Emerging Hyalomma lusitanicum: From identification to vectorial role and integrated control

In the Mediterranean basin, the tick species Hyalomma lusitanicum Koch stands out among other species of the Hyalomma genus due to its wide distribution, and there is great concern about its potential role as a vector and/or reservoir and its continuous expansion to new areas because of climate warming and human and other animal movements. This review aims to consolidate all the information on H. lusitanicum, including taxonomy and evolution, morphological and molecular identification, life cycle, sampling methods, rearing under laboratory conditions, ecology, hosts, geographical distribution, seasonality, vector role and control methods. The availability of adequate data is extremely relevant to the development of appropriate control strategies in areas where this tick is currently distributed as well as in new areas where it could become established in the near future.

Invariant representations in deep learning for optoacoustic imaging

Image reconstruction in optoacoustic tomography (OAT) is a trending learning task highly dependent on measured physical magnitudes present at sensing time. A large number of different settings and also the presence of uncertainties or partial knowledge of parameters can lead to reconstruction algorithms that are specifically tailored and designed to a particular configuration, which could not be the one that will ultimately be faced in a final practical situation. Being able to learn reconstruction algorithms that are robust to different environments (e.g., the different OAT image reconstruction settings) or invariant to such environments is highly valuable because it allows us to focus on what truly matters for the application at hand and discard what are considered spurious features. In this work, we explore the use of deep learning algorithms based on learning invariant and robust representations for the OAT inverse problem. In particular, we consider the application of the ANDMask scheme due to its easy adaptation to the OAT problem. Numerical experiments are conducted showing that when out-of-distribution generalization (against variations in parameters such as the location of the sensors) is imposed, there is no degradation of the performance and, in some cases, it is even possible to achieve improvements with respect to standard deep learning approaches where invariance robustness is not explicitly considered.

Pharmacogenetic studies in Alzheimer disease

INTRODUCTION

Alzheimer disease (AD) is the most common cause of dementia and is considered one of the main causes of disability and dependence affecting quality of life in elderly people and their families. Current pharmacological treatment includes acetylcholinesterase inhibitors (donepezil, galantamine, rivastigmine) and memantine; however, only one-third of patients respond to treatment. Genetic factors have been shown to play a role in this inter-individual variability in drug response.

DEVELOPMENT

We review pharmacogenetic reports of AD-modifying drugs, the pharmacogenetic biomarkers included, and the phenotypes evaluated. We also discuss relevant methodological considerations for the design of pharmacogenetic studies into AD. A total of 33 pharmacogenetic reports were found; the majority of these focused on the variability in response to and metabolism of donepezil. Most of the patients included were from Caucasian populations, although some studies also include Korean, Indian, and Brazilian patients. CYP2D6 and APOE are the most frequently studied biomarkers. The associations proposed are controversial.

CONCLUSIONS

Potential pharmacogenetic biomarkers for AD have been identified; however, it is still necessary to conduct further research into other populations and to identify new biomarkers. This information could assist in predicting patient response to these drugs and contribute to better treatment decision-making in a context as complex as aging.

On the robustness of model-based algorithms for photoacoustic tomography: Comparison between time and frequency domains

For photoacoustic image reconstruction, certain parameters such as sensor positions and speed of sound have a major impact on the reconstruction process and must be carefully determined before data acquisition. Uncertainties in these parameters can lead to errors produced by a modeling mismatch, hindering the reconstruction process and severely affecting the resulting image quality. Therefore, in this work, we study how modeling errors arising from uncertainty in sensor locations affect the images obtained by matrix model-based reconstruction algorithms based on time domain and frequency domain models of the photoacoustic problem. The effects on the reconstruction performance with respect to the uncertainty in the knowledge of the sensors location are compared and analyzed both in a qualitative and quantitative fashion for both time and frequency models. Ultimately, our study shows that the frequency domain approach is more sensitive to this kind of modeling errors. These conclusions are supported by numerical experiments and a theoretical sensitivity analysis of the mathematical operator for the direct problem.

