STAT3 phosphorylation at serine 727 activates specific genetic programs and promotes clear cell renal cell carcinoma (ccRCC) aggressiveness

The signal transducer and activator of transcription 3 (STAT3) is a transcription factor mainly activated by phosphorylation in either tyrosine 705 (Y705) or serine 727 (S727) residues that regulates essential processes such as cell differentiation, apoptosis inhibition, or cell survival. Aberrant activation of STAT3 has been related to development of nearly 50% of human cancers including clear cell renal cell carcinoma (ccRCC). In fact, phosho-S727 (pS727) levels correlate with overall survival of ccRCC patients. With the aim to elucidate the contribution of STAT3 phosphorylation in ccRCC development and progression, we have generated human-derived ccRCC cell lines carrying STAT3 Y705 and S727 phosphomutants. Our data show that the phosphomimetic substitution Ser727Asp facilitates a pro-tumoral phenotype in vitro, in a Y705-phosphorylation-independent manner. Moreover, we describe that STAT3 phosphorylation state determines the expression of different subsets of target genes associated with distinct biological processes, being pS727-dependent genes the most related to cellular hallmarks of cancer. In summary, the present study constitutes the first analysis on the role of overall STAT3 phosphorylation state in ccRCC and demonstrates that pS727 promotes the expression of a specific subset of target genes that might be clinically relevant as novel biomarkers and potential therapeutic targets for ccRCC.

Iron cycle disruption by heme oxygenase-1 activation leads to a reduced breast cancer cell survival

Heme oxygenase-1 (HO-1), which catalyzes heme degradation releasing iron, regulates several processes related to breast cancer. Iron metabolism deregulation is also connected with several tumor processes. However the regulatory relationship between HO-1 and iron proteins in breast cancer remains unclear. Using human breast cancer biopsies, we found that high HO-1 levels significantly correlated with low DMT1 levels. Contrariwise, high HO-1 levels significantly correlated with high ZIP14 and prohepcidin expression, as well as hemosiderin storage. At mRNA level, we found that high HO-1 expression significantly correlated with low DMT1 expression but high ZIP14, L-ferritin and hepcidin expression. In in vivo experiments in mice with genetic overexpression or pharmacological activation of HO-1, we detected the same expression pattern observed in human biopsies. In in vitro experiments, HO-1 activation induced changes in iron proteins expression leading to an increase of hemosiderin, ROS levels, lipid peroxidation and a decrease of the growth rate. Such low growth rate induced by HO-1 activation was reversed when iron levels or ROS levels were reduced. Our findings demonstrate an important role of HO-1 on iron homeostasis in breast cancer. The changes in iron proteins expression when HO-1 is modulated led to the iron accumulation deregulating the iron cell cycle, and consequently, generating oxidative stress and low viability, all contributing to impair breast cancer progression.

Survival study and factors associated with mortality in Chilean patients on peritoneal dialysis infected with SARS-CoV-2

The Covid-19 pandemic has been responsible for millions of deaths worldwide. Patients with comorbidities- such as those on peritoneal dialysis (PD)- present higher morbidity and mortality than the general population. We prospectively evaluated all Chilean patients on PD (48 centres) and followed those who had Covid-19 from the beginning of the Covid-19 pandemic in Chile (March 2020) to January 2021 (start of vaccination campaign). We described demographic history, comorbidities, factors related to infection, need for hospitalisation and death due to Covid-19. During the study period, 106 adults on PD were infected by SARS-CoV-2, with a mean age of 53.1 (±16.3) and of which 53.9% were female. From that group, 54.8% required hospitalisation and 24.5% (n = 26) died due to Covid-19. Most of the patients (63.4%) were infected at home and 22.8% during hospitalisation for other reasons. There was a significant association for Covid-19 mortality with: being ≥60 years old, diabetes, time on PD ≥5 years, need for hospitalisation and hospital-acquired infection. At 90 days of follow-up, all deaths associated to Covid-19 occurred before 40 days. We conclude that patients on PD without Covid-19 vaccination have a high mortality and need for hospitalisation associated to Covid-19. To avoid this negative outcome, it is necessary to intensify strategies to avoid contagion, especially in those ≥60 years old, with diabetes and/or ≥5 years spent on PD.

