Dermoscopic Evaluation of Actinic Changes in the Lips of Indigenous Children Living at High Altitude in Ecuador: A Descriptive Study

BACKGROUND High altitude increases sunlight exposure, resulting in actinic keratosis, which predisposes people to skin cancer. The dermoscopy procedure evaluates keratotic and pigmented skin changes. This study aimed to describe the clinical and dermoscopic actinic changes in the lips of 25 indigenous children living at high altitude in Ecuador. MATERIAL AND METHODS An observational study was conducted in a public school in the Andes region of Ecuador (August-November 2019). Twenty-five children, males and females, age 5-15 years were assessed by complete physical examination, digital dermoscopic photographs, and punch biopsies. Descriptive statistics and Fisher's exact test were used to summarize and analyze the data. RESULTS We included 17 (68%) boys and 8 (32%) girls with a mean age of 9.8±2.0 years. Clinical lips findings reported desquamation [52% Upper Lip (UL); 40% Lower Lip (LL)], fissuring (8% UL; 8% LL), scabs (8% UL; 8% LL), and discoloration (40% UL; 20% LL). Dermoscopic features included a white-yellow lip color (24% UL; p=0.02). The main morphologic pattern of blood vessels was monomorphic (88% UL; p<0.001), polymorphous (60% LL; p<0.001), dotted pattern (64% UL; 28% LL; p=0.02), and linear-irregular (32% UL; 72% LL; p=0.01). Girls had radiating white structures on UL (p=0.025), while boys presented white structureless areas (UL 63.6%; LL 77.8%; p=0.032). No differences in dermoscopic findings were observed according to Fitzpatrick scale score (FSS). Punch biopsies showed no indications of actinic cheilitis. CONCLUSIONS Dermoscopic features in indigenous children living in high altitudes were related to actinic damage, but histopathological findings were negative.

Polymorphisms in MDM2 and TP53 Genes and Risk of Developing Therapy-Related Myeloid Neoplasms

One of the most severe complications after successful cancer therapy is the development of therapy-related myeloid neoplasms (t-MN). Constitutional genetic variation is likely to impact on t-MN risk. We aimed to evaluate if polymorphisms in the p53 pathway can be useful for predicting t-MN susceptibility. First, an association study revealed that the Pro variant of the TP53 Arg72Pro polymorphism and the G allele of the MDM2 SNP309 were associated with t-MN risk. The Arg variant of TP53 is more efficient at inducing apoptosis, whereas the Pro variant is a more potent inductor of cell cycle arrest and DNA repair. As regards MDM2 SNP309, the G allele is associated with attenuation of the p53 apoptotic response. Second, to evaluate the biological effect of the TP53 polymorphism, we established Jurkat isogenic cell lines expressing p53Arg or p53Pro. Jurkat p53Arg cells presented higher DNA damage and higher apoptotic potential than p53Pro cells, after treatment with chemotherapy agents. Only p53Pro cells presented t(15;17) translocation and del(5q). We suggest that failure to repair DNA lesions in p53Arg cells would lead them to apoptosis, whereas some p53Pro cells, prone to cell cycle arrest and DNA repair, could undergo misrepair, generating chromosomal abnormalities typical of t-MN.

Improved Automatic Detection of New T2 Lesions in Multiple Sclerosis Using Deformation Fields

BACKGROUND AND PURPOSE

Detection of disease activity, defined as new/enlarging T2 lesions on brain MR imaging, has been proposed as a biomarker in MS. However, detection of new/enlarging T2 lesions can be hindered by several factors that can be overcome with image subtraction. The purpose of this study was to improve automated detection of new T2 lesions and reduce user interaction to eliminate inter- and intraobserver variability.

MATERIALS AND METHODS

Multiparametric brain MR imaging was performed at 2 time points in 36 patients with new T2 lesions. Images were registered by using an affine transformation and the Demons algorithm to obtain a deformation field. After affine registration, images were subtracted and a threshold was applied to obtain a lesion mask, which was then refined by using the deformation field, intensity, and local information. This pipeline was compared with only applying a threshold, and with a state-of-the-art approach relying only on image intensities. To assess improvements, we compared the results of the different pipelines with the expert visual detection.