Seasonal Dynamics of Fleas (Siphonaptera: Pulicidae, Ceratophyllidae and Leptopsyllidae) on Oryctolagus cuniculus in a Meso-Mediterranean Area of Central Spain

Flea infestations of wild rabbits were examined monthly in central Spain in a meso-Mediterranean area for 5 yr. A total of 1,180 wild rabbits were trapped and 7,022 fleas were collected from them. Overall, the prevalence was 74.1% with a mean flea index of 5.95 fleas per rabbit. Four flea species were identified: Spilopsyllus cuniculi (Dale, 1878) was the most abundant species (accounting for 74.3% of fleas collected) followed by Xenopsylla cunicularis (Smit, 1957), Odontopsyllus quirosi (Gil Collado, 1934), and Nosopsyllus fasciatus (Bosc, 1800) (18.9, 6.7, and 0.1%, respectively). The highest prevalence was observed in S. cuniculi (48.6%) followed by X. cunicularis, O. quirosi, and N. fasciatus (34.3, 20.0, and 0.6%, respectively). Odontopsyllus quirosi and S. cuniculi were mainly collected from autumn to spring with the peak of infestation in winter, while X. cunicularis was mainly found from spring to autumn with maximum levels of infestation during the summer months. The relevance of these findings is discussed.

A method for the calibration of wideband ultrasonic sensors for optoacoustics

A method for calibration of ultrasonic sensors for optoacoustics that provides both frequency response and sensitivity is presented. In order to obtain the bandwidth and the frequency response of an uncalibrated sensor, a point source with broadband spectra generated by a laser-induced bubble on a copper wire submerged in water is employed. On the other hand, the sensitivity measurement relies on the spatial symmetry of the pressure pulse and on a calibrated transducer. Therefore, two sensors are employed to detect the pressure pulse at the same distance from the source. The symmetry of the acoustic field that arrives at both transducers is adjusted and verified by means of an optical interferometer that provides a null signal when the copper wire is placed at the right position. The method is tested on the characterization of a thin-film polymeric piezoelectric transducer with a cylindrical focused shape.

A systematic review of cognition and functionality in delusional disorder

Introduction

Current definitions for delusional disorder (DD) state that no cognitive or functional impairment is present. However, this assumption lacks empirical validation and has been questioned by numerous authors over the years. Through systematic search we collected articles that compare patients with DD with either healthy controls or patients with schizophrenia on the basis of their cognitive symptoms and their functional outcomes.

Objectives

Our aim is to draw conclusions from the available evidence on neurocognitive and functional affectation of DD.

Methods

Systematic electronic search was performed using Pubmed and Embase databases. Inclusion criteria included that selected articles must be original studies, must be published in peer-reviewed journals, must contain a sample of DD patients that is compared with a sample of healthy controls and/or patients with schizophrenia and that samples must be compared on the basis of cognitive and/or functionality parameters. A qualitative synthesis was performed due to heterogeneity in data.

Results

According to the information collected through our systematic review, DD patients tend to perform worse than healthy control in tests assessing cognitive functions. Results are not as conclusive regarding comparison between DD and schizophrenia, with mixed outcomes. When it comes to functionality, results are not conclusive either, with some degree of evidence pointing towards a better functioning in patients with DD in comparison to patients with schizophrenia.

Conclusions

Results agree with many authors who consider both conditions as part of a psychosis spectrum. Cognitive interventions, such as cognitive remediation, must be studied for their potential role in the treatment of patients with DD.

Generation of sub-microsecond quasi-unipolar pressure pulses

We present a method to generate sub-microsecond quasi-unipolar pressure pulses. Our approach is based on the laser irradiation of a thin copper wire submerged in water. The acoustic waveforms were recorded using two different, well characterized, wideband detection techniques: piezoelectric and optical interferometry. The results show that the irradiated target behaves as an omnidirectional source. Moreover, the peak pulse pressure linearly depends on the laser fluence and the source size. From the results, we propose an empirical equation for the spatial and temporal profile of the pressure pulse. The method has several advantages: ease of implementation, high repeatability, wide ultrasonic bandwidth and quasi-unipolar time profile. These features lead to potential applications of this acoustic source in ultrasonic characterization such as transducer systems, materials or passive devices.