Establishment of urinary exosome-like vesicles isolation protocol for FHHNC patients and evaluation of different exosomal RNA extraction methods

BACKGROUND

Molecular and cellular pathophysiological events occurring in the majority of rare kidney diseases remain to be elucidated. Familial hypomagnesemia with hypercalciuria and nephrocalcinosis (FHHNC) is a rare autosomal recessive disorder caused by mutations in either CLDN16 or CLDN19 genes. This disease is characterized by massive urinary wasting of magnesium and calcium, osmosis deregulation and polyuria. Patients with p.G20D homozygous mutation in CLDN19 gene exhibit different progression to kidney failure suggesting that beyond the pathogenic mutation itself, other molecular events are favoring disease progression. Due to the fact that biopsy is not clinically indicated in these patients, urinary exosome-like vesicles (uEVs) can be envisioned as a valuable non-invasive source of information of events occurring in the kidney. Exosome research has increased notably to identify novel disease biomarkers but there is no consensus standardized protocols for uEVs isolation in patients with polyuria. For this reason, this work was aimed to evaluate and refine different uEVs isolation methods based on differential centrifugation, the gold standard method.

RESULTS

Characterization by NTA, cryo-TEM and immunoblotting techniques identified the most appropriate protocol to obtain the highest yield and purest uEVs enriched fraction possible from urine control samples and FHHNC patients. Moreover, we tested five different RNA extraction methods and evaluated the miRNA expression pattern by qRT-PCR.

CONCLUSIONS

In summary, we have standardized the conditions to proceed with the identification of differentially expressed miRNAs in uEVs of FHHNC patients, or other renal diseases characterized by polyuria.

Adalimumab treatment of anti-TNF-naïve patients with ulcerative colitis: Deep remission and response factors

BACKGROUND

Adalimumab is the second tumour necrosis factor antagonist (anti-TNF) adopted for the treatment of ulcerative colitis. Clinical data from naïve patients are scarce.

AIM

Examine the response to adalimumab in TNF-antagonist-naïve patients.

METHODS

This multicentre, observational, prospective study was conducted using a cohort of consecutive patients with ulcerative colitis. Clinical remission, mucosal healing and deep remission were examined employing the Mayo Score and Mayo Endoscopic Score. Clinical response was assessed using the Partial Mayo Score.

RESULTS

Of 53 individuals included in this study, 49.1% of patients were in clinical remission at week 8 and 60.3%, at week 52. Clinical response was observed in 84.9% and 69.8%, respectively. Mucosal healing was found in 62.3% and 67.9% of the patients, and 43.4% and 58.4% showed deep remission at week 8 and 52, respectively. After a year, 71.7% of the patients continued the adalimumab treatment. Adverse effects were observed in 28.3% of patients. Multivariate analysis showed that the long-term factor predictive of response at week 52 was the response in week 8 (expressed as Mayo Score; OR 0.66; 95% IC 0.1-0.67, p < 0.006).

CONCLUSIONS

Adalimumab treatment of ulcerative colitis is effective; the results are better in clinical practice and in patients naïve to anti-TNF.

Timing of Thiopurine or Anti-TNF Initiation Is Associated with the Risk of Major Abdominal Surgery in Crohn's Disease: A Retrospective Cohort Study

INTRODUCTION

Early stages of Crohn's disease [CD] are predominantly inflammatory and early treatment could be useful to change the natural history of CD. We aimed to evaluate the impact of early treatment in our cohort of CD patients.

METHODS

We retrospectively reviewed clinical records of all CD patients at our centre who have received immunomodulators. Time from diagnosis to first CD-related major abdominal surgery or end of follow-up was considered. Dates of diagnosis, of starting immunomodulators (thiopurines / anti-tumour necrosis factor [TNF]), and of the first CD-related surgery when appropriate were collected.

RESULTS

Of 422 patients who received thiopurines, 189 operated patients started thiopurines after a median of 117 months (interquartile range [IQR] 44-196) since diagnosis; non-operated patients, after a median of 30 months [IQR 6-128], p < 0,005. Odds ratio [OR] for surgery was 1.006 (95% confidence interval [CI]1.004-1008) for each month of delay in starting thiopurines. Among 272 patients who received anti-TNFs, 137 operated patients started anti-TNFs after a median of 166 months [IQR 90-233] since diagnosis; non-operated patients after a median of 59 months [IQR 14-162]; p < 0,005. OR for surgery was 1.008 [95% CI 1.005-1.010] for each month of delay in starting anti-TNFs. Among 467 patients who received thiopurines and/or anti-TNF, 210 operated patients started any immunomodulator after a median of 120 months [IQR 48-197] since diagnosis and non-operated patients after a median of 30 months [IQR 6-126], p < 0,005. OR for surgery was 1.008 [95% CI 1.005-1.010] for each month of delay in starting immunomodulators.

