[Long term follow-up of the tendinous urethral support: an anatomical approach for stress urinary incontinence]

Sling procedures have been around for decades in the management female stress urinary incontinence (SUI), but only in the past decade they have become the preferred technique. Minimally invasive procedures are the procedure of choice in many centers for your efficacy and low morbidity. The tendinous urethral support (TUS) represents an anatomical approach that consists in placing a midurethral low tension tape anchored to the tendinous arc bilaterally. From February 1999 to October 2000, 25 female patients (mean age: 53 years old), with SUI underwent TUS procedure, and 23 were available for follow-up. Those patients were followed until 72 months. After six months, 20 (87%) patients were dry, 2 (8.7%) improved and 1 (4.3%) incontinent. However, at the last evaluation, 15 (65.2%) investigation.

Magnetic resonance imaging in the preoperative staging of endometrial carcinoma

PURPOSE OF INVESTIGATION

Magnetic resonance imaging (MRI) has emerged as an important imaging modality in the evaluation of the extension of endometrial carcinoma which is essential in planning treatment and predicting prognosis. This study aimed to assess the value of MRI in the preoperative staging of endometrial carcinoma.

METHODS

We included in this study 162 patients with a histological diagnosis of endometrial carcinoma who underwent MRI pelvic imaging and surgical staging. MRI images were compared with pathological findings to measure MRI's sensitivity, specificity, positive and negative predictive values and diagnostic accuracy in what concerns myometrial, cervical and lymph node invasion.

RESULTS

MRI differentiation of deep myometrial invasion from superficial disease agreed with pathological findings in 77% of cases, with a sensitivity of 83%, a specificity of 72% and a diagnostic accuracy of 77%. Concerning cervical invasion, MRI had a sensitivity, specificity and diagnostic accuracy of 42%, 92%, 81% respectively. In assessing lymph node invasion, MRI presented a sensitivity of just 17%, a specificity of 99% and a diagnostic accuracy of 89%.

CONCLUSION

Our study confirmed the high accuracy of MRI imaging in assessing myometrial and cervical invasion in endometrial carcinoma. When evaluating lymph node invasion, micrometastases are responsible for the low sensitivy of MRI.

Phenothiazines as anti-multi-drug resistant tubercular agents

Pulmonary tuberculosis (TB) has again become a global problem: it infects 2.2 billion people world-wide, caused the deaths of over 3 million last year and will produce over 8 million new cases of TB this coming year. Although effective therapy is widely available for antibiotic susceptible strains of Mycobacterium tuberculosis, current drugs are relatively useless against multi-drug resistant infections (MDRTB). Mortality is almost complete within two years regardless of therapy, and in the case of co-infection with HIV/AIDS, mortality is 100% within a few months of diagnosis especially the M. tuberculosis strain in XDRTB. As of the time of this writing no new effective anti-TB drugs have been made available by the pharmaceutical industry and XDRTB. Because TB is an intracellular infection of the non-killing macrophage of the lung, any agent that is to prove effective must have activity against MDRTB and XDRTB strains that have been phagocytosed by the human macrophage. This review intents to provide cogent in vitro, ex vivo and in vivo evidence that supports the use of a variety of commonly available phenothiazines for the therapy of MDRTB and XDRTB, especially when the prognosis of the infection is poor and the use of the recommend agents can take place along lines of "compassionate therapy". In addition, we will describe the macrophage assay as indispensable when an agent is to be further studied for its effectiveness as an anti-TB drug. In vitro studies if not complemented by ex vivo studies will for the most part be dead-ended since few agents that have activity in vitro have any activity against phagocytosed M. tuberculosis.