Spirocercosis in red fox (Vulpes vulpes) in a natural reserve located in a meso-Mediterranean area

Spirocerca lupi Rudolphi 1809 (Nematoda Spirocercidae) has an indirect cycle involving intermediate and paratenic hosts, having domestic or wild canids as the main definitive hosts. The most frequent pathology affecting dogs is a granulomatous tumor-like growth containing adults in the oesophagus and aorta. There are very few references about the presence of nodules in the stomach. There is scant information about the epidemiology of this disease in wild red foxes in meso-Mediterranean areas. In this work we report on the natural infection of wild red foxes by Spirocerca lupi and the damage produced in the stomach wall in an area where contact with other potential definitive hosts (canids) is very rare. From July 2015 to November 2016, 61 red foxes were sampled. 18.03% of the stomach walls examined had nodules containing Spirocerca lupi adults and eggs. The prevalence of infection was similar for young and adult groups (23.81 and 18.18%; χ2 = 0.25; df = 1; P = 0.6171) and it was higher in females than in males (25.81 versus 10.00%, χ² = 2.58; df = 1; P = 0.1082). The red fox population in the area seems to be well established judging from their age distribution and the fact that they could be captured all year round. It would appear that in the absence of other main definitive host S. lupi population is able to survive just parasitizing red foxes. Pathologic effects of this parasite on red foxes seems to show some differences related to domestic dogs. These results also indicates as predator control programs can maintain suitable host populations with reduced level of infection.

Parametric modeling of wideband piezoelectric polymer sensors: Design for optoacoustic applications

In this work, we present a three-dimensional model for the design of wideband piezoelectric polymer sensors which includes the geometry and the properties of the transducer materials. The model uses FFT and numerical integration techniques in an explicit, semi-analytical approach. To validate the model, we made electrical and mechanical measurements on homemade sensors for optoacoustic applications. Each device was implemented using a polyvinylidene fluoride thin film piezoelectric polymer with a thickness of 25 μm. The sensors had detection areas in the range between 0.5 mm² and 35 mm² and were excited by acoustic pressure pulses of 5 ns (FWHM) from a source with a diameter around 10 μm. The experimental data obtained from the measurements agree well with the model results. We discuss the relative importance of the sensor design parameters for optoacoustic applications and we provide guidelines for the optimization of devices.

Modeling thin-film piezoelectric polymer ultrasonic sensors

This paper presents a model suitable to design and characterize broadband thin film sensors based on piezoelectric polymers. The aim is to describe adequately the sensor behavior, with a reasonable number of parameters and based on well-known physical equations. The mechanical variables are described by an acoustic transmission line. The electrical behavior is described by the quasi-static approximation, given the large difference between the velocities of propagation of the electrical and mechanical disturbances. The line parameters include the effects of the elastic and electrical properties of the material. The model was validated with measurements of a poly(vinylidene flouride) sensor designed for short-pulse detection. The model variables were calculated from the properties of the polymer at frequencies between 100 Hz and 30 MHz and at temperatures between 283 K and 313 K, a relevant range for applications in biology and medicine. The simulations agree very well with the experimental data, predicting satisfactorily the influence of temperature and the dielectric properties of the polymer on the behavior of the sensor. Conversely, the model allowed the calculation of the material dielectric properties from the measured response of the sensor, with good agreement with the published values.

Stereodynamics of the photodissociation of nitromethane at 193 nm: unravelling the dissociation mechanism

The photodissociation of nitromethane at 193 nm is reviewed in terms of new stereodynamical information provided by the measurement of the first four Dixon's bipolar moments, β0(2)(20), β0(0)(22), β0(2)(02), and β0(2)(22), using slice imaging. The measured speed-dependent β0(2)(20) (directly related with the spatial anisotropy parameter β) indicates that after one-photon absorption to the S3(2 (1)A″) state by an allowed perpendicular transition, two reaction pathways can compete with similar probability, a direct dissociation process yielding ground-state CH3 and NO2(1 (2)A2) radicals and a indirect dissociation through conical intersections in which NO2 radicals are formed in lower-lying electronic states. A particularly important result from our measurements is that the low recoil energy part of the methyl fragment translational energy distribution presents a contribution with parallel character, irrespective of the experimental conditions employed, that we attribute to parent cluster dissociation. Moreover, the positive values found for the β0(0)(22) bipolar moment indicates some propensity for the fragment's recoil velocity and angular momentum vectors to be parallel.

