Molecular characterization of a new whitefly-transmissible bipartite geminivirus infecting tomato in Panama

The nucleotide sequence of infectious clones of a tomato-infecting geminivirus from Panama [named tomato leaf curl virus (ToLCV-Pan) because of symptoms produced in infected tomato (plant stunting and mild leaf curling)] was determined. ToLCV-Pan has a bipartite genome (DNAs A and B) and computer analysis showed that the genome resembles that of other bipartite, whitefly-transmitted geminiviruses. DNA A (2584 nt) and B (2542 nt) have little sequence homology other than within the common region. ToLCV-Pan clones were introduced into Lycopersicon esculentum and infected plants developed the same symptoms as naturally infected tomatoes. Homology analysis of DNA A and B showed that ToLCV-Pan is most closely related to potato yellow mosaic virus (PYMV) from Venezuela. Pseudorecombination between ToLCV-Pan and PYMV did not give viable pseudorecombinant viruses. However, in some plants infected with the pseudorecombinant virus produced by ToLCV-Pan DNA A and PYMV DNA B, systemic movement of ToLCV-Pan DNA A was observed.

[SUNCT type headache. A report of a new case. Short-lasting, unilateral, neuralgiform, headache attacks with conjuctival injection and tearing]

We report a new case of short-lasting, unilateral, neuralgiform headache attacks with conjunctival injection and tearing (SUNCT). This rare headache, described in 1978, shares clinical traits with trigeminal neuralgia and cluster headache and its diagnostic classification as a unilateral headache with autonomic involvement has been the subject of considerable debate. The etiology of SUNCT is unknown, although it is considered a highly difficult pain to treat. We discuss our patient's symptoms and response to treatment with carbamazepine.

[Parry-Romberg syndrome: a form of focal vasculitis]

The Parry-Romberg syndrome (PRS), which was described many years ago, is a process of unknown etiology which evolves with invalidating lesions in one half of the face to which different neurologic, cutaneous or analytical abnormalities may be associated. A clinical, analytical and radiologic study of 5 patients in whom intracranial lesions were shown are herein presented. These findings, together with alterations in the cutaneous biopsies reported in the literature lead to the hypothesis that PRS may be due to a neurovascular alteration of immunologic basis, indicating antiinflammatory or immunosuppressive treatment.

Treatment of relapsing-remitting multiple sclerosis with natural interferon beta: a multicenter, randomized clinical trial

Preliminary results of a multicenter, randomized study on the effect of natural interferon beta (n-INFN-beta) in relapsing-remitting MS are reported. Sixty patients received either no treatment or n-IFN-beta (9 MIU three times a week, subcutaneously). After 6 months, the n-IFN-beta-treated group showed a 58% median reduction in the number of active lesions detected on monthly magnetic resonance imaging scans as well as a 38% reduction in the exacerbation rate as compared with the control group. Side-effects were mild and self-limiting. The study continues according to the protocol.

[Reversible cortical blindness associated with bilateral occipital lesions caused by cyclosporin A: report of two cases]

We report two cases of encephalopathy with cortical blindness associated with reversible bioccipital lesions in transplanted patients (of the kidney and bone marrow) who were being treated with cyclosporin A. We briefly discuss the pathogenesis of symptoms and review the literature.

[Frontal dementia-motor neuron disease: a case report and literature review]

The association between frontal dementia and motor neurone disease has been known for years now although its existence as a nosologic entity in its own right is still subject to debate. Lack of strict histological criteria and inspecificity in complementary tests which might otherwise lend weight to such a diagnosis prevent our considering it as much more than a mere clinical syndrome. We present here the case of a 56 year old female patient who developed a type of dementia with frontal characteristics associated with motor neurone disease. We discuss the clinical picture and review the relevant literature.

[Neurological manifestations of fat embolism syndrome]

Fat embolism is a frequent complication of long bone trauma. Although neurological signs are key elements in the diagnosis of this syndrome, little attention to them has been paid in the spanish literature. We present a retrospective study of 13 patients with fat embolism syndrome in which we focused on neurological manifestations and alterations in computerized tomography (CT) of the head. The most frequent symptom was impairment of consciousness of varying degrees. Three patients out of the 13 also presented focal signs (hemiparesis and partial seizures). CT revealed edema (4/7) and multiple low density foci (1/7). All but one patient recovered without sequelae. Our study does not allow us to establish either the physiopathology of fat embolism syndrome or the most effective treatment.

