Quantification of the major allergen from cypress (Cupressus arizonica) pollen, Cup a 1, by monoclonal antibody-based ELISA

BACKGROUND

Cypress pollen allergy is an important cause of rhinoconjunctivitis and asthma in Mediterranean countries. Cypress allergenic extracts are difficult to produce since they have low protein and high carbohydrate content, thus accurate standardization of them is essential to guarantee their quality. The aim of this study is to develop a sandwich ELISA for the quantification of Cup a 1, the major allergen of cypress (Cupressus arizonica) pollen extract.

METHODS

Monoclonal antibodies directed to purified Cup a 1 were produced. Two of them (9C7 as capture antibody and 3D2 as the tracer) were selected to develop a quantitative sandwich ELISA. This ELISA was subsequently evaluated and compared with other techniques.

RESULTS

The described ELISA is very sensitive with a detection limit of 8.7 ng/ml and a practical working range of 62.5-1,000 ng/ml. The assay is also highly reproducible with intra-assay and interassay coefficients of variation of less than 10%. The purified Cup a 1, used as standard, presents pectate lyase enzymatic activity. The assay also detected Cup a 1-like proteins in pollen from other Cupressaceae. A good correlation was obtained between Cup a 1 content of 12 C. arizonica pollen extracts and their IgE-binding activity.

CONCLUSIONS

The described Cup a 1 ELISA is sensitive, specific and reproducible and can be used for the quantification of Cup a 1 in C. arizonica and other related pollen extracts. It also provides a reliable indication of the allergenic activity of the whole cypress pollen extract.

Relationship between low bone mineral density and highly active antiretroviral therapy including protease inhibitors in HIV-infected patients

PURPOSE

The objectives of this study were to determine the prevalence of osteopenia and the factors associated with its presence in HIV-infected patients under highly active antiretroviral therapy (HAART) and to assess the changes of bone mineral density (BMD) in a population followed prospectively.

METHOD

BMD was assessed by dual-energy X-ray absorptiometry (DEXA) scans at the lumbar spine and at the femoral neck in 78 HIV-infected patients who had previously received HAART as the first antiretroviral regimen and in 11 antiretroviral-naive HIV-infected patients. BMD measurements were repeated in 70 treated patients who had completed 1 year of follow-up.

RESULTS

Thirty-seven (42%) patients showed osteopenia at any localization. The prevalence of osteopenia in PI-naive patients was 23% versus 49% in individuals who had received PI at any moment [p =.001; adjusted odds ratio (95% CI) = 0.11 (0.02-0.48)]. The frequency of osteopenia was significantly higher among men than among women [50% vs. 17%; p =.016; adjusted OR (95% CI) = 12.1 (2.22-66.20)]. The level of plasma albumin was independently associated with osteopenia [adjusted OR (95% CI) per each g/dL of plasma albumin decrease 2.55 (1.18-10)]. In patients in whom a second DEXA was done, no significant changes in BMD were found.

CONCLUSION

The prevalence of osteopenia in HIV-infected patients on HAART is high. Loss of BMD is associated with PI therapy, low plasma albumin level, and male sex. Osteopenia does not progress after 1 year of continued HAART.

A superconducting reversible rectifier that controls the motion of magnetic flux quanta

We fabricated a device that controls the motion of flux quanta in a niobium superconducting film grown on an array of nanoscale triangular pinning potentials. The controllable rectification of the vortex motion is due to the asymmetry of the fabricated magnetic pinning centers. The reversal in the direction of the vortex flow is explained by the interaction between the vortices trapped on the magnetic nanostructures and the interstitial vortices. The applied magnetic field and input current strength can tune both the polarity and magnitude of the rectified vortex flow. Our ratchet system is explained and modeled theoretically, taking the interactions between particles into consideration.

Imaging cobalt nanoparticles by amplitude modulation atomic force microscopy: comparison between low and high amplitude solutions

In many situations of interest amplitude modulation AFM is characterized by the coexistence of two solutions with different physical properties. Here, we compare the performance of those solutions in the imaging of cobalt nanoparticles. We show that imaging with the high amplitude solution implies an irreversible deformation of the nanoparticles while repeated imaging with the low solution does not produce noticeable changes in the nanoparticles. Theoretical simulations show that the maximum tip-surface force in the high amplitude solution is about 14nN while in the low amplitude solution is about -4nN. We attribute the differences in the high and low amplitude images to the differences in the exerted forces on the sample.

O/W microemulsions for oral drug delivery

Quaternary microemulsion compositions for oral administration using isopropyl myristate, polysorbate 80 and ethanol 96 degrees were developed and three ratio of polysorbate to ethanol were selected. Isotropic single-phase compositions were considered as microemulsions and were registered on a Pseudo-Ternary Phase Diagram. The objective was to formulate a therapeutic dose for lorazepam and loperamide in a drop liquid form. Another aim was to obtain a liquid oral formula for nifedipine taking advantage of its insured fast absorption to be used in hypertensive crises. The physical stability of the compositions was evaluated by normal aging, centrifugal resistance time and by cycling as well. The selected formulation characterization included density, pH and conductivity measurements. The particle size distribution was determined by a light scattering method and, finally the carried drugs concentration was valued. The versatility showed by this type of systems allows both to carry drugs of different physico-chemical properties and to deal with a number of pharmacotherapeutic objectives.

Osteoarticular pain and bone mineral density in renal transplantation

INTRODUCTION

The reduction of bone mineral density (BMD) levels is an important complication after renal transplantation. The prevalence of nontraumatic lesions may reach 22%. Patients with lower osseous mass suffer the highest number of lesions.

OBJECTIVE

Evaluate BMD in patients over 30-years old who have undergone renal transplantation more than 1 year prior, who attend a medical facility complaining of osteoarticular pain and were prescribed rest or any analgesia.

PATIENTS AND METHODS

One hundred twenty-three patients who received a renal transplant from a cadaveric donor from 1980 through 2000 were included in the present study to measure BMD levels in the hips and the vertebral column using a densitometer (Hologic 4500 QDR). Our study complied with WHO recommendations, which define normal values as a T score >-1 SD osteopenia as a (T score between <-1 and >-2.5 SD), and osteoporosis as a T score <-2.5 SD. Patients were divided into three groups according to gender and hormonal status. The following clinical and analytic data were collected: age, gender, race, age at onset of menopause, diabetes mellitus (DM), weight, size, retransplantation, period of evolution after transplantation, and parathormone (PTH), creatinine, and renal clearance values.