Photodissociation of pyrrole-ammonia clusters below 218 nm: quenching of statistical decomposition pathways under clustering conditions

The excited state hydrogen transfer (ESHT) reaction in pyrrole-ammonia clusters (PyH·(NH(3))(n), n = 2-5) at excitation wavelengths below 218 nm down to 199 nm, has been studied using a combination of velocity map imaging and non-resonant detection of the NH(4)(NH(3))(n-1) products. Special care has been taken to avoid evaporation of solvent molecules from the excited clusters by controlling the intensity of both the excitation and probing lasers. The high resolution translational energy distributions obtained are analyzed on the base of an impulsive mechanism for the hydrogen transfer, which mimics the direct N-H bond dissociation of the bare pyrrole. In spite of the low dissociation wavelengths attained (~200 nm) no evidence of hydrogen-loss statistical dynamics has been observed. The effects of clustering of pyrrole with ammonia molecules on the possible statistical decomposition channels of the bare pyrrole are discussed.

Slice imaging and wave packet study of the photodissociation of CH3I in the blue edge of the A-band: evidence of reverse 3Q0 ← 1Q1 non-adiabatic dynamics

The photodissociation of CH(3)I in the blue edge (217-230 nm) of the A-band has been studied using a combination of slice imaging and resonance enhanced multiphoton ionization (REMPI) detection of the CH(3) fragment in the vibrational ground state (ν = 0). The profiles of the CH(3) (ν = 0) kinetic energy distributions and the photofragment anisotropies are interpreted in terms of the contribution of the excited surfaces involved in the photodissociation process, as well as the probability of non-adiabatic curve crossing between the (3)Q(0) and (1)Q(1) states. In the studied region, unlike in the central part of the A-band where absorption to the (3)Q(0) state dominates, the I((2)P(J)), with J = 1/2, 3/2, in correlation with CH(3) (ν = 0) kinetic energy distributions show clearly two contributions of different anisotropy, signature of the competing adiabatic and non-adiabatic dynamics, whose ratio strongly depends on the photolysis wavelength. The experimental results are compared with multisurface wave packet calculations carried out using the available ab initio potential energy surfaces, transition moments, and non-adiabatic couplings, employing a reduced dimensionality model. A good qualitative agreement is found between experiment and theory and both show evidence of reverse (3)Q(0)←(1)Q(1) non-adiabatic dynamics at the bluest excitation wavelengths both in the fragment kinetic energy and angular distributions.

[Endonasal tubes as cause of pressure ulcers in the critical patient]

INTRODUCTION

One of the risks of using endonasal tubes (ET) is the appearance of pressure ulcers (PU).

OBJECTIVE

To ascertain the proportion of patients with nasal PU, study the risk factors of appearance, and find predictive variables.

MATERIAL AND METHODS

A six-month prospective, observational study of intensive care unit patients with ET.

VARIABLES

Variable response: "the appearance of pu as a result of the use of ET". Explanatory variables: age, duration of stay, length of time with ET, gender, sedation, norepinephrine perfusion, mechanical ventilation, anemia, nutritional state.

ANALYSIS

multivariate statistical techniques (multiple logistical regression). Statistics program g-stat 2.0. Significance level p < 0.05.

RESULTS

Sample of 48 patients. Proportion of patients with PU: 29.2%. Those patients with PU had similar ages, duration of stay and longer length of time with ET. Results of the Logistic Regression model: only the variable "time with ET" was statistically significant (p = 0.03; odds ratio: 1.047).

CONCLUSIONS

The length of time the patient is using an ET influences the appearance of nasal PU (risk increases 1.047 for each day with ET). None of the variables dealt with could be used as a predictive factor in the appearance of PU.