CONCLUSIONS

In our experience, time between diagnosis and thiopurine or anti-TNF initiation was associated with the risk of major abdominal surgery in Crohn's disease.

Quantitative response of nitrifying and denitrifying communities to environmental variables in a full-scale membrane bioreactor

The abundance and transcription levels of specific gene markers of total bacteria, ammonia-oxidizing Betaproteobacteria, nitrite-oxidizing bacteria (Nitrospira-like) and denitrifiers (N2O-reducers) were analyzed using quantitative PCR (qPCR) and reverse-transcription qPCR during 9 months in a full-scale membrane bioreactor treating urban wastewater. A stable community of N-removal key players was developed; however, the abundance of active populations experienced sharper shifts, demonstrating their fast adaptation to changing conditions. Despite constituting a small percentage of the total bacterial community, the larger abundances of active populations of nitrifiers explained the high N-removal accomplished by the MBR. Multivariate analyses revealed that temperature, accumulation of volatile suspended solids in the sludge, BOD5, NH4(+) concentration and C/N ratio of the wastewater contributed significantly (23-38%) to explain changes in the abundance of nitrifiers and denitrifiers. However, each targeted group showed different responses to shifts in these parameters, evidencing the complexity of the balance among them for successful biological N-removal.

Exploring the links between population dynamics of total and active bacteria and the variables influencing a full-scale membrane bioreactor (MBR)

Long-term dynamics of total and active bacterial populations in a full-scale membrane bioreactor (MBR) treating urban wastewater were monitored during nine months by temperature-gradient gel electrophoresis (TGGE) of partial 16S-rRNA genes, amplified from community DNA and RNA templates. The bacterial community, dominated by Alphaproteobacteria, displayed the required characteristics for a successful and steady contaminant removal under real operating conditions. The evolution of population dynamics showed that a fully-stable microbial community was not developed even after technical stabilization and steady performance of the MBR were achieved. Non-metric multidimensional scaling and BIO-ENV demonstrated that the trends of the populations were often mostly explained by temperature, followed by the concentration of volatile suspended solids and C/N ratio of the influent. These variables were mainly responsible for triggering the shifts between functionally redundant populations. These conclusions contribute to the prediction of the complex profiles of adaptation and response of bacterial populations under changing conditions.

Removal performance of heavy metals in MBR systems and their influence in water reuse

The removal performance of heavy metals by two experimental full-scale membrane bioreactors (microfiltration and ultrafiltration) and the influence of activated sludge total suspended solid (TSS) concentration were studied under real operational conditions. Influent and effluent Be, Sc, V, Cr, Mn, Co, Ni, Cu, Zn, As, Mo, Cd, Ba, Sn, Sb, Pb and U concentrations were analysed by inductively coupled plasma-mass spectrometry. An average contamination rate for most of the analysed heavy metals was observed in raw wastewater, resulting in effluents without limitation for reuse in agricultural destinations according to Spanish law. Removal efficiencies up to 80% were obtained regardless of whether microfiltration or ultrafiltration membranes were used, except for As, Mo and Sb. The removal yields of different heavy metals can be strengthened by increasing the activated sludge TSS concentration, mainly at concentrations above 10 g/L.