RESULTS

There were 51 men (41.1%) included. Forty postmenopausal (32.5%) and premenopausal women (26%) were also included. In all patients we observed a correlation between a reduction in BMD values and age, duration post-transplantation, and body weight (P<.05). Reduced BMD levels in premenopausal women were related with lower body weight, (P<.05) and elevated PTH levels (P<.024).

CONCLUSIONS

We observed that patients who had undergone transplantation displayed a moderately higher risk of suffering a fracture. Such risk increased in the case of women with more frequent fractures in the vertebral column. In 23.8% of patients reporting osseous pain, there was no reduction in BMD levels. Therefore, we must look for other disorder, responsible for the pain and prescribe adequate treatment.

Severely elevated intrarenal arterial impedance and abnormal venous flow pattern in a normal functioning kidney graft

Serial Doppler sonographic impedance measurements represent the most common diagnostic method for noninvasive monitoring of kidney grafts. Severely elevated arterial impedance is almost always associated with graft dysfunction. However, we describe in the present work a renal transplant recipient with optimal graft function despite permanently elevated arterial impedance (pulsatility index (PI) ranging from 2.9-3.0, and resistive index (RI) = 1.0 as well as an abnormal venous flow pattern. In contrast, the contralateral graft from the same cadaver donors transplanted into a 17-year-old female patient displayed normal range PI and RI values in conjunction with a normal serum creatinine. Known causes of arterial impedance elevation such as rejection, cyclosporine, urinary obstruction, and external graft compression were excluded. Other extrarenal causes of high impedance, such as aortic insufficiency and reduced aortic compliance, were also excluded. No evidence of impaired venous outflow at the site of the anastomosis of the main renal vein to the iliac vein was found. Those findings support the view that impedance indexes are hemodynamic rather than functional parameters.

Tacrolimus in induction immunosuppressive treatment in renal transplantation: comparison with cyclosporine

The aim of the study was to compare the efficacy and safety of induction immunosuppression therapies based on tacrolimus or cyclosporine (CsA) in kidney transplantation. The 240 kidney allograft recipients were divided into two groups: group 1 (n=94) received tacrolimus (.01 mg/kg per day), mycophenolate mofetil (MMF, 2 g/d), and steroids (30 mg/d); and group 2 (n=146) CsA (6 mg/kg per day), MMF (2 g/d), and steroids (30 mg/d). Antilymphocyte serum was administered in cases of acute tubular necrosis. The acute rejection rate was higher among group 2 (30.6%) compared with group 1 patients (12.2%) (P=.001). There were no significant differences between the groups in terms of age, gender, body surface area, serologic virus markers (in donor and recipient), baseline creatinine levels, cause of death, HLA incompatibilities, response to acute tubular necrosis, and number of dialysis sessions. We conclude that both immunosuppressive regimens are effective and safe in kidney transplantation. The survival rates of patients and grafts were similar, but the incidence and degree of acute rejection events were reduced in group 1; this finding may forecast a decreased incidence of chronic renal allograft nephropathy.

Significance of cytomegalovirus infection in renal transplantation

The aim of this study was to establish the relationship between vascular lesion chronic allograft nephropathy (CAN) and the presence of cytomegalovirus (CMV) in kidney transplanted patients. We studied 259 consecutive kidney transplant recipients with a minimum follow-up of 6 months; the induction immunosuppressive therapy included a calcineurin inhibitor, mycophenolate mofetil, steroids, and the use of an antilymphocyte serum if the patients developed delayed graft function. CMV early antigen detection (pp65) was performed on a weekly basis between days 30 and 90 post transplantation. Prophylactic treatment was administered in the donor +/recipient-risk group, and preemptive therapy delivered for positive antigenemia namely 3 days of intravenous [IV] gancyclovir [GCV] plus 11 days of oral therapy [in the case of infection], or 14 days of IV GCV [in the case of disease]). An acute kidney allograft rejection episode preceded CMV in 64.3% of the patients, and CMV preceded acute rejection in 35.7% of the cases. We conclude that CMV disease is an independent risk factor for CAN. CMV infection is probably associated with CAN, suggesting that the greater the viral load, the higher the risk of CAN. It may be advisable to perform universal prophylaxis to lower the viral load and CAN.

[Bone mineral density in children with osteogenesis imperfecta]

OBJECT

Osteogenesis imperfecta is the term used for a group of disorders of collagen synthesis which cause increased bone fragility. The aim of our study was to evaluate the BMD in patients with OI.

MATERIAL AND METHODS

We used dual-energy x ray absorptiometry, Hologic QDR 4500W (DEXA), to compare the bone mineral density (BMD) of 8 patients aged from 3 years to 20 years who had osteogenesis imperfecta with an age and sex matched control group.

RESULTS

DEXA detected highly significant differences in BMD respecting control group. The mean BMD in the patients with osteogenesis imperfecta was 62.6 % of normal in lumbar spine (p < 0.01) and 63.01 % of normal in the femoral neck (p < 0.01) using Wilcoxon test.

CONCLUSION

DEXA is an objective, reproductible and sensitive method of measurement of BMD in children. It may help to stablish the diagnosis, to asses prognosis and possibly to monitor the response to different types of treatment.

Rat glomerulosa cells in primary culture and E. coli lipopolysaccharide action

During endotoxic shock there is a dysfunction of the adrenal gland; both corticosterone and aldosterone secretion are altered. The aim of the present study is to use glomerulosa cells in primary culture as a target of lipopolysaccharide (LPS) action. Glomerulosa cells cultured in basal conditions are able to proliferate; bFGF and ACTH have antagonic effects, bFGF increases proliferation whereas ACTH is antimitogenic. LPS has a biphasic effect, in the short term it is antimitogenic and in the long term increases the proliferation rate. LPS inhibits ACTH-induced corticosterone secretion in a dose-dependent manner in glomerulosa cells in culture similar to that in fasciculata cells, but it does not exert an important direct effect on aldosterone secretion. These results show that LPS exerts different effects in ACTH and ANG II signal transduction pathways and in the two enzymes which catalyze the late step in the steroidogenesis, 11beta-hydroxylase and aldosterone synthase, which could be in agreement with the existence of both enzymes, regulated independently, in rat zona glomerulosa cells.