Crossed beam photodissociation imaging of HeH+ with vacuum ultraviolet free-electron laser pulses

Molecular photofragmentation has been studied by event imaging on HeH+ ions at 32 nm (38.7 eV) in a fast ion beam crossed with the free-electron laser in Hamburg (FLASH), analyzing neutral He product directions and energies. Fragmentation into He(1snl,n > or = 2)+H+ was observed to yield significant photodissociation at 32 nm with an absolute cross section of (1.4+/-0.7) x 10(-18) cm2, releasing energies of 10-20 eV. A clear dominance of photodissociation perpendicular to the laser polarization was found in contrast to the excitation paths so far emphasized in theoretical studies.

Soft x-ray laser spectroscopy on trapped highly charged ions at FLASH

In a proof-of-principle experiment, we demonstrate high-resolution resonant laser excitation in the soft x-ray region at 48.6 eV of the 2 (2)S(1/2) to 2 (2)P(1/2) transition of Li-like Fe23+ ions trapped in an electron beam ion trap by using ultrabrilliant light from Free Electron Laser in Hamburg (FLASH). High precision spectroscopic studies of highly charged ions at this and upcoming x-ray lasers with an expected accuracy gain up to a factor of a thousand, become possible with our technique, thus potentially yielding fundamental insights, e.g., into basic aspects of QED.

Effect of farnesol on Candida dubliniensis morphogenesis

AIMS

Cell-cell signalling in Candida albicans is a known phenomenon and farnesol was identified as a quorum sensing molecule determining the yeast morphology. The aim of this work was to verify if farnesol had a similar effect on Candida dubliniensis, highlighting the effect of farnesol on Candida spp. morphogenesis.

METHODS AND RESULTS

Two different strains of C. dubliniensis and one of C. albicans were grown both in RPMI 1640 and in serum in the presence of absence of farnesol. At 150 micromol l(-1) farnesol the growth rate of both Candida species was not affected. On the contrary, farnesol inhibited hyphae and pseudohyphae formation in C. dubliniensis.

CONCLUSION

Farnesol seems to mediate cell morphology in both Candida species.

SIGNIFICANCE AND IMPACT OF THE STUDY

The effect of farnesol on C. dubliniensis morphology was not reported previously.

Genome size and ploidy of Paracoccidioides brasiliensis reveals a haploid DNA content: Flow cytometry and GP43 sequence analysis

The aim of this study was to evaluate genome size and ploidy of the dimorphic pathogenic fungus Paracoccidioides brasiliensis. The cell cycle analysis of 10 P. brasiliensis isolates by flow cytometry (FCM) revealed a genome size ranging from 26.3+/-0.1Mb (26.9+/-0.1fg) to 35.5+/-0.2Mb (36.3+/-0.2fg) per uninucleated yeast cell. The DNA content of conidia from P. brasiliensis ATCC 60855-30.2+/-0.8Mb (30.9+/-0.8fg) -showed no significant differences with the yeast form, possibly excluding the occurrence of ploidy shift during morphogenesis. The ploidy of several P. brasiliensis isolates was assessed by comparing genome sizing by FCM with the previously described average haploid size obtained from electrophoretic karyotyping. The analysis of intra-individual variability of a highly polymorphic P. brasiliensis gene, GP43, indicated that only one allele seems to be present. Overall, the results showed that all analysed isolates presented a haploid, or at least aneuploid, DNA content and no association was detected between genome size/ploidy and the clinical-epidemiological features of the studied isolates. This work provides new knowledge on P. brasiliensis genetics/genomics, important for future research in basic cellular/molecular mechanisms and for the development/design of molecular techniques in this fungus.

New insights into the cell cycle profile of Paracoccidioides brasiliensis

The present work focuses on the analysis of cell cycle progression of Paracoccidioides brasiliensis yeast cells under different environmental conditions. We optimized a flow cytometric technique for cell cycle profile analysis based on high resolution measurements of nuclear DNA. Exponentially growing cells in poor-defined or rich-complex nutritional environments showed an increased percentage of daughter cells in accordance with the fungus' multiple budding and high growth rate. During the stationary growth-phase cell cycle progression in rich-complex medium was characterized by an accumulation of cells with higher DNA content or pseudohyphae-like structures, whereas in poor-defined medium arrested cells mainly displayed two DNA contents. Furthermore, the fungicide benomyl induced an arrest of the cell cycle with accumulation of cells presenting high and varying DNA contents, consistent with this fungus' unique pattern of cellular division. Altogether, our findings seem to indicate that P. brasiliensis may possess alternative control mechanisms during cell growth to manage multiple budding and its multinucleate nature.