Linking hydrolytic activities to variables influencing a submerged membrane bioreactor (MBR) treating urban wastewater under real operating conditions

The seasonal variation of the hydrolytic activities acid and alkaline phosphatase, α-glucosidase and protease, was studied in both the aerated and anoxic phases of a full-scale membrane bioreactor (MBR) (total operational volume = 28.2 m(3)), operated in pre-denitrification mode and fed real urban wastewater. Non-metric multidimensional scaling (MDS) and BIO-ENV analysis were used to study the distribution of enzyme activities in different seasons of the year (spring, summer and autumn) and unveil their relationships with changes in variables influencing the system (composition of influent wastewater, activated sludge temperature and biomass concentration in the bioreactors). The activities of all the tested hydrolases were remarkably dynamic, and each enzyme showed complex and diverse patterns of variation. Except in the summer season, the variables included in this study gave a good explanation of those patterns and displayed high and consistent correlations with them; however, markedly different correlation trends were found in each season, indicating dissimilar adaptation responses of the community to the influence of changing conditions. A consistent and highly negative correlation between protease and α-glucosidase was revealed in all the experiments. The variables included in this study showed contrary influences on these activities, suggesting an alternation of the major groups of carbon-degrading hydrolases in connection to changes in temperature and the availability and composition of nutrients in the different seasons. Sampling over a long period of time was required to adequately lay down the links between hydrolytic activities and the variables influencing the MBR system. These results highlight the complexity of the regulation of substrate degradation by the mixed microbial sludge communities under real operating conditions.

Vanishing neoclassical viscosity and physics of the shear layer in stellarators

The drift kinetic equation is solved for low density TJ-II plasmas employing slowly varying, time-dependent profiles. This allows us to simulate density ramp-up experiments and describe from first principles the formation and physics of the radial electric field shear layer. The main features of the transition are perfectly captured by the calculation, and good quantitative agreement is also found. The results presented here, that should be valid for other nonquasisymmetric stellarators, provide a fundamental explanation for a wealth of experimental observations connected to the shear layer emergence in TJ-II. The key quantity is the neoclassical viscosity, which is shown to go smoothly to zero when the critical density is approached from below. This makes it possible for turbulence-related phenomena, and particularly zonal flows, to arise in the neighborhood of the transition.

Respirometric assays of two different MBR (microfiltration and ultrafiltration) to obtain kinetic and stoichiometric parameters

A comparison of two different medium scale MBRs (ultrafiltration and microfiltration) using respirometric methods has been achieved. The ultrafiltration membrane plant (0.034 microm pore size) maintained recirculation sludge flow at seven times the influent flow, and membranes were backwashed every 5 min and chemically cleaned weekly. The microfiltration membrane plant (0.4 microm pore size) maintained recirculation sludge flow at four times the influent flow, membrane-relax was applied after the production phase and membranes were chemically cleaned in the event of high trans-membrane pressure. Both technologies showed a similar performance with regard to heterotrophic kinetic and stoichiometric parameters and organic matter effluent concentrations. The influent was characterized by means of its COD fractions and the average removal percentages for COD concentrations were around 97% for both plants in spite of influent COD fluctuation, temperature variations and sludge retention time (SRT) evolution. Both SRT evolution and temperature affect the heterotrophic yield (Y(H)) and the decay coefficient (bH) in the same range for both plants. Y(H) values of over 0.8 mg COD/mg COD were obtained during the unsteady periods, while under steady state conditions these values fell to less than 0.4 mg COD/mg COD. bH by contrast reached values of less than 0.05 d(-1).

Impurity temperature correction factors for the transmission grating spectrometer in the TJ-II stellarator

Impurity ion temperature and velocity profiles are obtained across plasmas in the TJ-II stellarator by performing charge-exchange recombination spectroscopy with a diagnostic neutral beam injector. For this, a tridirectional (toroidal plus two poloidal opposing views) multichannel spectroscopic diagnostic, incorporating 12-way fiber arrays, a compact f/1.8 spectrograph, and a back-illuminated CCD, permits Doppler line shifts and widths (of the C VI line at 529.05 nm) to be determined with 1-2 cm spatial resolution. For good photon counting statistics under Li-coated wall conditions, 600 μm diameter fibers collect and transmit light to curved 100 μm wide input slits. When calibrated with a neon pencil lamp this entrance slit width results in a non-Gaussian instrumental function that, if not handled correctly, can result in systematically underestimated impurity temperatures. Here we develop and present correction factors for this effect for a range of conditions.