[Analysis of survival in dialysis: hemodialysis versus peritoneal dialysis and the significance of comorbidity]

To choose the best possible dialysis technique for those patients with end-stage renal disease continues to be a matter of debate. Even after putting aside the evident influence that economic and geographic factors as well as the health politics may have in the selection of the technique, different studies comparing survival between hemodialysis (HD) and peritoneal dialysis (PD) have shown contradictory results which could be explained by the differing methodological and statistical methods used together with the different influence assigned to the comorbidity found when starting the treatment, a situation that has increased the confusion about this topic. Based on this we performed a retrospective analysis with a follow-up time of seven years including all those patients who started dialytic treatment in our area, with a final number of 3.106 hemodialysis patients and 542 peritoneal dialysis patients. Those patients who were transferred to another treatment technique during the time of the study were excluded. Age higher than 70 years, cardiovascular disease, liver disease, diabetes mellitus and the presence of dyslipidemia were included as comorbidity factors. Peritoneal dialysis patients were younger than those treated by hemodialysis (54.53 vs 60.1 years), but suffered from higher cardiovascular comorbidity and were more often diabetic. The global survival was the same in both groups up to 32 months of treatment. Although no differences were found when comparing those patients without comorbidity factors, those with comorbidity had better survival on hemodialysis. Age higher than 70 years was the only comorbidity factor with statistically significant difference for a better survival in hemodialysis.

Textile dyeing wastewater treatment in a sequencing batch reactor system

This study was undertaken to examine the feasibility of treating biologically textile wastewater for organic carbon removal. The study was conducted over a lab scale SBR equipped with an in-house developed data acquisition and control software. From monitored operation of SBR and dissolved oxygen values, together with a simple compressed air ON/OFF control scheme, on-line Oxygen Uptake Rate (OUR) profiles during aerobic reaction periods were obtained. Due to the high variability of wastewater characteristics, periodical analyses of textile wastewater were conducted and thus characterized for pH, conductivity, total and volatile solids, COD, ammonia, and TKN. After an initial period of activated sludge adaptation to textile wastewater, the SBR was operated at step-feed strategy to reduce the effluent biodegradable matter presents in the wastewater by SBR water change ratio modification and feeding strategy.

Adhesion Forces between Lewis(X) Determinant Antigens as Measured by Atomic Force Microscopy

The adhesion forces between individual molecules of Lewis(X) trisaccharide antigen (Le(X) ) have been measured in water and in calcium solution by using atomic force microscopy (AFM, see graph). These results demonstrate the self-recognition capability of this antigen, and reinforce the hypothesis that carbohydrate-carbohydrate interaction could be considered as the first step in the cell-adhesion process in nature.

Effects of extremely hot days on people older than 65 years in Seville (Spain) from 1986 to 1997

The effects of heat waves on the population have been described by different authors and a consistent relationship between mortality and temperature has been found, especially in elderly subjects. The present paper studies this effect in Seville, a city in the south of Spain, known for its climate of mild winters and hot summers, when the temperature frequently exceeds 40 degrees C. This study focuses on the summer months (June to September) for the years from 1986 to 1997. The relationships between total daily mortality and different specific causes for persons older than 65 and 75 years, of each gender, were analysed. Maximum daily temperature and relative humidity at 7.00 a.m. were introduced as environmental variables. The possible confounding effect of different atmospheric pollutants, particularly ozone, were considered. The methodology employed was time series analysis using Box-Jenkins models with exogenous variables. On the basis of dispersion diagrams, we defined extremely hot days as those when the maximum daily temperature surpassed 41 degrees C. The ARIMA model clearly shows the relationship between temperature and mortality. Mortality for all causes increased up to 51% above the average in the group over 75 years for each degree Celsius beyond 41 degrees C. The effect is more noticeable for cardiovascular than for respiratory diseases, and more in women than in men. Among the atmospheric pollutants, a relation was found between mortality and concentrations of ozone, especially for men older than 75.

Tachyphylaxis following regular use of formoterol in exercise-induced bronchospasm

BACKGROUND

Formoterol is a highly effective therapeutic agent in the prevention of exercise-induced bronchospasm (EIB). Regular use of beta-adrenergic drugs may result in a reduction in the protective effect afforded by these bronchodilators against bronchoconstrictor stimuli. It is unknown whether this effect extends to formoterol and exercise.

METHODS

We performed a randomized, double-blind, parallel clinical trial in 19 patients with EIB. Each patient received inhaled formoterol or placebo twice daily during 4 weeks. Patients performed two exercise tests in a cycle ergometer on the 1st, 14th, and 28th study days separated 3 hours from each other. A dose of formoterol was given 30 min prior to the 2nd test.

RESULTS

There were significant differences in bronchoprotection between days 1 and 14 (p = .012) and between days 1 and 28 (p = .012) in the formoterol group. No differences were found in the placebo group. The evolution of the bronchoprotection index was also significantly different between the formoterol and the placebo group (p = .002) from day 1 to 28.

CONCLUSIONS

Tachyphylaxis developed to the protective effect of formoterol against EIB after 4 weeks of regular dosing. Tolerance was already found on day 14, though not progressive. Formoterol should be recommended only as needed in EIB.

[Massive bilateral adrenal hemorrhage after conservative tumor surgery in the isthmus of a horseshoe kidney]

OBJECTIVE

To present a fatal case of massive bilateral suprarrenal haemorrhage (MBSH) after partial nephrectomy.

CLINICAL CASE

An 82 year old male treated with oral anticoagulants was diagnosed by means of CT scan and arteriography of having an avascular tumor located at the isthmus of a horseshoe kidney. A tumorectomy with safety surgical margins was performed; It was diagnosed of having a renal adenocarcinoma, which was almost completely necrotic. During the postoperative period, the patient presented abdominal pain, nausea, fever, hypotension and severe respiratory distress. Biochemical studies showed mild hyponatremia and azotemia, accompanied by anemia, leucocytosis and thrombocytosis. An abdominal CT scan demonstrated a MBSH, which produced the patients death soon afterwards.

DISCUSSION

Tumoral pathology of horseshoe kidneys presents important topographic and anatomopathologic differences with respect to non-fused kidneys. MBSH is a rare complication of many stress processes especially if an anticoagulant treatment coexists. The treatment has to be initiated as soon as we suspect MBSH, which should be confirmed by hormonal determinations and/or the presence of hyperdense suprarenal lesions at the CT scan.

