[Evaluation of a molecular hybridization trial for the detection of circulating DNA of hepatitis B virus. Immunoclinical correlation]

Immunoclinical correlation of the HBV circulating DNA was performed. The DNA was detected by means of a hybridization technique set-up in fluid phase using a complementary DNA probe labelled with 125I (Abbott-Genostics). The correlation was carried-out in 12 serum including 8 from known HBV carriers with or without liver disease. Only the positive HBeAg serum shown circulating viral DNA in ranges between 60 to 2800 pcg/ml. The assay shows to be easy to perform, however the expensive cost plus the use of a short-life isotope makes difficult in routine use, which still is under research. The immunopathogenic significance of the findings is discussed.

Morphological studies of cytotoxic lesions in reversible endotoxic shock

Reversible endotoxic shock was induced in adult rats by intravenous injection of E. coli 0111:B4 lipopolysaccharide (LPS) and the progression of metabolic and morphological alterations was evaluated. Serum samples and biopsies from adrenal gland, liver and lung were studied at different times after LPS injection. Histological changes in these tissues were observed after endotoxin administration, coinciding with both the acute-phase and the recovery-phase of shock (24-72h after LPS injection). Signs of tissue regeneration can be correlated with the regression of some serum parameters to their normal values. All these results indicate that in this experimental model of endotoxic shock, a reversible status was established, which will allow further studies of the endotoxic pathophysiological mechanisms in vivo, avoiding the complexity of the non-reversible process.

[Prevalence of Trypanosoma cruzi infection in Nicaraguan students. Isle of Youth Special Municipality. February, 1987]

A seroepidemiologic study on American trypanosomiasis was performed to a group of Nicaraguan students in Isle of the Youth Special Municipality, during February 1987, using indirect hemagglutination and indirect immunoflorescence techniques. The prevalence obtained with both tests and the percentage of the most frequent titer of indirect immunofluorescence are pointed out. The youth living in rural zones presented higher risk of acquiring the infection than those living in urban zones. The students coming from the Atlantic Coast, Rio San Juan and Masaya, presented the highest positive rates. Of those who were interviewed, 59% identified the Triatoma, and 13% of them manifested to have seen it inside homes. The background of being bitten by the Tritoma was present in 16.2% of those with positive results.

[Diagnostic usefulness of neurospecific enolase determination in pleural fluid]

To investigate the diagnostic usefulness of the measurement of neurospecific enolase (NSE) in pleural fluid 116 consecutive patients with pleural effusion were prospectively evaluated. In 95 of them, carcinoembryonic antigen (CEA) was also measured for comparative purposes. The habit of smoking did not apparently influence the NSE levels. In the 43 malignant effusions the mean value of NSE (25.0 +/- 27.4) was significantly higher (p less than 0.001) than in benign effusions (8.7 +/- 7.1). The values above 12 ng/ml had a sensitivity of 51% for malignancy, with a specificity of only 74%. The specific sensitivity of NSE was lower than that of CEA; neither individually nor as a whole these markers modified the diagnostic yield of cytology (67%). The mean value of NSE in tuberculous pleural effusions (14.4 +/- 8.3), different from that found in malignancies (p less than 0.05), was significantly higher (p less than 0.001) than that found in other benign diseases (6.2 +/- 4.7). The results of this study demonstrate the nonspecific character of an increased level of NSE, and the low diagnostic yield of this enzyme as a pleural tumour marker.

Cardiac surgery at San Pablo Heart Institute: a preliminary report of the first year experience

A series of 341 patients undergoing cardiac surgery, of which 276 underwent coronary artery bypass grafting (CABG) and 37 underwent valve replacement, is presented herein. Results of mortality and morbidity are shown, discussed and compared to that of other institutions, and found favorable. These patients represent our first year of experience at the San Pablo Heart Institute.

[Infected cyst of the seminal vesicle associated with malformation of the upper urinary tract and contralateral vesiculitis. Embryonal and clinical aspects]

Congenital cyst of the seminal vesicle is a rare anomaly related with developmental anomaly of the mesonephric duct that is frequently associated with unilateral malformation of the upper urinary tract. New imaging techniques (ultrasound, CT, MRI) have allowed us to rediscover and study seminal vesicle disorders and its adjacent area. These techniques have afforded a better definition of cyst characteristics, its contents and anatomic relations, thus permitting more effective surgical treatment.