Background subtraction in pulsed photoacoustics through neural-network processing

We report on the application of neural-network processing to pulsed photoacoustics for improving the detection limit by subtracting the window-heating-associated background. This technique was applied to the measurement of ethylene traces excited by a TEA (transverse electrical discharge in gas at atmospheric pressure) CO(2) laser. The signal contains a term that shows absorption saturation, characteristic of the absorbing gas, and another, generated by window heating, linearly dependent on laser energy. At low concentrations, normalization to laser energy is not possible owing to the different absorption mechanisms. To overcome this problem we relied on a neural-network filter, trained with experimentally obtained patterns, that subtracts the background and returns the sample concentration. This way, we reduced the detection limit to 20% of the previous limit obtained by reading the main resonance peak amplitude.

Evaluation of the quality of the water in El Hondo natural park located in the east of Spain

The purpose of the present work was to evaluate the quality of the water in El Hondo Park, an important wetland located in the east of Spain (province of Alicante) and included on the Ramsar List. The influence of the input of pollutants was assessed over a 14-month period in order to propose remedial action. Three different sources of waters were studied: irrigation water, brackish water and reservoir water. The irrigation water was found to have a high value of conductivity with high concentrations of Cl-, SO(4)2-, Na+ and K+ due to the influence of the brackish water. The concentration of organic matter given as CODT (total chemical oxygen demand) was found to be in the range of 70-600 mg/L of CODT, which was comparable to low-middle strength wastewater. A high concentration of Chlorophyll (a) was found in samples of reservoir water and the eutrophication of this water was thus observed. A high linear relationship was found among CODT, CODF (filtered COD) and BOD5; among electrical conductivity (E.C.), Cl-, SO4(-2), Na+, K+, Ca2+ and Mg2+ and among pH, CO3H- and CO(3)2- in all the samples evaluated. Taking this fact into consideration, a simplified water quality index (WQI) was calculated. Using this parameter, the quality of the water from different sources and its variation during the period evaluated was determined to be at a maximum during the months of December to February, which coincided with the period of high precipitations and low temperature. The highest values of this parameter were found in the samples corresponding to the reservoir water while the lowest values were found in the samples of the brackish water. By determination of the WQI, the influence of the brackish water on the quality of water for irrigation and reservoir waters was confirmed.

[Graves' disease with associated thyroid nodules (nodular Graves' disease). Clinical, diagnostic and therapeutic considerations]

BACKGROUND

Sometimes Graveś disease (GD) can appear in association with thyroid nodules, which seems to increase the risk of carcinoma. In this article, we try to establish clinical characteristics, diagnostic means and appropriate treatment for Graves patients with co-existent nodules.

METHOD

A retrospective study was made of 153 consecutive patients who underwent operation for GD between 1967 and 2000. Each patient was subject to a regular protocol including physical examination, diagnostic test, total or subtotal thyroidectomy and follow-up in the long term with the purpose of making a valuation of the postsurgical morbidity, evolution and relapses. Data were processed through computing in order to get the statistical information.

RESULTS

28.1% of GD had thyroid nodules and carcinoma was diagnosed in four patients (9.3%), all of them belonging to papillary variety. Surgery consisted of 57 subtotal thyroidectomies (37.3%) and 94 total thyroidectomies. Parathyroid and recurrent morbidity was established in 4.6 and 3.9%, respectively, a year later since the operation, though it had a strong tendency to decrease from 1980. 96% of cases showed no relapse.

CONCLUSIONS

Nodular GD is very common in our setting, especially in Graveś patients with late beginning who wait for ages until they are undergone surgery. Initial treatment should be by means of braking therapy with antithyroid drugs and clinical, cytologic and ultrasonographic control. Surgery would be advised, from the outset or during the follow-up, in view of either any suspicion about cancer or presence of local growth. The procedure of choice is total thyroidectomy performed with low morbidity.

Myeloid mixed chimerism is associated with relapse in bcr-abl positive patients after unmanipulated allogeneic bone marrow transplantation for chronic myelogenous leukemia

BACKGROUND AND OBJECTIVE

Although bcr-abl polymerase chain reaction (PCR) positivity after bone marrow transplantation (BMT) for chronic myelogenous leukemia (CML) is significantly related to relapse, the predictive value of the assay is not very high and therefore most investigators consider that qualitative RT-PCR data alone are too imprecise to enable clinical decisions to be taken in individual cases. To define the clinical outcome of bcr-abl positive patients after unmanipulated BMT better, we sought the origin of hematopoiesis and traced its evolution over time.