Capillary electrophoretic analysis of inorganic anions in atmospheric hailstone samples

A new application of capillary electrophoresis (CE) for measuring inorganic anions in hailstones was carried out. Five hailstone specimens were collected from large blocks of ice that fell in January 2000 in some provinces of Spain. Sample handling and preparation procedures were performed with care. CE analysis of anions was carried out using indirect UV detection at 254 nm with a negative power supply (-15 kV) and hydrostatic injection (10 cm for 30 s) at 35 degrees C. Anion separation was completed in less than 4 min. The working electrolyte consisted of 4.7 mM sodium chromate, 4.0 mM OFM-OH (tetradecyltrimethylammonium hydroxide), 10 mM CHES [2-(N-cyclohexylamino)ethanesulfonic acid], and 0.1 mM calcium gluconate (pH 9.1). Good repeatability of migration times after eight injections (<0.7% RSD), adequate linearity responses (r2>0.9) as well as satisfactory detection limits (<0.35 ppm) were achieved. The analytical results provided by CE were compared with those obtained by traditional wet-chemical (WCH) methods. Most of the results obtained by CE were consistent with those of WCH, except for one sample.

Suppressed ion chromatography for monitoring chemical impurities in steam for geothermal power plants

A suppressed ion chromatography (IC) technique has been evaluated as a chemical monitoring tool for detecting major anions (F-, Cl-, NO3- and SO4(2-)) of condensed steam in geothermal power plants. It is shown that the suppressed IC technique provides a suitable means for preventing possible damage to generating equipment in the geothermal industry. An electrical conductivity detector (0.1 microS sensitivity) with an anion-exchange column (IonPac AS4A-SC), a micro-membrane suppressor (AMMS II), and an isocratic high-pressure pump system were successfully used for detecting low concentrations of inorganic anions. Method detection limits for the anions of interest were <0.184 mg/L. Details of the IC methodology as well as some experimental results obtained during its application for the chemical monitoring of geothermal steam pipes are also described.

Heat waves in Madrid 1986-1997: effects on the health of the elderly

OBJECTIVE

The objective of this paper is to analyse and quantify the effects exerted on summer mortality by extremes of heat, particularly among persons aged 65-74 and 75 years and over, groups in which mortality is higher.

METHODS

The study included the period from 1 January 1986 to 31 December 1997, for all people aged over 65 years resident in Madrid, based on mortality due to all causes except accidents (ICD-9 codes 1-799), and circulatory (390-459) and respiratory (460-487) causes. Meteorological variables analysed were: daily maximum temperature, daily minimum temperature and relative humidity. To control the effect of air pollution on mortality we considered the daily mean values of sulphur dioxide (SO2), total suspended particulate (TSP), nitric oxides (NOx), nitrogen dioxide (NO2) and tropospheric ozone (O3). Univariate and multivariate ARIMA models were used. Box-Jenkins pre-whitening was performed.

RESULTS

The results yielded by this study indicate a mortality increase up to 28.4% for every degree the temperature rises above 36.5 degrees C, with particular effect in women over the age of 75 years and circulatory-cause mortality. The first heat wave that leads to the greatest effects on mortality, due to the higher number of susceptible people and the duration of the heat wave, show an exponential growth in mortality. Furthermore, low relative humidity enhances the effects of high temperature, linking dryness to air pollutants, ozone in particular.

CONCLUSIONS

Since a warmer climate is predicted in the future, the incidence of heat wave should increase, and more comprehensive measures, both medical and social, should be adopted to prevent the effects of extreme heat on the population, particularly the elderly.

Enzymatic esterification of an acid with an epoxide using an immobilized lipase from Mucor miehei as catalyst: optimization of the yield and isomeric excess of ester by statistical analysis

We have developed the methodology for the esterification of an acid with an epoxide using 2-chlorobutyric acid and 1,2-epoxy-5-hexene catalysed by a Mucor miehei-immobilized lipase. Thus, this methodology could be applied to obtain 2-chloroesters. A factorial design of experiments and a central composite design have been used to optimise the synthesis of these esters. The variables chosen were temperature and initial catalyst concentration, while the responses were yield and isomeric excess of the ester. According to this study, temperature was the most important factor, having a positive influence on the yield and a small negative influence on the isomeric excess of the ester. The yield and isomeric excess of the ester show a greater dependence on temperature compared to the catalyst concentration. Although the effect of the catalyst concentration on both responses is smaller than the temperature effect, the higher selectivity presented by the biocatalyst towards the studied ester considerably decreased the final product distribution.

[Factors modulating the efficacy of psychosocial treatment in children with attention deficit hyperactivity disorder]

INTRODUCTION

Treatment of patients with attention deficit hyperactivity disorder (ADHD) in recent decades has not been in one way only but rather by using various approaches (pharmacological, behavioural, cognitive, etc.). It is becoming increasingly obvious that hyperactivity requires a multi-disciplinary approach with clear instructions for parents and teachers. Teachers need most information regarding ADHD and its treatment so as to use the techniques which are most effective for directing behaviour in the classroom.

OBJECTIVES

This study had two objectives. Firstly, we wished to analyze the efficacy of a psychosocial programme with multiple components (programme for individualized treatment in the classroom) in 50 children with ADHD using the methodology of significant clinical change analysis of Jacobson and Truax (1991). Secondly, to try to define the variables which may modulate cognition and behaviour and possibly affect the results and success or failure of the programme.

DEVELOPMENT

Regarding the first objective, it was found that a much more significant proportion improved after following the hyperactivity/impulsivity programme, in the opinions of parents and teachers. Regarding the second objective the results show that the variables which may modulate the efficacy of treatment are deficits in inhibitory control, anxiety, disobedience, isolation and social inadaptation.

[Activity of new fluoroquinolones against clinical isolates of Acinetobacter baumannii]

Acinetobacter baumannii is an opportunistic pathogen associated with numerous nosocomial infections. In recent years it has shown extraordinary ease in developing resistance to most antimicrobial agents, which is a serious problem as it makes these infections difficult to treat. We determined the in vitro activity of eight quinolones, five betalactam agents and colistin in 160 clinical isolates of A. baumannii. In general, we observed a high rate of resistance to the quinolones (90%), excluding clinafloxacin (25%), and to ampicillin-sulbactam (61.25%) and imipenem (50%). Colistin is the agent with least resistance (13.125%), although its toxicity limits its therapeutic use. Clinafloxacin may be a good option to treat A. baumannii infections, especially in cases of therapeutic failure with other antimicrobial agents.