RESULTS

The multichannel pipeline based on the deformation field obtained a detection Dice similarity coefficient close to 0.70, with a false-positive detection of 17.8% and a true-positive detection of 70.9%. A statistically significant correlation (r = 0.81, P value = 2.2688e-09) was found between visual detection and automated detection by using our approach.

CONCLUSIONS

The deformation field-based approach proposed in this study for detecting new/enlarging T2 lesions resulted in significantly fewer false-positives while maintaining most true-positives and showed a good correlation with visual detection annotations. This approach could reduce user interaction and inter- and intraobserver variability.

Evaluating the effects of white matter multiple sclerosis lesions on the volume estimation of 6 brain tissue segmentation methods

BACKGROUND AND PURPOSE

The accuracy of automatic tissue segmentation methods can be affected by the presence of hypointense white matter lesions during the tissue segmentation process. Our aim was to evaluate the impact of MS white matter lesions on the brain tissue measurements of 6 well-known segmentation techniques. These include straightforward techniques such as Artificial Neural Network and fuzzy C-means as well as more advanced techniques such as the Fuzzy And Noise Tolerant Adaptive Segmentation Method, fMRI of the Brain Automated Segmentation Tool, SPM5, and SPM8.

MATERIALS AND METHODS

Thirty T1-weighted images from patients with MS from 3 different scanners were segmented twice, first including white matter lesions and then masking the lesions before segmentation and relabeling as WM afterward. The differences in total tissue volume and tissue volume outside the lesion regions were computed between the images by using the 2 methodologies.

RESULTS

Total gray matter volume was overestimated by all methods when lesion volume increased. The tissue volume outside the lesion regions was also affected by white matter lesions with differences up to 20 cm(3) on images with a high lesion load (≈50 cm(3)). SPM8 and Fuzzy And Noise Tolerant Adaptive Segmentation Method were the methods less influenced by white matter lesions, whereas the effect of white matter lesions was more prominent on fuzzy C-means and the fMRI of the Brain Automated Segmentation Tool.

CONCLUSIONS

Although lesions were removed after segmentation to avoid their impact on tissue segmentation, the methods still overestimated GM tissue in most cases. This finding is especially relevant because on images with high lesion load, this bias will most likely distort actual tissue atrophy measurements.

A179L, a new viral Bcl2 homolog targeting Beclin 1 autophagy related protein

Autophagy is a relevant cellular defense mechanism that directly eliminates intracellular pathogens and has a crucial role for innate and adaptive immune responses. Some viruses have developed tools to counteract this cellular response. A179L, the viral Bcl2 homolog of African swine fever virus, interacts with proapoptotic Bcl2 family proteins to inhibit apoptosis. Here we report that this gene manipulates autophagy by interacting with Beclin 1 through its BH3 homology domain. At subcellular level, A179L colocalized with Beclin 1 at mitochondria and the endoplasmic reticulum. Virus infection inhibited autophagosome formation in cells; however, when autophagy was induced prior to or at the time of infection the number of infected cells was severely decreased.