Spectroscopic analysis of small organic molecules: A comprehensive near-edge x-ray-absorption fine-structure study of C6-ring-containing molecules

We report high-resolution C 1s near-edge x-ray-absorption fine-structure (NEXAFS) spectra of the C6-ring-containing molecules benzene (C6H6), 1,3- and 1,4-cyclohexadiene (C6H8), cyclohexene (C6H10), cyclohexane (C6H12), styrene (C8H8), and ethylbenzene (C8H10) which allow us to examine the gradual development of delocalization of the corresponding pi electron systems. Due to the high experimental resolution, vibrational progressions can be partly resolved in the spectra. The experimental spectra are compared with theoretical NEXAFS spectra obtained from density-functional theory calculations where electronic final-state relaxation is accounted for. The comparison yields very good agreement between theoretical spectra and experimental results. In all cases, the spectra can be described by excitations to pi*- and sigma*-type final-state orbitals with valence character, while final-state orbitals of Rydberg character make only minor contributions. The lowest C 1s-->1pi* excitation energy is found to agree in the (experimental and theoretical) spectra of all molecules except for 1,3-cyclohexadiene (C6H8) where an energy smaller by about 0.6 eV is obtained. The theoretical analysis can explain this result by different binding properties of this molecule compared to the others.

Cytotoxic and genotoxic butanolides and lignans from Aiouea trinervis

The ethanolic extracts from the roots, the underground trunk and the leaves of Aiouea trinervis were active in the brine shrimp (Artemia salina) lethality assay (LD (50): 1.93, 0.92 and 262.1 microg/mL, respectively). Fractionation of the extracts led to the isolation of four butanolides, namely (-)-epilitsenolides C (2) and C (1) ( 1 and 2), isoobtusilactone A ( 3) and obtusilactone A ( 4), two of which ( 1 and 2) are reported for the first time as genuine natural products. The lignans (+)-sesamin ( 5) and (+)-methylpiperitol ( 6) and polyprenol-12 ( 7) were isolated as well. Their structures were determined with spectral methods (1D-, 2D-NMR and MS). Compounds 1, 2, 3, 5 and 6 were tested for their cytotoxic activities in Hep (2) human cancer cells. The butanolides 2 and 3 were the most active (IC (50): 5.96 microg/mL and 4.95 microg/mL, respectively) whereas the other compounds showed moderate IC (50) values ranging from 12.20 microg/mL to 25.64 microg/mL. The genotoxic properties of the crude ethanolic extracts and of compounds 3 and 5 were also evaluated in this study on CHO K1 and HTC mammalian cells with single-cell gel electrophoresis (comet assay). The crude extracts as well as the compounds tested induced DNA migration in this assay, which was indicative of DNA damage (genotoxic effect).

Is prophylactic colectomy indicated in patients with MYH-associated polyposis?

OBJECTIVES

The MYH gene has recently been associated with multiple colorectal tumours. It participates in the DNA base-excision-repair, avoiding mutations in other genes, namely the APC and Ki-ras. Recently, biallelic MYH mutations have been described in patients with attenuated polyposis and in 7.5% with classic polyposis and no detectable APC mutation. The aim of this study was to analyse the incidence of germ-line MYH mutations in selected Portuguese families recorded in a hereditary tumour registry and to evaluate the risk of colorectal cancer in this syndrome.

PATIENTS AND METHODS

Nineteen APC mutation negative patients, 13 presenting attenuated polyposis and 6 with classic familial adenomatous polyposis (> 100 adenomas), were screened for germline biallelic MYH mutations.