Vinorelbine, ifosfamide and cisplatin as first-line treatment in patients with inoperable non-small cell lung cancer

To assess, in a multicenter setting, the effectiveness of a combination of vinorelbine, ifosfamide and cisplatin in the treatment of non-small cell lung cancer, 123 patients (males=116) with a mean age of 60 years (range 27-75) with stage IIIb/IV non-small cell lung cancer (NSCLC) and performance status <or=2 were treated with vinorelbine (VNR; 25 mg/m(2)) on days 1 and 8; ifosfamide (IFO; 3 g/m(2)) on day 1; and cisplatin (CDDP; 80 mg/m(2)) on day 1, in repeated cycles of 21 days. Response rates, overall patient survival and toxicity profiles of the three-drug combination were assessed. The number of evaluable patients was 112, with a total of 441 cycles administered (mean=3.6 cycles/patient). Dose intensities (mg/m(2)/week; calculated in patients who concluded the proposed treatment and expressed as mean, median, and standard deviation) were: VNR 13.65, 13.32, 4.7; IFO 918.88, 868.97, 258.1; CDDP 23, 24.68, 6.98. Response rates were: complete response=3 (2.4%); partial response=58 (47.2%%); stable disease=20 (16.3%). The most frequent toxic events were nausea and vomiting (G1=33%, G2=31%, G3=8%). Neutropenia was the dose limiting toxicity (G1=6%, G2=11%, G3=10%, G4=7%). Alopecia G3 was a common undesirable effect in all the patients. Time to progression was 296 days (95% confidence interval 261-332) and the mean survival time was 338 days (95% CI 301-374). We conclude that the described therapeutic schedule is effective with good survival rates and response ratios together with a good tolerance and an acceptable toxicity level.

Regulation of endothelial nitric oxide synthase expression in the vascular wall and in mononuclear cells from hypercholesterolemic rabbits

BACKGROUND

We recently obtained evidence demonstrating that cultured bovine endothelial cells contain cytosolic proteins that form complexes with the 3'-untranslated region of endothelial nitric oxide synthase (eNOS) mRNA and are associated with its destabilization. The aim of this study was to determine the presence of such proteins and eNOS expression in hypercholesterolemic rabbits as an in vivo model of endothelial dysfunction.

METHODS AND RESULTS

Endothelium-dependent relaxation to acetylcholine and the calcium ionophore A23187 was reduced in aortic segments from hypercholesterolemic rabbits compared with controls. Treatment of hypercholesterolemic rabbits with cerivastatin (0.1 mg. kg body wt(-1). d(-1)) restored endothelium-dependent relaxation. Aortic eNOS expression was reduced in hypercholesterolemic rabbits and was accompanied by enhanced binding activity of a 60-kDa cytosolic protein and reduced stability of eNOS mRNA. Cerivastatin treatment upregulated eNOS expression and reduced the interaction of the cytosolic protein with the 3'-untranslated region of eNOS mRNA. Mononuclear cells from hypercholesterolemic rabbits also showed a marked reduction of eNOS expression and eNOS mRNA stability and an increase in binding activity of the cytosolic protein, which were also prevented by cerivastatin treatment.

CONCLUSIONS

These results demonstrate the presence of a 60-kDa protein that binds to eNOS mRNA and reductions in eNOS expression in both vascular wall and mononuclear cells that are prevented by cerivastatin.

Nasal biopsies of children exposed to air pollutants

Southwest Metropolitan Mexico City (SWMMC) atmosphere is a complex mixture of air pollutants, including ozone, particulate matter, and aldehydes. Children in SWMMC are exposed chronically and sequentially to numerous toxicants, and they exhibit significant nasal damage. The objective of this study was to assess p53 accumulation by immunohistochemistry in nasal biopsies of SWMMC children. We evaluated 111 biopsies from 107 children (83 exposed SWMMC children and 24 control children residents in a pollutant-compliant Caribbean island). Complete clinical histories and physical examinations, including an ear-nose-throat (ENT) exam were done. There was a significant statistical difference in the upper and lower respiratory symptomatology and ENT findings between control and exposed children (p < 0.001). Control children gave no respiratory symptomatology in the 3 months prior to the study; their biopsies exhibited normal ciliated respiratory epithelium and were p53-negative. SWMMC children complained of epistaxis, nasal obstruction. and crusting. Irregular areas of whitish-gray recessed mucosa over the inferior and middle turbinates were seen in 25% of SWMMC children, and their nasal biopsies displayed basal cell hyperplasia, decreased numbers of ciliated and goblet cells, neutrophilic epithelial infiltrates, squamous metaplasia. and mild dysplasia. Four of 21 SWMMC children with grossly abnormal mucosal changes exhibited strong transmural nuclear p53 staining in their nasal biopsies (p 0.005, odds ratio 26). In the context of lifetime exposures to toxic and potentially carcinogenic air pollutants, p53 nasal induction in children could potentially represent. a) a checkpoint response to toxic exposures, setting up a selective condition for p53 mutation, or b) a p53 mutation has already occurred as a result of such selection. Because the biological significance of p53 nuclear accumulation in the nasal biopsies of these children is not clear at this point, we strongly suggest that children with macroscopic nasal mucosal abnormalities should be closely monitored by the ENT physician. Parents should be advised to decrease the children's number of outdoor exposure hours and encourage a balanced diet with an important component of fresh fruits and vegetables.

Long-term depolarization regulates the alpha1s, subunit of skeletal muscle Ca2+ channels and the amplitude of L-type Ca2+ currents

The effects of long-term depolarization on the level of alpha1s and on L-type Ca2+ currents of skeletal muscle were investigated. Long-term depolarization (14 h) caused a 50% decrease of alpha1s, revealed with the Western blot technique. This decline was prevented by preincubation with the Ca2+ channel blocker nifedipine. Electrophysiological experiments using the voltage-clamp technique were performed to measure the actions of long-term depolarization on Ca2+ currents and charge movement. A progressive decline in the amplitude of the Ca2+ currents by depolarizations lasting 0.5-14 h was observed. Similar to Western blot results, the fall in current amplitude was prevented by nifedipine, and it depended on external Ca2+. The nonlinear charge mobilized by step pulses was also significantly reduced (50%) by long-term depolarization. It is suggested that alpha1s subunit is down-regulated by long-term depolarization by a very stringent mechanism and that, in this process, Ca2+ ions permeating through L-type channels play a key role. A new role for the L-type Ca2+ current in skeletal muscle fibers in which the channels are self-regulated is proposed.