Intrarenal manometry in the diagnosis of acute rejection superimposed on acute tubular necrosis in renal transplantation

We used fine-needle intrarenal manometry as a guide for detection of acute rejection superimposed on protracted oliguric acute tubular necrosis occurring in the postoperative course of human renal transplantation. We followed intrarenal pressure (IRP) in 31 patients who received 32 renal transplants, 12 from living related donors and 20 from cadaveric donors. There were 19 rejection episodes and 10 episodes of transient cyclosporin A (CyA) nephrotoxicity. Nine patients had posttransplant acute renal failure. Levels of IRP (mmHg) in acute rejection were (mean +/- SD) 48.6 +/- 11.1, significantly higher (p less than 0.001) than the levels in CyA nephrotoxicity (28.2 +/- 5.21), acute tubular necrosis (24.5 +/- 5.5) and normal functioning grafts (26.4 +/- 6.63). Antirejection treatment was associated with return to normal of IRP after 10 days. Intrarenal manometry was performed routinely ever 2-3 days in patients who had postoperative acute renal failure. Increments in IRP were detected on the 7-10th postoperative day in 7 patients who had 10-25 days of post-transplant oliguria. Renal biopsy findings were compatible with acute rejection, and the patients responded to intravenous bolus of steroids. We suggest that fine-needle intrarenal manometry is a reliable test for the detection of acute rejection in circumstances when traditional parameters of altered renal function cannot be evaluated.

[Hepatic markers (Ac-HVA-IgM and AcHBc-IgM) in cases of infectious hepatitis in Dominican children]

The presence of IgM antibodies for the HVA and HBc antigens in 90 children of 15 or less years with acute hepatitis were investigated, finding that 62% (58) were positive for HVA, 8.9% (8) for HBc and 27.8% (25) did not show antibodies for HVA or HBc (non-A non-B hepatitis); comments are made on some clinical and epidemiological findings such as a higher frequency of blood transfusions in HNANB, more males in HB and HNANB, and more hepatomegaly and liver sensitivity in HNANB.

[Acute gastroenteritis due to Vibrio parahaemolyticus in Spain. Presentation of 8 cases]

Eight cases of acute gastroenteritis caused by Vibrio parahaemolyticus in humans are described; to our knowledge, they are the first such reported cases in Spain. All cases appeared between August 20th and October 15th, with a frequency of 8.3% regarding the overall adult patients with acute gastroenteritis, and 11.5% regarding the overall patients with positive stool culture for any enteropathogenic organism. The eight strains were Kanagawa positive and in three patients other enteropathogenic organisms were isolated in addition to Vibrio parahaemolyticus, i.e. Aeromonas hydrophila in two and Salmonella serovariety enteritidis in another. In all cases fish or shellfish had been ingested outside the patients' homes; except for one patient, who ate living clams in the seaside of Galicia, all patients ingested them at seaside restaurants from the Barcelona province. The clinical features of acute gastroenteritis were definite in all patients, but no patients had significant electrolyte losses or required hospital admission. Recovery was spontaneous and no antimicrobial agents were required. All strains were sensitive to tetracyclines, aminoglycosides, cefotaxime, ceftazidime and nearly always to co-trimoxazole.

Induction of reversible shock by Escherichia coli lipopolysaccharide in rats. Changes in serum and cell membrane parameters

Reversible endotoxic shock was induced in adult rats by i.v. injection of Escherichia coli O111:B4 lipopolysaccharide (1.6 mg/100 g). The shock progression was evaluated by measuring serum glucose levels as well as activities of aspartate aminotransferase (GOT) and alkaline phosphatase in serum. A rapid increase of serum glucose levels occurs, after LPS injection, followed by hypoglycaemia (minimum values at 6 h) with progressive reversion to control values. Serum GOT activity increased (twofold) 6 h after endotoxin administration and returned to control values at 72 h. No appreciable changes occurred in serum alkaline phosphatase activity. Endotoxaemia produced a decrease in the cytochrome P-450 levels in all target organs considered: lung, adrenal glands and liver. The progressive decrease in the serum albumin concentration as well as changes of the physical properties of the plasma membranes observed in vivo, can not be explained only by direct interaction of endotoxin with the target organs, underlining the importance of serum mediators in the induction of the shock response.