[Carotid artery dissection at the cervical level presenting as unilateral paresis of lower cranial nerves]

Internal carotid artery dissection at the cervical level is a known cause of stroke in young patients. The usual clinical presentation is strong ipsilateral cephalea and oculosympathetic paresis or ischemic symptoms in the affected artery. Paresis of the lower cranial nerves due to local compression in the space behind the parotid is rarely found and may complicate the diagnosis by leading physicians to look for anomalies in the vertebro-basilar territory. We present a patient with internal carotid artery dissection at the cervical level diagnosed by angiography. Symptoms at presentation were hemicranial cephalea accompanied by Villaret's syndrome. We point out the importance of keeping this diagnostic possibility in mind when looking for the etiology of subacute paresis of the lower cranial nerves.

The prevalence of multiple sclerosis in the Sanitary District of Vélez-Málaga, southern Spain

Since little is known about the prevalence of multiple sclerosis (MS) in Spain, we undertook an epidemiologic study to ascertain the prevalence of MS in the Sanitary District of Vélez-Málaga, close to the city of Málaga, in southern Spain. The crude prevalence rate of MS in Vélez-Málaga was 53 per 100,000, twice as high as the prevalence previously reported in both the city and province of Málaga. The MS prevalence in the Sanitary District of Vélez-Málaga is similar to that in Sicily and in Cyprus.

[Neurophthalmological alterations in multiple sclerosis]

With the aim of defining the neuro-ophthalmological alterations in multiple sclerosis, both with respect to visual and oculomotor aspects, we have studied a sample of 100 clinically definite multiple sclerosis patients, all in the remittent phase of the disease. We compared them with a sample of 100 unrelated healthy controls, matched for age and sex. Visuomotor alterations were found in 99%, purely visual alterations in 38%, purely oculomotor alterations in 3%, and mixed alterations in 58% of the MS patients. Comparisons with controls showed significant statistical differences in all the tests used in the study. The neuro-ophthalmological examination in multiple sclerosis permits us to detect subclinical lesions and arrive at a better comprehension of central nervous system involvement in this disease, thereby contributing collaborating to better patient care.

[Neurologic complications induced by the treatment of the acute renal allograft rejection with the monoclonal antibody OKT3]

The treatment of the acute renal allograft rejection with the monoclonal antibody orthoclone OKT3 produces both systemic and neurologic alterations. In a series of 21 patients with an acute renal allograft rejection treated with this monoclonal antibody, 20 with a renal allograft transplantation and one with a renal and pancreatic allograft transplantation, 29% referred headache associated with fever and vomiting, and 14.2% presented severe neurological alterations induced by the treatment. We stress the need to know these secondary effects to differentiate them from other central nervous system disorders, particularly those of infectious origin.

Effect of transfer factor on myelosuppression and related morbidity induced by chemotherapy in acute leukaemias

The aim of this study is to determine the safety and efficacy of Transfer Factor (TF) in accelerating the haematopoietic recovery in patients with acute leukaemias (AL), following intensive therapy to induce remission of the disease. Twenty-two patients with different types of AL (16 AML, three BC-CML and three ALL) were studied. The patients were divided in two groups. Group 1 (eight AML, two BC-CML and one ALL) received, after myelosuppression induced by chemotherapy, TF (1 unit daily, subcutaneous) until leucocyte count was > 2.5 x 10(9)/l and platelet count > 80 x 10(9)/l. Group 2 was considered the control group and did not receive TF. Treatment with TF accelerated the recovery of neutrophils, leucocytes, platelets (P < 0.001) and haemoglobin (P < 0.01). As a logical consequence, incidence and severity of infection and haemorrhage were lesser in the TF group than in the control group. There was no evidence that TF accelerated the re-growth of leukaemic cells. It seems that TF is safe in AL, accelerating haematopoietic recovery. However, it should be used with caution until results of additional trials become available.

[Treatment of acute lymphoid leukemia (ALL) in the child]

PURPOSE

To analyse the results of the therapy administered to children with ALL in Cuba.

PATIENTS AND METHODS

Four-hundred and twenty-five children (aged below 15 years), diagnosed of ALL in 8 different Cuban hospitals between 1973 and 1991, were evaluated. Five different therapeutic regimes were used: three "classic" GLATHEM protocols in the first period (1973-1981) and two intensive BFM-like protocols in the second period (1982-1991). The Kaplan-Meier method was applied for survival analysis, and the differences were evaluated by the log-rank and Mantel-Cox methods.

RESULTS

Two-hundred and sixty-five patients were included in the first period, 81 with low-risk disease, 133 with standard risk and 51 with poor-risk leukaemia. The second period comprised 160 cases, 50 of low-risk, 83 with standard risk and 27 with poor-risk leukaemia. The disease-free survival probability at 60 months was 35% for the first group and 55% for the second (p < 0.0001). The 60-month survival (SV) as a whole was 45% for the "classic" treatments and 60% for the BFM-like protocols (p < 0.01). The disease-free survival (DFS) probability for each prognostic group was as follows: 50% for low-risk, 43% for standard risk, and 25% for poor-risk (p < 0.001) and the probability of survival as a whole was, respectively, 65%, 49% and 28% (p < 0.001). as for this compilation, 172 patients were out of any treatment for periods ranging between 14 and 168 months.