Canines as sentinel species for assessing chronic exposures to air pollutants: part 2. Cardiac pathology

The principal objective of this study is to evaluate by light and electron microscopy (LM, EM) the heart tissues in stray southwest and northeast metropolitan Mexico City (SWMMC, NEMMC) dogs and compare their findings to those from 3 less polluted cities (Cuernavaca, Tlaxcala, and Tuxpam). Clinically healthy mongrel dogs, including 109 from highly polluted SWMMC and NEMMC, and 43 dogs from less polluted cities were studied. Dogs residing in cities with lower levels of pollutants showed little or no cardiac abnormalities. Mexico City and Cuernavaca dogs exhibited LM myocardial alterations including apoptotic myocytes, endothelial and immune effector cells, degranulated mast cells associated with scattered foci of mononuclear cells in left and right ventricles and interventricular septum, and clusters of adipocytes interspersed with mononuclear cells. Vascular changes included scattered polymorphonuclear leukocytes (PMN) margination and microthrombi in capillaries, and small venous and arteriolar blood vessels. Small veins exhibited smooth muscle cell hyperplasia, and arteriolar blood vessels showed deposition of particulate matter (PM) in the media and adventitia. Unmyelinated nerve fibers showed endoneural and epineural degranulated mast cells. EM examination of myocardial mast cells showed distended and abundant rough endoplasmic reticulum with few secretory granules. Myocardial capillaries exhibited fibrin deposition and their endothelial cells displayed increased luminal and abluminal pinocytic activity and the formation of anemone-like protrusions of the endothelium into the lumen. A close association between myocardial findings, lung epithelial and endothelial pathology, and chronic inflammatory lung changes was noted. The myocardial changes described in dogs exposed to ambient air pollutants may form the basis for developing hypothesis-driven mechanistic studies that might explain the epidemiological data of increased cardiovascular morbidity and mortality in people exposed to air pollutants.

Canines as sentinel species for assessing chronic exposures to air pollutants: part 1. Respiratory pathology

A complex mixture of air pollutants is present in the ambient air in urban areas. People, animals, and vegetation are chronically and sequentially exposed to outdoor pollutants. The objective of this first of 2 studies is to evaluate by light and electron microscopy the lungs of Mexico City dogs and compare the results to those of 3 less polluted cities in MEXICO: One hundred fifty-two clinically healthy stray mongrel dogs (91 males/61 females), including 43 dogs from 3 less polluted cities, and 109 from southwest and northeast metropolitian Mexico City (SWMMC, NEMMC) were studied. Lungs of dogs living in Mexico City and Cuernavaca exhibited patchy chronic mononuclear cell infiltrates along with macrophages loaded with particulate matter (PM) surrounding the bronchiolar walls and extending into adjacent vascular structures; bronchiolar epithelial and smooth muscle hyperplasia, peribronchiolar fibrosis, microthrombi, and capillary and venule polymorphonuclear leukocytes (PMN) margination. Ultrafine PM was seen in alveolar type I and II cells, endothelial cells, interstitial macrophages (Mtheta), and intravascular Mtheta-like cells. Bronchoalveolar lavage showed significant numbers of alveolar macrophages undergoing proliferation. Exposure to complex mixtures of pollutants-predominantly particulate matter and ozone-is causing lung structural changes induced by the sustained inflammatory process and resulting in airway and vascular remodeling and altered repair. Cytokines released from both, circulating inflammatory and resident lung cells in response to endothelial and epithelial injury may be playing a role in the pathology described here. Deep concern exists for the potential of an increasing rise in lung diseases in child populations exposed to Mexico City's environment.

Dextranase (alpha-1,6 glucan-6-glucanohydrolase) from Penicillium minioluteum expressed in Pichia pastoris: two host cells with minor differences in N-glycosylation

Differences in glycosylation between the natural alpha-1,6 glucan-6-glucanohydrolase from Penicillium minioluteum and the heterologous protein expressed in the yeast Pichia pastoris were analyzed. Glycosylation profiling was carried out using fluorophore-assisted carbohydrate electrophoresis and amine absorption high-performance liquid chromatography (NH(2)-HPLC) in combination with matrix-assisted laser desorption-time of flight-mass spectrometry. Both microorganisms produce only oligomannosidic type structures, but the oligosaccharide population differs in both enzymes. The native enzyme has mainly short oligosaccharide chains ranging from Man(5)GlcNAc(2) to Man(9)GlcNAc(2), of which Man(8)GlcNAc(2) was the most represented oligosaccharide. The oligosaccharides linked to the protein produced in P. pastoris range from Man(7)GlcNAc(2) up to Man(14)GlcNAc(2), with Man(8)GlcNAc(2) and Man(9)GlcNAc(2) being the most abundant structures. In both enzymes the first glycosylation site (Asn(5)) is always glycosylated. However, Asn(537) and Asn(540) are only partially glycosylated in an alternate manner.

[Problems and proposals for improvement in the health care of economic immigrants]

OBJECTIVES

To analyse existing problems in health care to economic immigrants from the point of view of health and social professionals, health authorities and economic immigrants and to know which will be their proposals and priorities to improve economic immigrants's health assistance.

METHODS

Qualitative approach study made in Majorca island. (Spain). Three focus groups and three nominal groups with health and social workers from primary health care and hospital services were carried out as well as two partially structured interviews to health authorities, one Autonomic Authority and one Governmental Authority, and twelve partially structured interviews to economic immigrants identified trough key informants.

RESULTS

Health and social workers perceive the increase in the number of economic immigrants as a massive arrival. The main problems identified are: access restrictions to public health services for economic immigrants, the follow-up of these patients and diagnostic difficulties because lack of training in tropical medicine. Health and social workers's first proposal for improving this situation is their own training in tropical medicine. Autonomic Authority priorities are to guarantee access to public health services for all immigrants and to look actively for health problems in these population. Governmental Authority, instead, holds the legalization for all. In fact, economic immigrants are not concerned on health care because legalization and housing problems.

CONCLUSIONS

The main barriers identified by health and social workers in health care to economic immigrants are: access restrictions, follow-up and lack of training in tropical medicine. Health and social first proposal to improve this situation is their own training in tropical medicine while Autonomic and Central Authorities's priorities are not the same. For economic immigrants, health assistance is not their biggest concern.