17 EFFECT OF A PROGESTERONE INTRAVAGINAL DEVICE ON PREGNANCY RATE IN CROSSBREED DAIRY COWS UNDER TROPICAL CONDITIONS

The objectives of these experiments were to evaluate the effect of intravaginal progesterone device on crossbreed Holstein × Carora on pregnancy rate under 2 conditions: cycling and noncycling cows. The first experiment was conducted on 135 noncycling cows (45 ± 3 days postpartum) divided in 2 groups. The first group was treated with a timed AI procedure using a progesterone device for 9 days with an eCG injection on Day 6 and estradiol benzoate after progesterone device removal followed by AI 48 h later. The second group was not treated and they were checked until they came in heat and were inseminated. The second experiment was performed on 123 cycling cows and they were divided in 2 groups. The first group was submitted to a time AI treatment similar to that in experiment 1, and the second group was not treated and they were inseminated upon heat detection. Pregnancy rate on Day 120 postpartum was recorded and pregnancy rate was compared among the different proportion of Holstein (H) × Carora (C) crossbreed cows. For the first experiment, differences (P < 0.05) were observed between ¾ Carora ¼ Holstein (46.15%) compared with the other crossbreed groups (10% 7/8 H 1/8 C, 21.42% 5/8 H 3/8 C, 29.16% ½ H ½ C). In the second experiment, differences (P < 0.05) were observed between ¾ Carora ¼ Holstein (57.14%) compared with the other crossbreed groups (6.66% 7/8 H 1/8 C, 30.76% 5/8 H 3/8 C, 33.33% ½ H ½ C). For the variable pregnancy rate at 120 days postpartum, significant differences (P < 0.05) were observed in cycling cows (39.2%) treated with the progesterone device v. nontreated cows (21%). In noncycling cows, there were no differences between treated and nontreated cows. In conclusion, the use of progesterone device did not improve pregnancy rate in the noncycling cows, which could be related to the negative energy balance that cows undergo during the first part of gestation. However, the use of the progesterone device in cycling cows did improve the pregnancy rate compared with nontreated, cycling cows. We demonstrated that this dairy farm has a serious problem in detecting estrous, which was help by use of the progesterone device and timed AI. Also, the Carora blood included in dairy animals help them to perform better under tropical conditions and they can became pregnant much faster than animals with a high level of Holstein blood.

[Measurement of lens density with a Scheimpflug camera in diabetic patients]

OBJECTIVE

To assess if diabetes, in patients without cataracts or diabetic retinopathy, alters the densitometric values of the lens and to what degree this occurs.

METHODS

A total of 93 patients, divided into two groups, were studied: the diabetic patients had a visual acuity equal to or greater than 0.8 and normal eye funduscopy, and the control group consisted of healthy patients of a similar age. Measurements in all patients were made with the Scheimpflug camera and the lens density of the anterior capsule, anterior cortex and nucleus was defined. The values obtained in the two groups were compared by analysis of variance (ANOVA).

RESULTS

All densitometric values were greater in the diabetic patients than in the normal controls. The greatest difference was seen in the values of the anterior capsule, followed by the nucleus and cortex. The differences approached statistical significance (P=0.07) only in the case of the anterior capsule.

CONCLUSIONS

Diabetes increases densitometric values of the anterior capsule and to a lesser degree of the anterior cortex. However, further studies are necessary to verify if this alteration is of significance.

Utility of alkylaminoquinolinyl methanols as new antimalarial drugs

Mefloquine has been one of the more valuable antimalarial drugs but has never reached its full clinical potential due to concerns about its neurologic side effects, its greater expense than that of other antimalarials, and the emergence of resistance. The commercial development of mefloquine superseded that of another quinolinyl methanol, WR030090, which was used as an experimental antimalarial drug by the U.S. Army in the 1970s. We evaluated a series of related 2-phenyl-substituted alkylaminoquinolinyl methanols (AAQMs) for their potential as mefloquine replacement drugs based on a series of appropriate in vitro and in vivo efficacy and toxicology screens and the theoretical cost of goods. Generally, the AAQMs were less neurotoxic and exhibited greater antimalarial potency, and they are potentially cheaper than mefloquine, but they showed poorer metabolic stability and pharmacokinetics and the potential for phototoxicity. These differences in physiochemical and biological properties are attributable to the "opening" of the piperidine ring of the 4-position side chain. Modification of the most promising compound, WR069878, by substitution of an appropriate N functionality at the 4 position, optimization of quinoline ring substituents at the 6 and 7 positions, and deconjugation of quinoline and phenyl ring systems is anticipated to yield a valuable new antimalarial drug.