Urinary prostaglandin E and kallikrein activity in glomerular hyperfiltration induced by a meat meal in man

Because renal vasodilator systems may be involved in the physiologic response to a protein meal, we studied the relationship of prostaglandin E (PGE) and kallikrein (KE) activity to the renal hemodynamic changes induced by a meat meal. Ten normal subjects on a maintenance diet providing 1 g protein per kg and 100 mmol Na daily were studied before and after a meal of 86 g of meat protein, once without medication, and again after treatment with indomethacin (150 mg daily for 3 days before and 50 mg the morning of the test). A carbohydrate meal of similar caloric, Na and K content was used in control studies. Glomerular filtration rate (GFR, inulin clearance), renal blood flow (RBF, para-aminohippurate [PAH] clearance), PGE and kallikrein urinary excretion were determined. All studies were performed during water diuresis to avoid bladder catheterization. The protein load induced an increase in GFR (ml/min, mean +/- s.e.m.: baseline 107.2 +/- 6.05, peak postmeal 146.4 +/- 6.79, p less than 0.01) and RBF (baseline 529.7 +/- 42.9, postmeal 678.9 +/- 61.9, p less than 0.05). Renal hemodynamic changes were unrelated to changes in urinary PGE and KE excretion. Indomethacin treatment inhibited PGE excretion by 73% during the test meal but did not modify the protein-induced hyperfiltration. Our results suggest that these renal vasodilator systems are not primarily responsible for the hyperfiltration response. In addition, the data show that inhibition of prostaglandin synthesis is not a practical approach to prevent glomerular hyperfiltration in clinical practice.

Olive (Olea europea) pollen allergens--I. Immunochemical characterization by immunoblotting, CRIE and immunodetection by a monoclonal antibody

The pattern of reactivity of the Olea europea crude extract antigens was analysed after electroblotting to nitrocellulose from SDS-PAGE. The antigens contained in the 17, 19 and 42 K bands were most reactive with specific IgE from individual sera. Following immunization with a crude extract, one monoclonal antibody (OL-1) was raised against components which exhibited IgE binding capacity in electroblotting and crossed radioimmunoelectrophoresis (CRIE). Monoclonal antibody OL-1 reacted with the 17 and 19 K antigens and with three arcs of crossed immunoelectrophoresis (CIE), one of which is considered to contain a major allergen by CRIE.

Olive (Olea europea) pollen allergens--II. Isolation and characterization of two major antigens

A dialyzed extract of olive (Olea europea) pollen was fractionated by anion exchange chromatography on DEAE-Sepharose CL-6B using a discontinuous gradient of ammonium bicarbonate. The most important protein allergen was obtained from the 0.3 M fraction after gel filtration on Sephadex G-100 and separation by lentil-lectin Sepharose-4B. The major allergen of olive pollen was contained in the effluent and was designated Olea Antigen I. This material inhibited the RAST activity of 15 patients' sera that were tested. Analytical IEF demonstrated a major band at pH 5.3 and two minor ones at pH 5.6 and 5.0. When these were run into SDS-polyacrylamide gel electrophoresis in a second dimension, all were separated into two bands of mol. wt 17 and 19 K. A second protein, which is the next most important allergen, Olea Antigen II, was obtained from the 0.5 M fraction by chromatofocusing in a 4-7 pH range followed by filtration on Bio-gel P-30. Olea Antigen II had a mol. wt of 8 K as assessed by SDS-PAGE. IEF analysis displayed one main band at pH 3.6 and two minor bands at pH 3.8 and 4.0, respectively. OL-1, an anti-Olea europea monoclonal antibody (MAb) previously reported by us Lauzurica et al. (1988) reacted with the 17 and 19 K antigens from the crude extract and with Olea Antigen I but not with Olea Antigen II.

Evidence of cell-mediated immune contrasuppression in lepromatous leprosy: modulation of a putative T contrasuppressor cell-subset

Some lepromatous leprosy (LL) patients are characterized by the presence of activated suppressor T cells that specifically inhibit the immune response to Mycobacterium leprae antigens. Immune contrasuppressor (CS) cell activity antagonize suppressor function. Whereas the former function has been extensively studied in leprosy, the latter has not been explored. We studied the peripheral blood mononuclear cells (PBMNC) of 20 patients with leprosy (10 lepromatous and 10 tuberculoid) and six healthy contacts. We found CS-like activity in the PBMNC from some LL patients when assayed in vitro using lepromin as antigen. This CS-like function was found in CD8+, vicia villosa adherent (VV+) T cells. CS-like activity was not detected in PBMNC from either tuberculoid patients or healthy contacts. Pre-treatment of CD8+, VV+ cells with either recombinant IL-2 (5 u/ml) or recombinant interferon-gamma (1,000 u/ml) did not modify significantly their putative CS function. However, in 50% of lepromatous patients the pre-incubation of CD8+, VV+ cells with both lymphokines together increased significantly the CS-like activity. These data suggest that the in vitro immune response to M. leprae in some LL patients can be augmented by either modifying numerically the contrasuppressor T cells or activating them with lymphokines.