Applicability of the Sludge Biotic Index (SBI) for MBR activated sludge control

In 1994, Madoni created the Sludge Biotic Index (SBI) based on the presence and abundance of certain key protozoan groups. The use of this index has become increasingly common in wastewater treatment plant control and its applicability has been demonstrated. In this study, we applied the SBI index to a pilot-scale membrane bioreactor equipped with polyvinylidenefluoride hollow fibre membranes (0.04 microm pore size). Two different sludge retention times (SRT)--25 and 35 days--were assayed, with a constant hydraulic retention time of 30h. Operational conditions for MBR cause the fragmentation of flocs which are broken down into small dissipated elements with abundant dispersed bacteria. This process determines protozoan composition and colonization of the activated sludge. Results of the experiment showed a constant predominance of small flagellates, carnivorous ciliated protozoa and rotifers, above all in assays with 35-day SRT, independently of effluent quality. However, continuous changes in microbiota were observed, with a clear tendency for the SBI to increase over time as the sludge became more stable. Therefore, although it was not possible to establish an association between SBI and effluent quality for MBR activated sludge, the stabilisation of the process may be related to SBI.

Effects of lipids and aging on the neurotoxicity and neuronal loss caused by intracerebral injections of the amyloid-β peptide in the rat

The influence of diet and age on the area of lesion and on the neuronal density in the cerebral cortex was studied in rats following local injections of the amyloid-beta peptide (Abeta1-40) in PBS vehicle into the left frontal and cingulate cortices and compared with effects of injections of PBS alone into the corresponding regions of the right hemisphere The experiments were carried out in two groups of animals: one group of young adult rats and a second group of aged rats. Each group of animals, depending on the diet received, was divided into high-cholesterol, high-fat, and a control group. In order to evaluate the interaction of Abeta/PBS-cholesterol and of Abeta/PBS-fat, animals without dietary manipulation receiving Abeta and PBS injection were used as controls. The results showed that the greatest area of lesion was at Abeta injection sites in the high-cholesterol fed group of aged animals. The results also revealed a significant variance in the neuronal density by group and by injection type. Thus, high-cholesterol fed animals showed a greater reduction in neuronal density at Abeta and PBS-injected sites than that seen in the high-fat or control groups. The results also indicate that the loss of neurons at the Abeta injection site exceeds that seen in the PBS-injected area. The greatest reduction in the neuronal density was found at Abeta-injected site in the high-cholesterol fed group of aged animals. In conclusion, our findings indicate an interaction between lipids, age, and Abeta neurotoxicity, and might provide insights into the basic mechanisms involved in a short-term (acute-to-subchronic) response to Abeta peptide.

Amyloid beta peptide-induced cholinergic fibres loss in the cerebral cortex of the rat is modified by diet high in lipids and by age

The influence of diet and age on the effects of intracerebral injection of beta-amyloid peptide (Abeta1-40) in vehicle phosphate-buffered saline (PBS) and on the effects of vehicle alone on cholinergic fibres of the cerebral cortex was studied in rats. The experiments were carried in two groups of animals: one group of young adult rats and a second group of aged rats. Each group of animals, depending on the diet received, was divided into high-cholesterol, high-fat, and a control diet group. In order to evaluate the interaction of Abeta/PBS-cholesterol and of Abeta/PBS-fat, animals without dietary manipulation receiving Abeta and PBS injection were used as controls. High-cholesterol fed animals showed a statistically significant reduction of 49.62% in the number of cholinergic fibres at the Abeta injection site as compared with that at PBS injection site, while the high-fat and control animals showed a significant reduction of 28.13 and 26.81%, respectively. In all diet groups, the loss of cholinergic fibres caused by Abeta as compared to that caused by PBS injection was significantly greater in aged rats in comparison with that observed in the young animals. Furthermore, the results of a multivariate linear regression model revealed that the greatest reduction in cholinergic fibres was in the high-cholesterol fed animals (35 fibres/mm) as compared with that seen in the high-fat and control animals. A significantly greater reduction was also observed at Abeta injection site (28 fibres/mm) as compared with that caused by PBS injection, and a reduction of 16 cholinergic fibres per mm was found in aged animals as compared to that seen in young adult rats. These results show that high-cholesterol diet enhances the toxicity of Abeta peptide and that this is also age-dependent. Therefore, this study increases the evidences of the role of cholesterol in the pathology of Alzheimer's disease (AD).

Plasmodium ovale malaria acquired in central Spain

We describe a case of locally acquired Plasmodium ovale malaria in Spain. The patient was a Spanish woman who had never traveled out of Spain and had no other risk factors for malaria. Because patients with malaria may never have visited endemic areas, occasional transmission of malaria to European hosts is a diagnostic and clinical challenge.