RESULTS

Biallelic germline mutations in MYH were identified in 9 of the attenuated polyposis and in one of the classic polyposis patients. The mean age at the clinical diagnosis was 50.6 years (from 35 to 69 years); six were men and four women. Five patients belonged to families with affected siblings; three showed evidence for vertical transmission and two had no evidence for familial transmission of the disease. No extra-colonic manifestations were reported. All patients had surgical resections: five total colectomies, four reconstructive proctocolectomies and one left hemicolectomy. Eight patients had associated malignant degeneration: three T3N+, four T3N0 and one T1N+. In the follow-up two patients died due to tumour recurrence.

CONCLUSION

A large frequency of biallelic MYH mutations (69%) was found in APC mutation negative patients belonging to families with attenuated polyposis; the highest percentage was observed in families presenting evidence for horizontal transmission of the disease. The high percentage of degeneration found in these patients suggests that colonoscopy with polypectomies is not sufficient and prophylactic colectomy is recommended. The identification of MYH associated polyposis is important to evaluate the level of risk, particularly for the siblings.

BINDING PROPERTIES AND IMMUNOLOCALIZATION OF A FATTY ACID–BINDING PROTEIN IN GIARDIA LAMBLIA

We describe here a fatty acid-binding protein (FABP) isolated and purified from the parasitic protozoon Giardia lamblia. The protein has a molecular mass of 8 kDa and an isoelectric point of 4.96. A Scatchard analysis of the data at equilibrium revealed a dissociation constant of 3.12 x 10(-8) M when the labeled oleic acid was displaced by a 10-fold greater concentration of unlabeled oleic acid. Testosterone, sodium desoxycholate, taurocholate, metronidazol, and alpha-tocopherol, together with butyric, arachidonic, palmitic, retinoic, and glycocholic acids, were also bound to the protein. Assays with polyclonal antibodies revealed that the protein is located in the ventral disk and also appears in the dorsal membrane, the cytoplasm, and in the vicinity of the lipid vacuoles.

Clear-PEM: a dedicated PET camera for improved breast cancer detection

Positron emission mammography (PEM) can offer a non-invasive method for the diagnosis of breast cancer. Metabolic images from PEM using 18F-fluoro-deoxy-glucose, contain unique information not available from conventional morphologic imaging techniques like X-ray radiography. In this work, the concept of Clear-PEM, the system presently developed in the frame of the Crystal Clear Collaboration at CERN, is described. Clear-PEM will be a dedicated scanner, offering better perspectives in terms of position resolution and detection sensitivity.

Genetic stability of micropropagated almond plantlets, as assessed by RAPD and ISSR markers

Almond shoots produced by axillary branching from clone VII derived from a seedling of cultivar Boa Casta were evaluated for somaclonal variation using randomly amplified polymorphic DNA (RAPD) and inter-simple sequence repeats (ISSR) analysis. To verify genetic stability we compared RAPD and ISSR patterns of plantlets obtained after 4 and 6 years of in vitro multiplication. A total of 64 RAPD and 10 ISSR primers gave 326 distinct and reproducible band classes, monomorphic across all 22 plantlets analysed. Thus, a total of 7,172 bands were generated, exhibiting homogeneous RAPD and ISSR patterns for the plantlets tested. These results suggest that the culture conditions used for axillary branching proliferation are appropriate for clonal propagation of almond clone VII, as they do not seem to interfere with the integrity of the regenerated plantlets. These results allowed us to establish the use of axillary branching plantlets (mother-plants) as internal controls for the analysis of somaclonal variation of shoots regenerated from other in vitro culture processes performed with clone VII (adventitious regeneration, regeneration from meristem culture, virus sanitation programs and genetic engineering).