Mefloquine induces dose-related neurological effects in a rat model

Mefloquine is one of the drugs approved by the FDA for malaria chemoprophylaxis. Mefloquine is also approved for the treatment of malaria and is widely used for this purpose in combination with artesunate. However, the clinical utility of the compound has been compromised by reports of adverse neurological effects in some patients. In the present study, the potential neurological effects of mefloquine were investigated with six 7-week-old female rats given a single oral dose of the compound. Potential mefloquine-induced neurological effects were monitored using a standard functional observational battery, automated open field tests, automated spontaneous activity monitoring, a beam traverse task, and histopathology. Plasma mefloquine concentrations were determined 72 h after dosing by using liquid chromatography-mass spectrometry. Mefloquine induced dose-related changes in endpoints associated with spontaneous activity and impairment of motor function and caused degeneration of specific brain stem nuclei (nucleus gracilis). Increased spontaneous motor activity was observed only during the rats' normal sleeping phase, suggesting a correlate to mefloquine-induced sleep disorders. The threshold dose for many of these effects was 187 mg/kg of body weight. This dose yielded plasma mefloquine concentrations after 72 h that are similar to those observed in humans after the treatment dose. Collectively, these data suggest that there may be a biological basis for some of the clinical neurological effects associated with mefloquine.

10 PREGNANCY RATE IN DAIRY COWS CROSSBREED HOLSTEIN × CARORA, DURING TWO SEASONS OF THE YEAR UNDER TWO ESTRUS SYNCHRONIZATION PROGRAMS AND TROPICAL CONDITIONS IN VENEZUELA

Two experiments were performed in a commercial farm located in Lara, Venezuela. The objective was to evaluate the pregnancy rate in postpartum dairy cows with different genetic composition of Holstein (H) and Carora (C) breeds (1/2, 3/4, and 7/8) during two seasons of the year using estrus synchronization programs. The first experiment evaluated the pregnancy rate of three different breeding groups in two seasons of the year. All cows (n = 305) were treated with the Heatsynch program (Select Sires, Inc., Miami, FL, USA): Cycling cows between Days 36 and 42 after parturition were injected with two doses of PGF2� 14 days apart. Seven days later, after the last injection of PGF2�, the cows were injected with a GnRH analog (Buserelin). Seven days later cows were injected with PGF2� and after 24 h cows were injected with 1 mg of estradiol cypionate (ECP). Cows were inseminated when heat was detected, and after 48 h all cows that did not present heat were inseminated. During the period from January to May, 152 cows were treated. The average temperature (T) was 25.22�C and relative humidity (RH) was 70.16%. During the period from June to October, 153 cows were treated. The T was 25.26�C and RH was 72.58%. The pregnancy rates for the groups were 1/2H � C, n = 89, 28.08%; 3/4H � C, n = 143, 25.17%; and 7/8H � C, n = 73, 26.02%; they were not significantly different (P < 0.14). However, the pregnancy rate was higher in January-May (30.92%) than in June-October (22.87%; P < 0.05). The second experiment evaluated pregnancy rates in the different breeding groups (H � C), using two protocols, Heatsynch vs. Ovsynch (Select Sires, Inc.). The Ovsynch program is similar to the Heatsynch program; however, the last injection of ECP in the Heatsynch program is changed to the GnRH analog after 48 h from the last injection of PGF2�. Cows were inseminated 24 h after the GnRH injection. Pregnancy rate was lower for cows treated with the Heatsynch program (21.15%) than for those treated with the Ovsynch program (45.28%; P < 0.01). Furthermore, cows in the 1/2 and 3/4 breeding groups had higher pregnancy rates than those in the 7/8 breeding group (1/2 = 42.05%, 3/4 = 38.33%, and 7/8 = 16.72%; P < 0.01). Data were analyzed using logistic regression analysis. In conclusion, the introduction of the Carora breed in the dairy herd increased the adaptability of the Holstein cows to tropical conditions by increasing their reproductive efficiency. Furthermore, pregnancy rates were increased using synchronization programs that did not require heat detection. This demonstrated the possibility of increasing reproductive performance in the tropics by incorporating estrus synchronization systems that do not require heat detection. These studies also demonstrated that the incorporation of dairy breeds adapted to tropical conditions, such as the Carora breed, aids in improving reproductive performance under high RH conditions.