Short-term treatment with captopril in hypertension due to acute glomerulonephritis

We report that the inhibition of the angiotensin converting enzyme is an effective short-term treatment of low-renin hypertension in acute glomerulonephritis (AGN). We treated 9 patients who had AGN with moderate to severe hypertension and suppressed plasma renin activity with 25-50 mg of captopril per os every 6-8 hours. Control of blood pressure was achieved in 1-2 hours and maintained thereafter. Captopril therapy was associated with an increase in plasma renin activity, a decrease in plasma aldosterone and an increase in the urinary excretion of prostaglandin E2 and kallikrein, independent of changes in urine output. Creatinine clearance increased 39.6 +/- SE 15.2% with captopril and decreased in the postcaptopril period, suggesting that captopril exerted a reversible effect on glomerular filtration rate, possibly modifying intrarenal vasoconstriction. Our study shows that rapid control of hypertension in AGN may be obtained with oral inhibition of the angiotension converting enzyme. Stimulation of PGE2 and kinins, as well as angiotensin II blockade appear to contribute to the hypotensive effect of the drug; by inference, the suppressed activity of vasodilator systems seems to play a significant role in the hypertension of AGN.

Relationship between glomerular filtration rate and renal blood flow at different levels of protein-induced hyperfiltration in man

1. We studied the relationship between changes in glomerular filtration rate (GFR) determined as inulin clearance (CIn), and changes in renal blood flow (RBF), determined as p-aminohippurate clearance (CPAH), after the ingestion of a large (1.35 +/- SEM 0.04 g/kg, n = 9), moderate (1.08 +/- 0.03 g/kg, n = 10) or mild (0.55 +/- 0.02 g/kg, n = 8) protein load given as a meat meal. Control subjects (n = 10) received a carbohydrate meal. 2. CIn and CPAH increased after a protein meal. Two hours after eating the test meal, GFR levels were (mean +/- SEM) 160.0 +/- 13.8 (P less than 0.05), 141 +/- 7.69 and 127.8 +/- 9.07 ml/min in the groups that received a large, moderate and mild protein load, respectively. Peak CIn values after the meal were 211.6 +/- SEM 14.92 (P less than 0.001), 177.5 +/- 10.88 (P less than 0.01) and 129.0 +/- 8.72 ml/min after a large, moderate and mild protein load, respectively. 3. At peak GFR levels after the meal, filtration fraction (FF) (CIn X 100/CPAH) increased significantly (P less than 0.02) with the large and with the moderate protein load, but not with the mild protein load. 4. There was a significant (P less than 0.001) positive relationship between increments of FF and increments of CIn, but not CPAH, whether the values were expressed as post-meal/pre-meal ratios or as absolute changes.(ABSTRACT TRUNCATED AT 250 WORDS)

Response to acute protein load in kidney donors and in apparently normal postacute glomerulonephritis patients: evidence for glomerular hyperfiltration

25 kidney donors who had undergone nephrectomy 1-11 years ago, 35 patients followed up for 13 years after poststreptococcal glomerulonephritis, and 44 controls were investigated for their capacity to increase their glomerular filtration rate after an acute oral load of 100-150 g of protein. Their mean baseline creatinine clearances (Ccrl, ml/min +/- SEM) were similar (controls 108.5 +/- 6.1; kidney donors 115.4 +/- 8.54; postacute nephritis 82.0 +/- 6.45), but the postmeal filtration rates (Ccr2) were significantly (p less than 0.05) lower in the two patient groups (kidney donors 137.4 +/- 11.60; postacute nephritis 90.3 +/- 5.30) than in the controls (161.5 +/- 9.39), as was the Ccr2/Ccr1 ratio (p less than 0.01, controls 1.58 +/- SEM 0.10; kidney donors 1.20 +/- 0.07; postacute nephritis 1.18 +/- 0.08). In normal individuals the degree of change was inversely related to the initial creatinine clearance and varied from 135.6% +/- 43.0 when Ccrl was less than 70 ml/min to 32.7% +/- 9.50 when Ccrl was 130 ml/min or higher. This relative response was decreased in kidney donors and postacute nephritis patients. Kidney donors and apparently normal postacute nephritis patients thus have diminished renal reserve capacity.

Cationic antigens in poststreptococcal glomerulonephritis

Antigen charge is an important factor in the pathogenesis of experimental immune complex glomerulonephritis. Its potential role in man was investigated in post-streptococcal glomerulonephritis, a disease where the causative agent is known. Cationic, extracellular streptococcal antigens were detected in 8 of 18 renal biopsies from patients with acute poststreptococcal glomerulonephritis (APSGN). The antigen was found mainly in earlier biopsies in which both IgG and IgM were present. Patients' sera taken at the time of biopsy contained antibody to cationic, streptococcal antigens. Cationic moieties are known to have affinity for the glomerular basement membrane and it is possible that the type of antigen described here initiates APSGN via in situ immune complex formation.