Interplay of intra-atomic and interatomic effects: an investigation of the 2p core level spectra of atomic Fe and molecular FeCl2

The 2p photoabsorption and photoelectron spectra of atomic Fe and molecular FeCl2 were studied by photoion and photoelectron spectroscopy using monochromatized synchrotron radiation and atomic or molecular beam technique. The atomic spectra were analyzed with configuration interaction calculations yielding excellent agreement between experiment and theory. For the analysis of the molecular photoelectron spectrum which shows pronounced interatomic effects, a charge transfer model was used, introducing an additional 3d(7) configuration. The resulting good agreement between the experimental and theoretical spectrum and the remarkable similarity of the molecular with the corresponding spectrum in the solid phase opens a way to a better understanding of the interplay of the interatomic and intra-atomic interactions in the 2p core level spectra of the 3d metal compounds.

Dynamically and quasiforbidden transitions in photoionization of open-shell atoms: a combined experimental and theoretical study

Completely fine-structure-resolved photoelectron spectra produced from sodium atoms selectively excited into the Na* 2p(6)3p (2)P(1/2) and (2)P(3/2) states were obtained using a third generation synchrotron source in conjunction with laser pumping and high-resolution spectrometry. The spectra show dramatically different behaviors. The strong variations observed in the regions of the Na+ 2p(5)3p (1,3)L(J) photolines and the Na+ 2p(5)4p (1,3)L(J) shakeup satellites are explained within a generalized geometrical model, accounting for the intermediate angular momentum coupling in the ionic states.

Probing the molecular environment using spin-resolved photoelectron spectroscopy

Angle- and spin-resolved photoelectron spectroscopy with linearly and circularly polarized synchrotron radiation were used to study the electronic structure of model triatomic molecules, hydrogen sulfide, and carbonyl sulfide. The spin-polarization measurements of the molecular field split components of the S 2p photolines revealed a strong effect of the different molecular environments. The validity of simple atomic models to explain the results is discussed.

Genetic relatedness of Portuguese almond cultivars assessed by RAPD and ISSR markers

Randomly amplified polymorphic DNA (RAPD) and inter-simple sequence repeat (ISSR) markers were used to analyse the genetic diversity of Portuguese Prunus dulcis cultivars and their relationship to important foreign cultivars. Of the primers tested, 6 (out of 60) RAPD and 5 (out of 18) ISSR primers were selected for their reproducibility and high polymorphism. Out of 124 polymerase chain reaction fragments that were scored, 120 (96.8%) were polymorphic. All the plants could be discriminated and constitute a very heterogeneous group. Five unidentified almond plants found in the region of Foz Côa (north Portugal) and wild almond (P. webbii) from Italy and Spain were also included. Four main groups of plants could be distinguished: P. dulcis cultivars; one Foz Côa plant; P. webbii; and P. persica (outgroup). The segregating Foz Côa plant may represent a feral individual or a hybrid between P. dulcis and P. webbii.

[Birdshot retinochoroidopathy. Five clinical cases analysis]

PURPOSE

The Birdshot retinochoroidopathy is a rare chronical intraocular inflammatory disease. The authors made a comparative study of the disease's clinical manifestations and its response to therapy.

METHODS

We selected five patients who had ocular inflammation which presented on the ocular fundus examination typical multifocal yellow-white patches of depigmentation of choroid and pigment epithelium and vitreous inflammation.

RESULTS

All the patients showed early spots of hypofluorescence that became hyperfluorescent in the venous phase of angiography, a depression of b-wave amplitude of electroretinogram, a blue-yellow defect of colour vision and carried HLA-A 29 antigen. We recorded an improvement of the visual acuity and of the clinical picture after treatment with corticosteroid and cyclosporine A.

CONCLUSION

Even though Birdshot retinochoroidopathy is a rare pathology in Southern Europe, the cases presented allowed us to conclude that early diagnosis and appropriate therapy greatly improve the well being of these patients (Arch Soc Esp Oftalmol 2002; 77: 247-256).

Human secretory immune response to fatty acid-binding protein fraction from Giardia lamblia

The secretory immune response in humans infected with Giardia lamblia was studied by using saliva samples and an 8-kDa antigen capable of binding fatty acids. This antigen was not recognized by saliva samples from healthy individuals. The antigen may be useful in diagnostic studies of G. lamblia infection.