Anaerobiospirillum succiniciproducens phosphoenolpyruvate carboxykinase. Mutagenesis at metal site 1

Anaerobiospirillum succiniciproducens phosphoenolpyruvate (PEP) carboxykinase catalyses the reversible metal-dependent formation of oxaloacetate (OAA) and ATP from PEP, ADP and CO(2). Mutations of PEP carboxykinase have been constructed where the residues His(225) and Asp(263), two residues of the enzyme's putative Mn(2+) binding site, were altered. Kinetic studies of the His225Glu, and Asp263Glu PEP carboxykinases show 600- and 16,800-fold reductions in V(max) relative to the wild-type enzyme, respectively, with minor alterations in K(m) for Mn(2+). Molecular modeling of wild-type and mutant enzymes suggests that the lower catalytic efficiency of the Asp263Glu enzyme could be explained by a movement of the lateral chain of Lys(248), a critical catalytic residue, away from the reaction center. The effect on catalysis of introducing a negatively charged oxygen atom in place of N(epsilon-2) at position 225 is discussed in terms of altered binding energy of the intermediate enolpyruvate.

[Comparison of the sensitivity and specificity of the electrocardiography criteria for left ventricular hypertrophy according to the methods of Romhilt-Estes, Sokolow-Lyon, Cornell and Rodríguez Padial]

INTRODUCTION AND OBJECTIVES

Because left ventricular mass is associated with an increase in the risk of morbidity and mortality of cardiovascular diseases in the general population having the electrocardiogram as an accessible and inexpensive method for the diagnosis of left ventricular hypertrophy, we decided to calculate the sensitivity and specificity of 5 electrocardiographic criteria for the diagnosis of left ventricular hypertrophy and to compare the results of the original authors to ours.

PATIENTS AND METHODS

135 patients were evaluated; 46 patients were excluded by the following criteria: chronic obstructive pulmonary disease, complete left or right bundle branch block, cardiovascular ischemic disease or Wolf-Parkinson-White Syndrome. 89 patients remained and had an electrocardiogram performed applying the following criteria: Romhilt-Estes Point-Score system. Sokolow-Lyon (SV1 + RV5 or V6 > 3.5 mV) and (RaVL > 1.1 mV), Cornell and Rodríguez Padial. Left ventricular hypertrophy was defined by the Penn Convention Criteria.

RESULTS

In our study we obtained the following results: a) Romhilt-Estes had a sensitivity of 12% and a specificity of 87%; b) Sokolow-Lyon (SV1 + RV5 or V6) had a sensitivity of 22% and a specificity of 79%; c) Sokolow-Lyon (RaVL) has a sensitivity of 18% and a specificity of 92%; d) Cornel had a sensitivity of 31% and a specificity of 87%, and e) Rodríguez Padial had a sensitivity of 82% and a specificity of 8%. There are similarities between our results and the authors's original ones. However, there are significant statistical differences between them (p < or = 0.01).

CONCLUSION

Our conclusion is that these criteria have a low diagnostic value in the isolated interpretation of patients with left ventricular hypertrophy, and we need to integrate them with the whole medical history and physical examination.

[Cardiovascular risk factors in 15 patients in chronic hemodialysis in Temuco city. Descriptive comparison with the general Chilean population]

BACKGROUND

Patients in chronic hemodialysis have a high mortality due to cardiovascular diseases.

AIM

To study cardiovascular risk factors and nutritional status in a group of patients in maintenance hemodialysis.

PATIENTS AND METHODS

Body mass index, blood pressure, serum levels of totals cholesterol, HDL cholesterol, triglycerides and albumin were measured in 15 patients (8 male) in maintenance hemodialysis. Data were compared with available figures for the normal Chilean population.

RESULTS

Age ranged from 33 to 60 years old in female patients and from 22 to 63 years old in males. Thirteen subjects (87%) had high blood pressure, all had HDL cholesterol levels below 35 mg/dl, four (27%) had a total cholesterol over 200 mg/dl, three had triglyceride levels over 200 m/dl, two (13%) smoked and none were diabetic. Mean body mass index was normal, albumin levels were 4.16 and 4.02 g/dl and serum creatinine was 11.64 and 9.68 mg/dl in males and females respectively. The estimated prevalence of high blood pressure, hypercholesterolemia and smoking in the general Chilean population range from 9 to 22%, from 50 to 52% and from 45 to 51% respectively.