Urinary excretion of prostaglandins (PGE2 and PGF2 alpha) and kallikrein in acute glomerulonephritis

We studied prostaglandins and kallikrein urinary excretion in 14 children with acute poststreptococcal glomerulonephritis within 48 hours of hospital admission (period A), and again, 4-6 weeks later, when they were clinically recovered (period B). Seventeen apparently healthy children were studied as controls. The results (mean +/- SEM) indicate that PGE2 urinary excretion (ng/kg/day) was diminished during both periods of study (control group = 2.06 +/- 0.43, patients = period A 0.91 +/- 0.28 [P less than 0.02], period B 0.92 +/- 0.21 [P less than 0.02]). PGF2 alpha urinary excretion (ng/kg/day) was also suppressed during period A, but not during period B when large individual variability existed (control group = 7.10 +/- 1.07, patients period A 3.56 +/- 0.66 [P less than 0.001], period B 10.51 +/- 5.01 [NS]). Kallikrein urinary excretion (EU/kg/day) was also depressed during the acute phase and remained low during convalescence (control group = 0.492 +/- 0.1, patients period A 0.143 +/- 0.044 [P less than 0.001], period B 0.265 +/- 0.093 [P less than 0.02]). There was no difference in PGE/PGF ratio between controls and patients in the periods of study (control 0.328 +/- 0.055, period A 0.395 +/- 0.144, period B 0.384 +/- 0.128). Urine volume (ml/day) was lower in period A (582 +/- 75.8) but comparable in period B (1020 +/- 140.2) and control children (1210 +/- 80.2). No correlation could be found between the urinary excretion of PGE2, PGF2 alpha and kallikrein with any of the following parameters: urinary or serum sodium and potassium, serum or urinary osmolality, Cosm, urine flow, plasma renin activity, plasma or urinary aldosterone, hypertension or fluid retention.(ABSTRACT TRUNCATED AT 250 WORDS)

TPD-MS study of carbonation and hydration of Yb2O3(C)

A TPD-MS study of the behaviour of Yb2O3(C) against atmospheric environment has been carried out. Contrary to suggestions in the literature, the results show that after prolonged atmospheric exposure (3 years) bulk hydration and carbonation of ytterbia take place. If this sample, previously regenerated by calcination in helium flow at 870 K, is exposed to the atmosphere up to 80 hours, only surface reactions seem to occur. The present study, in which several CO2 and H2O treatments have been included, suggests that over Yb2O3, the hydration and carbonation reactions are related to each other, the amount and thermal stability of adsorbed CO2 being determined by the surface water content. The discussion of the results is based on a surface model of Yb2O3.

Long-term prognosis of epidemic poststreptococcal glomerulonephritis in Maracaibo: follow-up studies 11-12 years after the acute episode

In 1968 there was an epidemic outbreak of acute poststreptococcal glomerulonephritis in Maracaibo during which 384 cases were hospitalized. Of these cases, 120 were recalled in 1974 and the results of their investigations were reported. The present work concerns 71 patients from this group followed for 11-12 years and studied with measurement of creatinine clearance (CCr), protein excretion and urine sediment analyses. Measurements of serum immunoglobulins, cryoglobulins, C3 levels and rheumatoid factor titers were also made. One patient developed uremia and is in chronic dialysis. Persistent abnormalities were detected in 21.1% of the patients. Depressed creatinine clearance was found in 12.6% of the patients and proteinuria (0.5-2.0 g/day) in 11.2%. Microscopic hematuria occurred in 4.1%. Only 2 patients wer hypertensive. Transient serological abnormalities were seen in 36 patients: elevated IgG levels in 27, serum cryoglobulins in 17 and a low C3 level in 1 patient. Cryoglobulins were found in 50% of the patients with abnormal renal findings and in 22.9% of the patients with normal renal function and urine sediment. Children (at the time of the epidemic) had urinary abnormalities less frequently (16.1%) than did adults (55.5%). Of 9 patients who had been found abnormal five years before, 3 were improved or normal, 3 were stable and 3 showed progressive disease. our studies indicate that uremia is rare in the first decade after epidemic poststeptococcal glomerulonephritis. Nevertheless, the increasing incidence of depressed renal function dictates the need for continued follow-up of this group of patients.