CONCLUSIONS

1) The percentage of remissions was similar for both groups of treatments. 2) The results attained with BFM-like protocols were better than those of the "classic" therapy with regard to the SV and DFS differences. 3) Significant differences can be appreciated between good- and poor-prognosis groups for both types of treatment.

p53 gene rearrangements in chronic myelocytic leukemia

We performed Southern-blot analysis of the p53 gene in 41 consecutive patients with typical chronic myelocytic leukemia (CML). In two of them, we were able to study cells during both the chronic and the accelerated phases. Only one of the 29 chronic-phase samples had rearrangement of the p53 gene, whereas three of the nine accelerated-phase samples and one of the five patients in blast crisis exhibited rearrangements. Gene deletion was observed in two patients, one in accelerated phase and the other in blast crisis. One patient with a nonrearranged p53 gene in chronic phase showed rearrangement after progression to the accelerated phase. On the other hand, one patient in accelerated phase exhibited rearrangements which disappeared after reversion to chronic phase with successful treatment. Our findings support the opinion that alterations of the p53 gene may play an important role in CML evolution.

Chemiluminescence production by neutrophils and immune complex levels in cancer patients

We studied the production of chemiluminescence (CL) by peripheral blood neutrophils from 24 normal subjects, 13 lung cancer patients with clinical stages (CS) III and IV, and 27 breast cancer patients with CS II, III, and IV. Evaluations were made before chemo- and radiotherapy treatments. CL was expressed as: baseline of the record background activity; area under the curve (AUC) of opsonized zymosan response; maximum peak (MP) response; time to MP (TMP); and total time (TT). Simultaneously, circulating immune complexes (CIC) in sera were evaluated by polyethylene glycol precipitation technique. The results demonstrated that lung cancer patients with CS III had an increase of TMP and TT values, while breast cancer patients with CS IV showed the lowest values of AUC and MP compared with the control group. The CIC levels were increased in all the cancer patients. There was no correlation between the baseline CL activity and the levels of immune complexes.

[Rearrangement of the bcl1 and bcl2 oncogenes in chronic lymphoid leukemia]

Oncogenes bcl1 and bcl2 are located in the rupture site of t(11;14) and t(14; 18), respectively. They have been found to rearrange in different B-cell malignancies. A molecular study of oncogenes bcl1 and bcl2 was carried out in 42 patients diagnosed of B-cell chronic lymphoid leukaemia. In 14.3% of the patients the rearrangement affected bcl1, but no differences were found with regard to stage and clinical course between these patients and those without any oncogen rearrangement. In all the patients studied bc12 was in a germinal configuration.

[In vitro formation of fibroblast colony-forming units in the bone marrow of patients with solid malignant tumors]

The number of bone marrow fibroblast colony-forming cells (CFU-F) were studied in twelve healthy donors, four colon (CP) and nine lung cancer patients (LP). A liquid culture system has been used to characterize human bone marrow CFU-F. The results showed any recognizable CFU-F in three patients with colon cancer and in two patients of the other group. One of the four CP and five of the nine LP presented a CFU-F value of 17 and 2, 8, 22, 29, 32, respectively compared to 65 from normal subjects. Two LP reached normal CFU-F values (normal range = 33-191). These data support the conclusion that the 84.6% of these solid tumor cancer patients study produced less number of proliferative status of fibroblast colony-forming cells.

Early prognostic factors for disability in multiple sclerosis, a European multicenter study

The effects of initial clinical variables on short-term prognosis are analyzed in a cross-sectional study of 574 multiple sclerosis patients from 7 centers in 5 European countries. Patients with a primary progressive course had a 2.3 higher mean disability score (EDSS) than the primary remittent group after a mean duration of disease of 6.6 years. High age at onset was associated with a primary progressive course, and was also related to increased risk of a rapid shift to a secondary progressive course. Among the remittent patients without a secondary progressive course a high age at onset was significantly correlated to a higher disability score. In the whole remittent group the presence of pyramidal and cerebellar symptoms at onset predicted both a high disability score and a rapid shift to a secondary progression, while the effect was reverse for sensory and visual symptoms. No difference between the sexes was found.