Molecular epidemiology and diagnosis of Leishmania: what have we learnt from genome structure, dynamics and function?

This paper reviews our exploration of the dynamics of the Leishmania genome and its contribution to epidemiology and diagnosis. We used as a model Peruvian populations of L. (Viannia) braziliensis and L. (V.) peruviana, 2 species very close phylogenetically, but phenotypically very different in biotope and pathology. We initially focused on karyotype analysis. Our data showed that chromosomes were subject to a fast rate of evolution, and were sensitive indicators of genetic drift. Therefore, molecular karyotyping appeared an adequate tool for monitoring (i) emergence of close species, (ii) ecogeographical differentiation at the intraspecific level, and (iii) strain 'fingerprinting'. Chromosome size variation was mostly due to the number of tandemly repeated genes (rDNA, mini-exon, gp63, and cysteine proteinase genes), and could involve the deletion of unique genes (L. (V.) braziliensis-specific gp63 families). Considering the importance of these genes in parasitism, their rearrangement might have functional implications: adaptation to different environments and pleomorphic pathogenicity. Our knowledge of genome structure and dynamics was used to develop new polymerase chain reaction (PCR) techniques. Amplification of gp63 genes followed by cleavage with restriction enzymes and study of restriction fragment length polymorphism (gp63 PCR-RFLP) allowed the discrimination of all species tested, even directly in biopsies with 95% sensitivity (compared with PCR amplification of kinetoplast deoxyribonucleic acid). At the intra-specific level, RFLP was also observed and corresponded to mutations in major immunogen domains of gp63. These seem to be under strong selection pressure, and the technique should facilitate addressing how the host's immune pressure may modulate parasite population structure. Altogether, gp63 PCR-RFLP represents a significant operational improvement over the other techniques for molecular epidemiology and diagnosis: it combines sensitivity, discriminatory power and prognostic value.

Tracing Woody Guthrie and Huntington's disease

Tracing the outlines of Woody Guthrie's life can be maddening. His outpouring of songs, words, and images attests to the rare creative spirit which possessed him like a devil, or angel, more often both. He was a figure which many of us hold dear as an emblematic American symbol of outspoken and independence-minded social consciousness. Drawn from Guthrie's collection of published and unpublished material in the Woody Guthrie Archives, including song lyrics, poems, prose, artwork--in short, every imaginable form of manuscript--the shadows that form and delineate Guthrie's life keep moving, much like dancing flames reflecting off a wall, illuminating some details while obscuring others. Guthrie, of course, had no choice about Huntington's disease (HD) or how it would impact his life. Characteristically, he moved with it, sang with it, and even danced with it. When HD finally silenced Guthrie in 1967, it nevertheless spurred his second wife, Marjorie Mazia, to action-action which continues today with the commitment and work of the Huntington's Disease Society of America (HDSA). Was it tragic? Or just the natural course of the disease? The interplay between artistry, inspiration, and devastation is what we explore here.

[Atrial septal defect percutaneous transvenous occlusion with the buttoned device]

PURPOSE

To analyse the experience with the use of Sideris' device for percutaneous transvenous occlusion of atrial septal defect (ASD).

METHODS

Thirty six procedures of ASD occlusion were performed in 32 patients; 27 (84.4%) female and five (15.6%) male, mean age of 16 years (4-61). All patients had secundum atrial septal defects with clinical and hemodynamic compromise. The ASD diameter measured < 31 mm and occupied less than 50% of the septal length in all cases. The basic device was used in 28 (87.5%) patients and the self centered model in four (12.5%). The direct implant technique was employed in 15 (41.7%) procedures while in the other 21 (58.3%) an over a wire technique was used. The size of the device was selected according with the Sideris' normogram.

RESULTS

Occlusion of the defect was achieved in 29 patients (90.63%). In two (6.25%) the position of the device was not adequate and in one (3.12%) the device embolized to the pulmonary artery. In these three cases the device was removed surgically during the defect closure. There was neither morbidity nor mortality in this series. Trivial or small residual shunt was detected with color flow mapping in three (9.4%) patients immediately after the procedure. In 22 patients with 12 months follow-up, trivial residual shunt was present in only one (4.5%). Structural modification of the device was detected in one patient, however with complete ASD occlusion and neither clinical nor hemodynamic disturbance.