DESIGN AND METHODS

Forty-nine patients received allogeneic BMT for CML (39 in chronic phase and 10 in accelerated phase/blast crisis). Median follow-up was 61 months (range 4-92). mRNA and DNA were used to assess bcr-abl and chimerism status respectively. Quantitative VNTR-PCR on total cells and lymphoid or myeloid population allowed us to assign and measure the origin of hematopoiesis.

RESULTS

Both bcr-abl positivity and the presence of mixed chimerism (MC) were significantly associated with relapse (p = 0.0009 and p < 0.0001 respectively). Relapse was observed in one of 39 patients with complete donor chimerism and in 6 of 9 patients with MC. These six cases showed increasing levels of host hemopoiesis and bcr-abl positivity in the CD15-positive population prior to relapse. The other three cases had decreasing or stable low-level MC which was restricted to the T-cells as well as bcr-abl negativity.

INTERPRETATION AND CONCLUSIONS

Whereas the simple detection of bcr-abl fails to identify patients who will relapse with certainty, the assessment of MC by VNTR-PCR does identify patients headed to relapse. Confirmation of myeloid involvement and increasing levels over time further elucidates the clinical outcome of bcr-abl positive patients after BMT.

Increasing mixed haematopoietic chimaerism after BMT with total depletion of CD4+ and partial depletion of CD8+ lymphocytes is associated with a higher incidence of relapse

In this study we analysed the incidence and clinical impact of the persistence of host haemopoiesis (mixed chimaerism, MC) after allogeneic BMT in 35 consecutive patients with haematologic malignancies using a total CD4+ cell-depleted graft with an adjusted dose of CD8+ cells (1x10(8)/kg). Chimaerism was assessed by PCR amplification of VNTRs in 30 evaluable patients: 19 non-CML and 11 CML cases which were also evaluated for the BCR-ABL transcript by RT-PCR. All but one had complete engraftment with a donor profile early post-BMT. At the end of the study period, 12 of 30 patients displayed MC (40%). The overall disease-free survival for MC patients was clearly unfavourable when compared to those who exhibited a donor profile (24.7% vs. 100%, P = 0.005). However, we found that only two of five patients with MC in the non-CML group relapsed, whereas a clear correlation could be made between MC and relapse in CML (seven showed MC, preceding cytogenetic or haematological relapse in six of them, which displayed a prior BCR-ABL mRNA positivity). In addition, a quantitative-PCR approach enabled us to demonstrate that increasing amounts of MC are invariably associated with subsequent relapse, whereas a low stable level of host or complete donor haemopoiesis is consistent with clinical complete remission. Although these results suggest that the clinical impact of MC may depend on the underlying disease, it is compatible with the concept that the graft-versus-leukaemia effect against CML is mainly exerted by donor CD4+ lymphocytes. Elimination of this cellular subset may be responsible for the inability of the graft to prevent a progressive increase in the tumor cell burden.

[Maze technique for the treatment of auricular fibrillation: initial experience]

INTRODUCTION AND OBJECTIVES

The MAZE procedure was developed as a surgical approach to the management of patients with atrial fibrillation refractory to medical treatment. This study seeks to identify the risk and benefits of adding the MAZE procedure in patients with atrial fibrillation undergoing surgery for underlying organic cardiac disorders.

MATERIAL AND METHODS

Since november 1993, we have performed 10 interventions with the MAZE procedure, for the treatment of refractory atrial fibrillation. The indication to perform the technique was systemic embolism in 5 patients, contraindication for the anticoagulant treatment in two cases and no response to antiarrhythmic treatment in 5 cases. Two patients had more than one indication. In all the cases another surgical procedure was performed, 5 replacements of mitral valve, a mitral repair, one tricuspid repair and tree repairs of an atrial septal defect.