Transmission of Mycobacterium tuberculosis to contacts of HIV-infected tuberculosis patients

We assessed the infectiousness of human immunodeficiency virus (HIV)-seropositive and HIV-seronegative individuals with pulmonary tuberculosis (TB) in a prospective cohort study. We enrolled, evaluated, and followed 104 close contacts of HIV-seropositive pulmonary TB patients and 256 close contacts of HIV-seronegative pulmonary TB patients using a standardized questionnaire, symptom review, chest radiograph, HIV serology, and tuberculin skin testing (TST). Contacts were followed for > or = 12 mo. TB infection at enrollment was 27% (28/104) among contacts of HIV-seropositive TB patients and 35% (90/256) among contacts of HIV-seronegative TB patients (odds ratio [OR] = 0.68, 95% confidence interval [CI] 0.41 to 1.12; p = 0.130). TST conversion occurred in 21% (42/ 204) of subjects; 8% (5/63) of contacts of HIV-seropositive index cases and 26% (37/141) of contacts of HIV-seronegative index cases (OR = 0.24, 95% CI 0.09 to 0.65; p = 0.003). TB was diagnosed in nine contacts; eight were contacts of HIV-seronegative index cases. HIV seropositivity in the index case was independently associated with a lower risk of TB infection among contacts, even among household contacts younger than 15 yr of age. Contacts of HIV-seropositive persons with pulmonary TB were less likely to have a positive TST response at 1 yr of follow-up than contacts of HIV-seronegative persons.

Enhanced serum glucocorticoid levels mediate the reduction of serosal mast cell numbers in diabetic rats

Rats turned diabetic by treatment with alloxan exhibit a significant reduction in serosal mast cell numbersin parallel with decreased insulin levels in the plasma. Our aim was to investigate the putative involvement of endogenous glucocorticoid hormone in this phenomenon. The findings indicated that rats treated with alloxan responded with an increase in levels of serum corticosterone concomitantly with decreased mast cell numbers in the pleural space. We found that either surgical bilateral adrenalectomy or pretreatment with the steroid antagonist RU 486 (20 mg/kg, i.p.) impaired the drop in pleural mast cell counts in alloxinated rats. Administration of insulin (15 U/kg) prevented the increase in corticosterone levels and restored pleural mast cell levels in diabetic animals. In addition, treatment of naive rats with corticosterone (0.5 mg/kg, s.c.) or dexamethasone (0.1 mg/kg, s.c.), for 3 consecutive days, led to a reduction in the number of mast cells recovered from the pleural cavity as noted in diabetic animals. In contrast, insulin reduced serum corticosterone levels and induced a significant elevation in pleural mast cell numbers in naive rats. We conclude that there is a causative relationship between increased levels of glucocorticoids and down-regulation of mast cell numbers associated with the diabetic state, both phenomena clearly sensitive to insulin.

Statistical properties of inter-series mixing in helium: from integrability to chaos

The photoionization spectrum of helium shows considerable complexity close to the double-ionization threshold. By analyzing the results from both our recent experiments and ab initio three- and one-dimensional calculations, we show that the statistical properties of the spacings between neighboring energy levels clearly display a transition towards quantum chaos.

Sistema de Informações Hospitalares como ajuste de risco em índices de desempenho