Capillary electrophoresis for measuring major and trace anions in thermal water and condensed-steam samples from hydrothermal springs and fumaroles

A new application of capillary electrophoresis for measuring major and trace anions in thermal water and condensed-steam samples is presented. Ten fluid samples were collected from hydrothermal springs and fumaroles located in a volcanic zone of Deception Island, Antarctica. Anion separation was achieved in less than 6 min using indirect UV detection at 254 nm with a negative power supply (-15 kV). The electrolyte consisted of 4.7 mM sodium chromate, 4.0 mM electroosmotic flow modifier (OFM) hydroxide, 10 mM 2-(N-cyclohexylamino)ethanesulfonic acid and 0.1 mM calcium gluconate (pH 9.1). Major anions (Cl-, SO4(2), PO4H2+, and CO3H-) were measured using hydrostatic injection (10 cm for 30 s) at 25 degrees C. Trace amounts of anions (F-, Br-, and NO3-) were better determined by electromigration injection (4 kV, 10 s) at 15 degrees C. Good reproducibility of the migration times (<0.72% RSD), a satisfactory linear response and accuracy as well as acceptable detection limits were successfully obtained.

Characterization of protein glycoforms with N-linked neutral and phosphorylated oligosaccharides: studies on the glycosylation of endoglucanase 1 (Cel7B) from Trichoderma reesei

Using anion-exchange chromatography the catalyticdomain of endoglucanase 1 (Cel7B) from Trichoderma reesei was resolved in multiple fractions with different isoelectric points, presumably related to different glycoforms of the enzyme. The protein fractions were analysed using lectins and electrospray MS. Isolated N-glycans were analysed by fluorophore-assisted carbohydrate electrophoresis and amine-adsorption HPLC. The results show that this particular preparation contained at least 14 different glycoforms. The major isoform contained only one GlcNAc, presumably N-linked, and one mannose, most probably O-linked to serine/threonine at a separate site. Except for a small population containing Man(5)GlcNAc(2)+1-2 Man, the rest of the protein had negatively charged phosphate-containing N-glycans. All glycoforms contained at least one O-linked mannose residue. The increased negative charge of the protein, introduced by oligosaccharide phosphorylation, is the most probable reason for the different isoelectric points and the occurrence of multiple peaks during purification.

[Epidemiology of Cuban hereditary ataxia]

INTRODUCTION

The hereditary ataxias in Cuba make up the highest concentration of these patients in the world. The spinocerebellar ataxia type 2 (SCA2) molecular form is predominant.

OBJECTIVES

To determine the prevalence and incidence of hereditary ataxias.

PATIENTS AND METHODS

We made a descriptive study of 440 patients and 1,633 members of families at risk from this disorder in the province of Holguín. We calculated the prevalence rate and incidence.

RESULTS

The rate of prevalence of patients in the province is 43 cases per 100,000 inhabitants; the highest rate was 503 cases per 100,000 inhabitants in part of the municipality of Baguanos. The age group that was most affected was that of 30-39 years, with a prevalence of 63.97 cases per 100,000 inhabitants. The rural population showed the highest incidence (62.04 cases per 100,000 inhabitants). The risk of members of affected families showing the disorder was 159.33 cases per 100,000 inhabitants in this province. The highest incidence was 18.08 cases per 100,000 inhabitants in Cacocum, where the incidence in the province was 4.39.

CONCLUSIONS

On average the disorder passes from one state to the next every year, which suggests that the extent of the disorder worsens with time. The prevalence and incidence are the highest in the world. This together with the dominant pattern of inheritance, the effect of anticipation and inexorably progressive course of the disorder shows the serious health problem that affects the Eastern region of Cuba.

Inhibition of platelet activation in stroke-prone spontaneously hypertensive rats: comparison of losartan, candesartan, and valsartan

In vitro studies have suggested that losartan interacts with the thromboxane (TxA2)/ prostaglandin H2 (PGH2) receptor in human platelets, reducing TxA2-dependent platelet activation. The aim of this study was to evaluate the effect of different angiotensin II type 1 receptor antagonists in stroke-prone spontaneously hypertensive rats (SHRSP). The level of platelet activation was assessed by determining P-selectin expression in platelets by flow cytometry. The ex vivo adhesion of platelets was also analyzed. The number of platelets that expressed P-selectin in SPSHR was significantly increased (% P-selectin expression: WKY 4 +/- 0, 4%; SHRSP 15.5 +/- 0, 8% [n = 8], p < 0.05). In SHRSP receiving losartan (20 mg/kg body weight per day) the percentage of platelets expressing P-selectin fell to levels close to that observed in WKY. The number of platelets from SHRSP treated with valsartan and candesartan (20 mg/kg body weight per day for 14 days) that expressed P-selectin was not significantly different from those from untreated SPRHR. Only losartan treatment reduced ex vivo platelet adhesion to a synthetic surface. The antiplatelet effect of losartan does not appear to be related to the level of blood pressure reduction. In ex vivo experiments, losartan significantly reduced the binding of the radiolabeled TxA2 agonist U46619 to platelets obtained from SHRSP in a dose-dependent manner. Treatment with losartan reduced the number of activated platelets in SHRSP independently of its blood pressure effects. TxA2-receptor blockade is proposed as a mechanism by which losartan can prevent platelet activation.

Can the creatinine dialysate-to-plasma ratio from the peritoneal equilibration test be replaced by the sodium dialysate-to-plasma ratio and the sodium level in the dialysate?

The peritoneal equilibration test (PET) is a useful tool that categorizes peritoneal transport. However, the method has some inconveniences. Some authors suggest that measuring the sodium level in the dialysate (NaD) or the dialysate-to-plasma ratio for sodium (D/PNa) can substitute for the PET. We applied a mathematical analysis [Fisher intraclass correlation coefficient (FICC)] to 43 PETs performed in 43 peritoneal dialysis patients (29 males, 14 females) with a mean age of 55.3 years (range: 28-85 years). Determinations of NaD, of sodium level in plasma (NaP), and of D/PNa at times 0, 30, 60, 120, and 240 minutes were added to the usual PET determinations. After using the NaD240 and the D/PNa240 values to calculate the cut-off values for the various peritoneal transport categories, we obtained a transport distribution very similar to that of the PET dialysate-to-plasma ratio for creatinine after 240 minutes (D/PCr240). At the same time, the FICC showed good (0.69) and excellent (0.77) correlation of NaD240 and D/PNa240 respectively with the D/PCr240. Therefore either of these two methods, which are cheaper and quicker than a PET, can be used to categorize peritoneal transport with a high degree of reliability.

