytoplasmic structure in Entamoeba

This work investigated the cellular location of the pyruvate:ferredoxin oxidoreductase (PFO) enzyme in Entamoeba. A 1.9 kb fragment located at the 3' end of the Ehpfo gene was cloned in the pRSETB vector and expressed. The recombinant peptide was purified and inoculated in rabbits. By Western blot assays the antibodies detected a single 130 kDa band in all E. histolytica strains tested and in E. moshkovskii. By immunofluorescence, the antibodies showed the presence of PFO in the plasma membrane and in a cytoplasmic structure that appeared as a ring or as a compact small body in E. histolytica strains. In E. invadens and E. moshkovskii (strains FIC and Laredo) PFO was located in the plasma membrane showing different fluorescence patterns. Immunofluorescence on E. histolytica synchronized cultures showed that the cytoplasmic structure appeared in 85, 60, 20 and 10% of the trophozoites in mitosis, G1, S and G2 phases, respectively. By in situ hybridization the Ehpfo gene was found in the nuclei and the trophozoites of the clone A, strain HM1:IMSS, differed in the Ehpfo gene content.

The clinical significance of molecular response in indolent follicular lymphomas

Most patients with follicular lymphoma (FL) achieve a complete response (CR) after treatment, but eventually most of them, particularly those with stage IV, relapse due to minimal residual disease (MRD). The t(14;18) gives rise to a rearrangement of the bcl-2 oncogene that constitutes an excellent target for detection of MRD by polymerase chain reaction (PCR). One hundred ninety-four previously untreated patients with indolent FL and detectable bcl-2 rearrangement were studied. The PCR assay was used to detect bcl-2-rearranged cells in blood and marrow before and after treatment. Molecular response rate was 37%, 53%, 56%, and 66% at 3 to 5, 6 to 8, 9 to 14, and 15 to 18 months from the start of therapy, respectively. Although molecular response was higher among clinical CRs, one third of partial responders at 3 to 5 months also achieved a molecular response. Patients who achieved a molecular response during the first year of treatment had a significantly longer failure-free survival (FFS) than those who did not (4-year FFS: 76% v 38%, respectively; P < .001). Similar results were also observed in the subset of patients in clinical CR 1 year after treatment. By multivariate analysis, beta2-microglobulin (beta2-M; P < .01), and molecular response (P < .001) were the most important variables associated with outcome. When we combined beta2-M and molecular response, three prognostic groups emerged: (1) low beta2-M and molecular responders, (2) low beta2-M and nonresponders or high beta2-M and responders, and (3) high beta2-M and nonresponders. The 4-year FFS of these 3 groups were 86%, 65%, and 23%, respectively. Finally, patients who achieved molecular response and sustained it had better FFS than those who either reverted back to PCR-positive or who never achieved molecular response. Serial PCR analysis to determine the molecular response in FL correlates well with outcome especially when combined with pretreatment beta2-M.