RESULTS

Soon after surgery 9 patients were in sinus rhythm, and one in atrial fibrillation. Four patients needed atrial pacing during the first days. One patient required a pacemaker due to symptomatic sinus bradycardia. During the first 3 months, 4 patients had episodes of paroxysmal atrial fibrillation and flutter. One patient died suddenly one month after surgery. Seven patients have completed two years of follow-up, and are in stable sinus rhythm, in functional class I and free of antiarrhythmic drugs. All of them have echocardiographic evidence of mechanical activity in both atria. Left atrium had been reduced from 5.3 +/- 0.7 cm to 4.5 +/- 0.7 cm (p < 0.05). No patient has presented new embolic events.

CONCLUSIONS

The MAZE procedure is a good choice in selected patients with atrial fibrillation refractory to medical treatment, or a precedent of systemic embolism. However, several problems can complicate the patient's course.

[An intimal sarcoma of the pulmonary artery. An immunohistochemical study]

Pulmonary artery intimal sarcomas tend to be presented with symptoms of pulmonary thromboembolism and grow regionally, with little capacity to metastasize. They probably originate from subendothelial cells, that become myofibroblasts. Knowledge of it is important to establish a presurgery diagnosis, with the possibility of a total resection, the only useful treatment until now. We report a case of a pulmonary artery primary sarcoma, in a 73 year old woman, admitted with hemoptysis and pleuritic chest pain, who died ten days after. Autopsy revealed an intraluminal mass at the pulmonary artery trunk, without regional nor distance involvement. Microscopic study showed a pleomorphic tumor with spindle and epithelioid cells, positive for actin, desmin and vimentin. All these data support the diagnosis of primary intimal sarcoma of the pulmonary artery. We want to emphasize the myogenic differentiation of the tumor, uncommon in previously reported cases.

Quantification of bovine albumin fraction V in cellular antigens of antileptospirosical Cuban vaccine vaxSpiral

A solid phase immunoradiometric assay (IRMA) for quantification of bovine albumin fraction V (Bov.Alb.FV) in antileptospirosical Cuban vaccine vaxSpiral is described in the present work. Anti-Bov.Alb.FV IgG raised against rabbit purified by affinity chromatography was used as first antibody. Anti-rabbit IgG labeled by Chloromine-T reaction was used as a tracer and the method has demonstrated to be sensitive with high intra- and inter-assay reproducibility. Eight lots of vaccinal antigens were evaluated and in all of the cases, the bovine albumin fraction V concentration was lower than 1 microgram/mL, as the World Health Organization (WHO) establishes. This IRMA is a simple and sensitive assay and could be used as control method for all human vaccines that use Bov.Alb.FV in their production process, even cellular vaccines.

[The mechanisms of satiation]

There are many published experimental studies which attempt to explain certain aspects of satiety, but only very few treat this problem as a whole, synthesizing concepts. At present, the understanding of the mechanisms of satiety is extremely interesting for the study and application of medical or surgical anti-obesity treatments.

[Endocrine metabolic and arterial pressure changes in morbidly obese patients treated with vertical gastroplasty]

When overweight surpasses 100% of the ideal weight, morbid obesity, the obese patients is condemned to a complete inability to work, social and sexual inability, and shall suffer from an increase in its morbidity and mortality. This depends to a large degree on the additions to the obesity of insulin resistance, carbohydrates intolerance, hypertriglyceridemia, hypercholesterolemia, and arterial hypertension, all of which is enveloped in a atmosphere of neuroendocrine alterations. An efficient method of treating this syndrome is weigh loss. Medical treatments have not achieved prolonged weight losses during long periods in morbid obese patients, which is a reason for surgery to try and propose new lines of treatment for these patients. The purpose of our study is to examine the effect of weight loss in 100 patients treated with vertical gastroplasty, on the metabolic disorders (triglycerides, cholesterol, glucose) and the arterial hypertension, which are considered to be risk factors in the mortality associated with morbid obesity. Our results indicate that the weight loss modified the metabolic conditions of the patients, with there being a decrease of the levels of triglycerides, cholesterol, glucose, and arterial pressure, after 6 to 12 months after the weigh loss.