Ultrastructural nasal pathology in children chronically and sequentially exposed to air pollutants

Southwest Metropolitan Mexico City (SWMMC) children are repeatedly exposed to a complex mixture of air pollutants, including ozone, particulate matter, and aldehydes. Nasal biopsies taken from these children exhibit a wide range of histopathologic alterations: marked changes in ciliated and goblet cell populations, basal cell hyperplasia, squamous metaplasia, and mild dysplasias. We studied the ultrastructural features of 15 nasal biopsies obtained from clinically healthy children 4 to 15 yr of age, growing up in SWMMC. The results were compared with nasal biopsies from 11 children growing up in Veracruz and exposed to low pollutant levels. Ultrathin sections of nasal biopsies revealed an unremarkable mucociliary epithelium in control children, whereas SWMMC children showed an epithelium comprised of variable numbers of basal, ciliated, goblet, and squamous metaplastic as well as intermediate cells. Nascent ciliated cells, as evidenced by the presence of migratory kinetosomes, were common, as were ciliary abnormalities, including absent central microtubules, supernumerary central and peripheral tubules, ciliary microtubular discontinuities, and compound cilia. Dyskinesia associated with these abnormal cilia was suggested by the altered orientation of the central microtubules in closely adjacent cilia. A transudate was evident between epithelial cells, suggesting potential deficiencies in epithelial junction integrity. Particulate matter was present in heterolysosomal bodies in epithelial cells and it was also deposited in intercellular spaces. The severe structural alteration of the nasal epithelium together with the prominent acquired ciliary defects are likely the result of chronic airway injury in which ozone, particulate matter, and aldehydes are thought to play a crucial role. The nasal epithelium in SWMMC children is fundamentally disordered, and their mucociliary defense mechanisms are no longer intact. A compromised nasal epithelium has less ability to protect the lower respiratory tract and may potentially leave the distal acinar airways more vulnerable to reactive gases. Impairment of mucociliary clearance has the potential to increase the contact time between deposited mutagenic particulate matter and the epithelial surface, thus increasing the risk for nasal carcinogenesis. Chronic exposures to air pollutants affect the whole respiratory tract; the nasal epithelium is an accessible and valuable sentinel to monitor exposures to toxic or carcinogenic substances.

Flow cytometry and the study of central nervous disease in patients with acute leukaemia

Central nervous system (CNS) leukaemia is still a matter of debate and new technologies are required to improve the classic morphological definition. One hundred and sixty-eight cerebrospinal fluid (CSF) samples from 31 patients with acute leukaemia were analysed by flow cytometry and conventional cytology. Concordant positive and negative findings were found in 158 samples but 10 produced discrepant results. Cytology seemed to offer more precise information in one CSF sample and flow cytometric accuracy could be demonstrated in five samples. We conclude that flow cytometry is of great help in confirming CNS leukaemia and eliminating other conditions. Therefore, leukaemic patients can benefit from double cytological and flow cytometric CSF studies.

[Hereditary ataxias in Cuba. Historical, epidemiological, clinical, electrophysiological and quantitative neurological features]

OBJECTIVE

This review has been designed to describe the main clinical, epidemiological, electrophysiological, molecular and quantitative neurological characteristics in SCA2.

DEVELOPMENT

The prevalence rate of patients with ataxia in Holguin province is 43 per 100,000 inhabitants. The prevalence of family members at risk of having this disorder is 159.33 per 100 thousand in this province. The main neurophysiological abnormality observed was reduction in the amplitudes of sensory potentials. These alterations are the expression of a predominantly axonal peripheral lesion with signs of myelin damage. Techniques of quantitative neurology were developed for evaluation of the main disorders of coordination such as asymmetry and adiadochokinesis. In Cuba 125 families have hereditary ataxia, 772 patients and 8 to 10,000 family members are at risk of developing this condition. Seventy percent of the patients with ataxia are concentrated in Holguin province. The most severely affected towns are Báguanos (a rate of 129.20 per 100,000 inhabitants), Holguin (71.85 per 100,000) and Cacocúm (69.83 per 100,000). These are the highest rates in the world.

CONCLUSIONS

The commonest molecular form in Cuba is the SCA2, observed in 120 families. Clinically it is characterized by a cerebellar syndrome associated with disorders of eye movements and osteotendinous reflexes.

An optimized amphiphilic cationic peptide as an efficient non-viral gene delivery vector

BACKGROUND

Due to their chemical definition and reduced size, the use of peptides as gene delivery systems is gaining interest as compared to the more common polymeric non-viral vectors. To achieve gene transfer efficiencies that would make peptides a realistic alternative to existing methods, we have evaluated and attempted to concert those properties with a direct impact on the activity of the system. These considerations have led to the design, synthesis and characterization of a 23-residue cationic peptide which we term RAWA.

METHODS

We have characterized RAWA biophysically and functionally. Biophysical studies include evaluation of DNA condensation and membrane perturbing activities. DNA transfer activity has been evaluated in cell culture at controlled DNA-to-peptide stoichiometries, using a luciferase gene as reporter. Requirements for additional effectors such as chloroquine and peptide cofactors have also been considered.

RESULTS

RAWA displays in vitro DNA condensing activity similar to that of protamines, reaching maximum effect at a peptide-to-DNA molar charge ratio (CR) of 4 (+/-). The reduced membrane perturbing activity diminishes its cytotoxic potential. In COS-7 cells, transfection efficiency with RAWA peptiplexes, compares favorably with well-recognized systems, including Lipofectamine Plus, Superfect, GenePorter and FuGene. The peptide-associated activity between free and DNA-bound species has been mapped by analyzing dependency on chloroquine treatment. The lack of significant serum inhibition and low toxicity make this system advantageous for potential in vivo application. A ternary complex including the acid-triggered fusogenic JTS-1 peptide is presented as a potential strategy for further in vivo studies.

CONCLUSIONS

We have developed a gene delivery system based on an amphipathic cationic peptide with improved DNA condensation ability and reduced cytotoxicity, which maintains membrane binding and perturbing activities. Observed efficiency with this molecule is very high and compares favorably with currently available transfection systems.