OBJETIVO: Analisar o uso do Sistema de Informações Hospitalares do Sistema Único de Saúde (SIH/SUS) no ajuste de risco das taxas de mortalidade hospitalar e avaliar a utilidade do índice de comorbidade de Charlson (ICC) no ajuste de risco de indicadores de desempenho. MÉTODOS: Foram selecionadas 40.299 internações ocorridas no Município do Rio de Janeiro entre dezembro de 1994 e dezembro de 1996. A medida de gravidade foi testada pelo ICC, que atribui pesos a 17 condições clínicas presentes nos diagnósticos secundários, a fim de obter a carga de morbidade do paciente (gravidade) independentemente do diagnóstico principal. Utilizou-se a regressão logística para avaliar o impacto do ICC na estimativa da chance de morrer no hospital. RESULTADOS: Nas internações selecionadas, observou-se que o ICC foi igual ou superior a um em apenas 5,7 % dos casos. Quando se aplicou o ICC combinado à idade, o percentual de casos com pontuação diferente de zero aumentou substancialmente. Os modelos testados apresentaram reduzida sensibilidade. CONCLUSÕES: Apesar de a presença de comorbidade ser importante na predição do risco de morrer, essa variável pouco discriminou a gravidade dos casos na base de dados do SIH/SUS, o que é explicado pela qualidade da informação diagnóstica nessa base de dados, na qual a idade é o preditor mais importante do risco de morrer, afora o diagnóstico principal. Apesar das limitações ainda existentes na qualidade da informação diagnóstica disponível no SIH/SUS, sugere-se o uso do ICC combinado como medida para ajuste do risco de morrer nas taxas calculadas a partir desses dados.

Palatal myoclonus: report of two cases

We describe two cases of palatal myoclonus (PM), one essential and another secondary to a stroke. Case 1: a 64 years old female who developed clicking sounds in both ears after a stroke and three years later on noticed a progressive involuntary movement of the throat associated with rhythmic contractions of the soft palate, muscles of tongue and throat. MRI showed an ischemic area in brainstem. The patient had a partial response to the use of sumatriptan 6 mg subcutaneously. Case 2: a 66 years old female who began with ear clicking at left ear that worsed slowly associated with tinnitus and arrhythmic movements of soft palate and an audible click at left ear. Brain MRI was normal; audiometry showed bilateral neurosensory loss. She was prescribed clonazepan 1 mg daily with complete recovery. Primary and secondary palatal myoclonus share the same clinical features but probably have different pathophysiological underlying mechanisms.

Molecular tools for the identification of Tuber melanosporum in agroindustry

Tuber melanosporum Vitt., Tuber magnatum Pico, and Tuber uncinatum Chat. can be differentiated by their morphological characters. Fraud problems have arisen recently with the importation to Europe of truffles from China. T. melanosporum is morphologically very close, but distinct from the Chinese species [Tuber indicum (Cooke and Massee) and T. himalayense BC (Zhang and Winter)]. We have optimized molecular tools to unequivocally identify T. melanosporum. DNA extraction from ascocarps of black truffles is not straightforward. Problems to obtain pure DNA are due to high contents of phenolic compounds, melanine, and various polymers (proteins, polysaccharides, etc). These compounds coprecipitate with the DNA during extraction and strongly inhibit the PCR reaction. We have developed an efficient and reliable protocol for DNA extraction from truffle ascocarps. It was used successfully for DNA extraction from mycorrhizal root tips as well as from canned preparations of T. melanosporum. Several approaches to identify T. melanosporum by PCR were developed. Two specific primers for T. melanosporum were designed after comparison of the ITS region of this species with those of three Chinese fungi. They proved to be efficient to specifically detect the presence of T. melanosporum by PCR. The mycorrhizal status of trees inoculated with T. melanosporum but unable to produce truffles was confirmed in a single-step PCR reaction. A multiplex PCR approach was also developed with three sets of primers (including a specific one for Chinese truffles) to detect, in one PCR reaction, the presence of any other Tuber species mixed with T. melanosporum ascocarps. This optimized protocol, in association with the specific primers we designed, is applicable to quality control in the truffle industry from the production stages to final commercial products.

Fang tip spread, puncture distance, and suction for snake bite

We measured the distance between fang tip punctures in defensive bites by western diamondback rattlesnakes (Crotalus atrox) and the distance between their retracted fangs. Because the fang tips at penetration average 112% further apart than their bases at rest, The Extractor, a device widely marketed in the United States for snake bite first aid, will not simultaneously cover both punctures of most adult New World pitvipers.