[Miliary tuberculosis. Autopsy study of 29 cases]

A retrospective anatomoclinic study of 29 cases of miliary tuberculosis, selected from 2.808 necropsies carried out at Hospital Central de Asturias between 1971 and 1994, is described. Fifty eight per cent of the patients were older than 50 years. Predisposing factors were identified in 80%: diabetes, alcoholism, chronic hepatopaty, silicosis, chronic renal failure, immunessupresive treatment and malignant neoplasms. A premorten correct clinical diagnosis were done in 8 cases (27.5%) and were suspected in 4 (13.7%). Typical miliary radiologic pattern was established in 17%. The more frequently affected organs were lungs (100%), liver (82%), spleen (75%), lymphatic nodes (55%) and bone marrow (41%). Early diagnosis and treatment is nowadays more difficult because of increasing of cryptic tuberculosis, involvement of resistant organs (pancreas), new predisposing factors (chronic renal failure), new risk groups (AIDS) and lack of demonstrative clinical and radiologic findings, so is necessary to maintain suspect of this disease always in mind.

[Acute ++indomethacin-induced hepatitis in a female patient with asymptomatic primary biliary cirrhosis]

We present an infrequent case of acute hepatitis by indomethacin, in a patient with a primary biliary cirrhosis, previously not diagnosed and asymptomatic, in who during in the follow-up, with a persistent analytical pattern of disociated cholestasis, a liver biopsy was indicated, with the final diagnosis of chronic non-suppurative destructive cholangitis.

[Perforated sigmoiditis. Experiences with 805 cases. A multicenter study]

This was a multicenter study corresponding to 40 services. For each patient, a card containing 90 questions was filled out. At the same time we sent a personal survey card with 11 criteria questions. Our cases corresponded to 805 patients, 457 males and 348 females. The highest frequency was between 50-80 years. The therapeutic methods most often used were: drainage plus Hartmann, 37.1%; drainage plus colostomy, 24.9%; resection and anastomosis without colostomy, 12.45%, and with colostomy, 5.11%; drainage plus exteriorization, 5.98%, and conservative, 4.6%. We studied the morbimortality correlation according to different anatomoclinical groups and techniques used. The results were nonsignificant for mortality and statistically significant for evisceration, eventration, diffuse peritonitis, upper gastrointestinal bleeding, anastomotic dehiscence and type of anastomosis, manual or instrumental.

[Cancer of the surgically treated stomach: 46 cases. Etiopathogenic, diagnostic and anatomopathologic aspects]

A retrospective study was made of 46 patients with operated stomach cancer (CEO) between 1971 and 1988, with respect to etiopathogenic diagnostic and pathologic aspects; it occurs most often in stomachs previously submitted to Billroth II type partial gastrectomy and there is a highly variable symptom-free interval, from 6 and 46 years in our series. The diagnosis, which unfortunately is usually late, is based mainly on gastroscopy with biopsy and/or cytology. On pathological study epithelial tumors predominate, particularly Lauren's intestinal type.

[Changes induced by simple jejuno-ileal by-pass models in the distribution of D-cells producing intestinal somatostatin. Experimental study]

Cells that produce somatostatin are widely distributed throughout the digestive tube. They are found in the stomach, small bowel, large bowel and pancreas. The authors used 54 Wistar rats, with an approximate weight of 300 gr, to evaluate the possible variations of the D cell population in isolated and functional intestinal segments, using jejuno-ileal bypass as a model. Rats were divided into three groups, a control group and two groups in which simple derivation techniques were performed following the techniques of Payne and DeWind, and Scott. Rats were sacrificed after 7, 30 and 90 days in subgroups of six animals. Macroscopic, microscopic and ultrastructural studies were carried out. Cells were specifically stained using immunocytochemical techniques (PAP). The corresponding values of the mucous areas were obtained using a computerized image analyzer (Quantimet 800) and then the number of D cells per mm2 mucosa was calculated. The results show a decrease in the number of D cells per mm2 of mucosa in the functional intestinal segments and degranulation of these cells, coinciding with the existence of large areas of rough endoplasmic reticulum (sign of cellular hyperactivity).