Prevalence of juvenile periodontitis in Chile

The aim of this survey was to study the prevalence of juvenile periodontitis in schoolchildren aged 15-19 years in Santiago, Chile. A random sample of 2500 schoolchildren (1318 male, 1182 female) that represented the full range of different socio-economic strata and ethnic groups seen in the population of Santiago, was used. Initially, the children were screened clinically at school by assessment of probing depths around the incisors and first molars with a WHO 621 pattern probe. Children with 2 or more teeth with 5.5 mm or deeper pockets were invited for a radiographic examination comprising bitewing radiographs of molars, and periapical radiographs of incisors. Any subject with 2 mm or more alveolar bone loss was invited for a full clinical and radiographic examination. After screening, 27 subjects had a tentative diagnosis of juvenile periodontitis. 4 of these refused radiographic examination and only accepted a thorough clinical examination. 23 subjects presented themselves for the radiographic and complete clinical examination. Of the 27 subjects selected for detailed examination, 8 subjects (7 female, and 1 male) were diagnosed as having juvenile periodontitis. There was an overall prevalence of juvenile periodontitis of 0.32% with 95% confidence, which gives a range of +/- 0.10%. When prevalence was assessed by socio-economic status, juvenile periodontitis was found more commonly in low socio-economic group. The results of the current study suggest that in Chile, there might be a relationship between socio-economic status and prevalence of juvenile periodontitis, and that this disease is more frequent in women.

[Active and inactive forms of cerebral cysticercosis. Study of 10 cases]

Ten cases of neuro-cysticercosis attended in our hospital over the last five years are presented. Six patients presented non-active parenchymatous calcifications of which four manifested epilepsy, one dementia caused by hydrocephalus and one other was asymptomatic. Two patients presented active intraparenchymatous cysts with a clinic of epilepsy. One patient presenting cisternal -ventricular-parenchymal involvement and another with ependymal -meningeal-parenchymal involvement, both suffered of psychiatric alterations. Ataxia and pyramidal deficits. The two patients with active parenchymal form were treated with Praziquantel obtaining a complete cyst remission (normal cranial Ot scan, in one case normal NMR) and neurological clinical symptoms. Two more patients treated with Praziquantel suffering ventricular and meningeal ependymal involvement presented little or no response to this treatment.

[Relationship between surface HLA-DR expression and NBT reduction in monocytes in patients with colorectal cancer]

The expression of HLA-DR antigens and their capacity to reduce nitroblue tetrazolium (NBT) have been evaluated in monocytes (Mo) from 28 patients with colorectal carcinoma (CCa) before antineoplastic treatment as well as in 29 normal control (NC). Simultaneously, circulating immune complexes (CIC) levels were studied in both groups. The results were expressed as the media of percentages. They show a decrease of Mo bearing HLA-DR (p less than 0.001 vs NC) and increase of MO with capacity to reduce NBT (p less than 0.001 vs NC). An increase of CIC levels in CCa compared to the NC (p less than 0.001) was also observed. We can postulate that the decrease in HLA-DR expression could be caused by the increase of toxic oxygen intermediates whose production was induced by CIC or tumoral antigens adherence.

The effect of RU486 on transport, development and implantation of mouse embryos

Pregnancy was interrupted in Swiss-Rockefeller mice by a single subcutaneous injection of the antiprogesterone RU486 given postcoitally. A dose of 0.1 mg/animal injected on day 1, produced partial inhibition of pregnancy, a notable delay in embryonic development and a slight retention of embryos in the oviducts. When the same dose was injected on day 2, 3 or 4, no implantation sites were seen at autopsy performed on day 12 of pregnancy. Treatment with 0.5 or 1 mg/animal on day 1 produced the loss of a large proportion of the embryos from the genital tract by day 4 of pregnancy and suppressed implantation completely. These observations indicate that preimplantation phenomena in mice are highly dependent on progesterone action.

Circulating immune complexes in breast and lung cancer, before and after chemotherapy

Circulating immune complexes (CIC) levels were evaluated in two groups of cancerous patients to try to correlate CIC levels, tumor stage and chemotherapy received. There were 40 patients with Lung Cancer (LC) clinical stages III and IV; 60 patients with Breast Cancer (BC) stages II, III and IV and 38 normal controls. LC patients showed significant increase in CIC values before, during and after treatment as compared to controls, without any difference among groups under different treatment combinations and tumor stage. Stage II BC patients showed decreased CIC levels during treatment (p less than 0.01 vs initial value). This decrease was maintained after treatment (p less than 0.02). Stage III BC patients showed different behaviour according to treatment: those who only received chemotherapy (ADM + CTX) showed no significant differences during treatment, and those treated with ADM + CTX and megestol acetate (MA) displayed decreased CIC levels after treatment (p less than 0.05) reaching similar control values. Stage IV patients treated with ADM + CTX + MA returned to normal CIC values during treatment. These results proved that combined treatment of chemotherapy and hormone therapy diminished CIC levels in BC patients, while therapy given to LC patients did not present any modifications.