[Kikuchi and Fujimoto disease]

We present a case of Kikuchi and Fujimoto's disease (KFD), revealed by malar rash, fever, arthritis and lymphadenopathy, suggesting Systemic Lupus Erythematosus (SLE). The relation between KFD and SLE is not yet completely understood and remains complex. There are few cases with a lupus-like presentation and the histopathologic features may be insufficient to confirm the KFD diagnosis definitively. The clinical presentation, the IgM deposits at the dermal-epidermal transition in the Lupus Band Test, and the presence of anticardiolipin antibody emphasises the relationship between these two entities and does not exclude the possibility of evolution to SLE, which makes the prognosis doubtful.

Phylogenetic relationships between European and Chinese truffles based on parsimony and distance analysis of ITS sequences

Phylogenetic relationships among truffle species from Europe and China were investigated through parsimony analysis of the ITS sequences. Three major clades were obtained among the species analysed. The so-called white truffles appeared polyphyletic since Tuber magnatum was grouped with brown truffles and not with the other white species (T. maculatum, T. borchii, T. dryophilum, T. puberulum). The black truffles investigated in this study, T. brumale, T. melanosporum, T. indicum and T. himalayense, were grouped in an independent clade. The Périgord black truffle T. melanosporum and the Chinese black truffles T. indicum and T. himalayense, were very closely related. The delimitation of these species was estimated by a distance analysis on several isolates collected from different geographic areas. In spite of intraspecific variations of the internal transcribed spacers (ITS) sequences, T. melanosporum and the Chinese black truffles can be unambiguously attributed to distinct taxa.

Teleconsultation for cooperative acquisition, analysis and reporting of ultrasound studies

We have developed a teleconsultation system to support cooperation between doctors at different institutions in the acquisition, analysis and reporting of ultrasound studies. All the relevant activities were supported by the application. The system enabled remote supervision of the ultrasound study as it was being performed, cooperative static image acquisition and analysis, as well as report writing. Cooperative analysis of previously acquired studies was also possible. The system is undergoing evaluation in five hospitals in Portugal.

A fully human antibody neutralising biologically active human TGFbeta2 for use in therapy

Phage display provides a methodology for obtaining fully human antibodies directed against human transforming growth factor-beta (TGFbeta) suitable for the treatment of fibrotic disorders. The strategy employed was to isolate a human single chain Fv (scFv) fragment that neutralises human TGFbeta2 from a phage display repertoire, convert it into a human IgG4 and then determine its TGFbeta binding and neutralisation properties and its physical characteristics. Several scFv fragments binding to TGFbeta2 were isolated by panning of an antibody phage display repertoire, and subsequent chain shuffling of the selected V(H) domains with a library of V(L) domains. The three most potent neutralising antibodies were chosen for conversion to IgG4 format. The IgG4 antibodies were ranked for their ability to neutralise TGFbeta2 and the most potent, 6B1 IgG4, was chosen for further characterisation. 6B1 IgG4 has a high affinity for TGFbeta2 with a dissociation constant of 0.89 nM as determined using the BIAcore biosensor and only 9% cross-reactivity with TGFbeta3 (dissociation constant, 10 nM). There was no detectable binding to TGFbeta1. 6B1 IgG4 strongly neutralises (IC50 = 2 nM) the anti-proliferative effect of TGFbeta2 in bioassays using TF1 human erythroleukaemia cells. Similarly, there was strong inhibition of binding of TGFbeta2 to cell surface receptors in a radioreceptor assay using A549 cells. 6B1 IgG4 shows no detectable cross-reactivity with related or unrelated antigens by immunocytochemistry or ELISA. The 6B1 V(L) domain has entirely germline framework regions and the V(H) domain has only three non-germline framework amino acids. This, together with its fully human nature, should minimise any potential immunogenicity of 6B1 IgG4 when used in therapy of fibrotic diseases mediated by TGFbeta2.