CONCLUSION

The Sideris' device is safe and efficient for ASD occlusion in selected patients. Although there is a relatively high incidence of residual shunt immediately after the procedure, the shunt itself tends to become smaller or disappear during the follow-up and it does not preclude clinical and hemodynamic improvement.

The toad skin NaCl check-valve

Short-circuited toad skins exposed to chloride-containing Ringer's on the outer side exhibit a large inward chloride flux. Conversely, toad skins exposed to nominally chloride-free Ringer's externally and chloride Ringer's internally manifest a very low chloride outflux. This chloride-dependent rectification of chloride flux serves to conserve NaCl transported from low NaCl concentration outer solutions to which amphibians are normally exposed. Once chloride is transported inwardly it cannot return to the outer solution, with chloride rectification acting as a check-valve for transported NaCl.

Leishmaniasis in the lowlands of Bolivia, prevalence of the disease in two groups of localities with different settlement ages in Carrasco Tropical, Cochabamba

The invasion of the Bolivian Jungle has brought the new colonists some unfamiliar diseases, among which we study Leishmaniasis. A previous study described the situation in Yapacaní. Departamento of Santa Cruz, a primary rain forest lowland area. We now focus on the characteristics of Carrasco Tropical, close to a hilly territory of the andean mountains. We studied 11 localities ("colonies") grouped as unions with different lengths of residence in the area. We considered males and females over 15 years old as "at risk" and studied in them all forms of leishmanial infection, through clinical and laboratory (smears) means, including the Montenegro Skin Test (IDRM). Cutaneous ulcers and scars were seen in 2.9% (10 patients of 339 at risk, 6 from "27 de octubre", a younger settlement, 4 from the older Tamboradas): mucocutaneous lesions in 3 (1 from the younger settlement); and skin scars alone in 10.3% (35 from the younger area). The only 2 females with positive findings in the study were seen in this latter group. Transmission is apparently associated with the primary forest which exists at the foot of the Andes in the area, which is visited preferentially by young men.

The use of nonradioactive DNA probes for the characterization of Leishmania isolates from Peru

We describe conditions for dot blot DNA hybridization studies using biotinylated kDNA probes from Leishmania. The sensitivity and specificity attained with biotinylated or 32P-labeled probes were equivalent. The lower level of detection obtained was 100 parasites that were blotted on nitrocellulose paper and then treated with Proteinase K. Studies were performed with 112 Leishmania isolates from Andean (uta) and sylvatic mucocutaneous (espundia) patients and all were determined to belong to the Leishmania braziliensis complex.

Characterization of Leishmania species from Peru

Twenty-six isolates of Leishmania parasites of Peruvian origin were studied by isoenzyme electrophoresis of four marker enzymes (ASAT, ALAT, G6PD and GPI), kinetoplast DNA hybridization and monoclonal antibody binding and compared with marker strains of the New World organisms L. b. braziliensis, L. b. guyanensis, L. m. mexicana and L. m. amazonensis. 12 of the isolates studied were of Andean origin; 11 of these were isolated from patients with Andean cutaneous leishmaniasis. The organisms originating from the Peruvian Amazonian forest were isolated from patients with cutaneous (12 cases) or mucocutaneous (2 cases) leishmaniasis. One of the Andean isolates was obtained from an infected phlebotomine vector. 25 of the new isolates were identified as L. braziliensis ssp. according to the three techniques employed. The results of monoclonal antibody binding showed that 23 of the isolates were indistinguishable from L. b. braziliensis. Two isolates identified as L. braziliensis ssp. according to their isoenzyme profiles and k-DNA hybridization patterns could not be classified at the subspecies level. The isolate obtained from the phlebotomine vector could not be identified. No evidence of the existence of parasites of the L. mexicana complex in Peruvian territory was found in this study. The results obtained show a remarkable similarity between Leishmania of Andean origin and L. b. braziliensis.

Relevance of hemin for in vitro differentiation of Trypanosoma cruzi

Simple culture conditions that allow good growth and high yields of trypomastigotes are described. The proportion of metacyclic trypomastigotes increases with the concentration of hemin in the culture medium, reaching a peak of 80% after 10 days with 20 mg hemin/liter.