CONCLUSIONS

This group of patients has a high frequency of high blood pressure and low HDL cholesterol levels.

[Cholinergic action of Bay K-8644 on the rat heart sinus node automaticity]

The actions of different concentrations of a dihydropyridine agonist (Bay K-8644) on rat heart sinus node automaticity and their interactions with atropine, were studied. The experiments were performed using a portion of the right atrium that contained the sinus node, perfused with Tyrode's solution at 37 degrees C and registering the action potentials with intracellular microelectrodes (Ag-KCL). The series of Bay K with or without atropine were perfused during 10 min. Atropine, 1 x 10(-5) M, did not change sinus frequency after 30 min of perfusion (237 +/- 6 to 229 +/- 7 action potentials/min; n = 24). Bay K, 2.8 x 10(-8) M (10 ug/L) did not change sinus frequency (240 +/- 9 to 246 +/- 12; n = 8, but in the presence of atropine, caused an increment (225 +/- 7 to 256 +/- 12 p < 0.05). Bay K, 7 x 10(-8) M (25 ug/L) and 1.4 x 10(-7) M (50 ug/L, caused an increase in sinus frequency (237 +/- 5 to 279 +/- 15; n = 9 p < 0.05 and 254 +/- 6 to 291 +/- 6; n = 6 p < 0.05 respectively) that occurred sooner in the presence of atropine. It is concluded that Bay-K has a cholinergic effect that interferes with its positive chronotropic action, specially at low concentrations.

Isolation and chemical composition of the leucocytes from donkey, horse, mule and pig

1. Leucocytes from the blood of adult and young donkeys (Equus asinus L.), adult horses (Equus caballus L.), adult mules (Equus asinus x Equus caballus) and adult pigs (Sus scrofa L.) were obtained in a high degree of purity (99.9%) using Na2-EDTA-dextrans mixtures. 2. Sialic acids were released, purified, identified and determined from both non-delipided and delipided leucocytes. 3. N-glycolylneuraminic was the predominant sialic acid. N-acetylneuraminic acid and N,O-diacetyl-neuraminic acid were also found in all materials. Except in pig, other unidentified sialic acid(s) were also detected. 4. The concentration of total sialic acids (microgram/mg protein) is different according to the species, and in donkey species according to the age. 5. Galactose, glucose, mannose, fucose and (in a less amount) ribose were determined. Their total content is about 2-3-fold that of hexosamines. 6. There is a higher cholesterol content in adult donkey leucocytes than in those of young ones. 7. Total lipids, cholesterol or phospholipid contents are similar among the leucocytes of the above-mentioned species. 8. The similarities are marked in the electrophoresis patterns of proteins and glycoproteins for the donkey, mule and horse samples. 9. The molecular weights for leucocytes proteins were estimated as ranging between 230,000 and 20,000; and for the main protein bands, between 120,000 and 22,000.

[Purification of peroxidases and separation of isoperoxidases from various plant species (author's transl)]

The partial purification of peroxidase (EC.1.11.1.7) and separation of isoperoxidases by disc electrophoresis from Cucurbita Pepo L., Phaseolus vulgaris L., Cicer arietinum L. and Hordeum, Secale and Triticum sp., have been studied. Peroxidase from fruit of pumpkin and from 6-day-old coleoptiles of French bean and chick pea has been partially purified, 128-, 174-, and 140-fold, respectively. The apparent Km at the optimum pH were: pumpkin (epicarp.), 2.7 X 10(-4) M; barley, common rye and wheat (primary leaves, in all cases), 1.4 X 10(-5), 1.2 X 10(-5) and 3.1 X 10(-5) M, respectively. Isoperoxidases have been separated by disc electrophoresis on 7% polyacrylamide gel and stained with p-phenylenediamine. Differences in patterns of anodic and cathodic isozymes were observed: 3 isozymes from fruits of pumpkin, 4 from French bean, 4 from chick pea, 11 from leaves of barley, 10 from leaves of common rye and 9 from leaves of wheat.