Genome-Wide Identification and Gene Expression Analysis of Sweet Cherry Aquaporins (Prunus avium L.) under Abiotic Stresses

Aquaporins (AQPs) are integral transmembrane proteins well known as channels involved in the mobilization of water, small uncharged molecules and gases. In this work, the main objective was to carry out a comprehensive study of AQP encoding genes in Prunus avium (cv. Mazzard F12/1) on a genome-wide scale and describe their transcriptional behaviors in organs and in response to different abiotic stresses. A total of 28 non-redundant AQP genes were identified in Prunus spp. Genomes, which were phylogenetically grouped into five subfamilies (seven PIPs, eight NIPs, eight TIPs, three SIPs and two XIPs). Bioinformatic analyses revealed a high synteny and remarkable conservation of structural features among orthologs of different Prunus genomes. Several cis-acting regulatory elements (CREs) related to stress regulation were detected (ARE, WRE3, WUN, STRE, LTR, MBS, DRE, AT-rich and TC-rich). The above could be accounting for the expression variations associated with plant organs and, especially, each abiotic stress analyzed. Gene expressions of different PruavAQPs were shown to be preferentially associated with different stresses. PruavXIP2;1 and PruavXIP1;1 were up-regulated in roots at 6 h and 72 h of hypoxia, and in PruavXIP2;1 a slight induction of expression was also detected in leaves. Drought treatment strongly down-regulated PruavTIP4;1 but only in roots. Salt stress exhibited little or no variation in roots, except for PruavNIP4;1 and PruavNIP7;1, which showed remarkable gene repression and induction, respectively. Interestingly, PruavNIP4;1, the AQP most expressed in cherry roots subjected to cold temperatures, also showed this pattern in roots under high salinity. Similarly, PruavNIP4;2 consistently was up-regulated at 72 h of heat and drought treatments. From our evidence is possible to propose candidate genes for the development of molecular markers for selection processes in breeding programs for rootstocks and/or varieties of cherry.

The role of bone anabolic drugs in the management of periodontitis: a scoping review

The aim of this scoping review was to summarise current knowledge about the effects of bone anabolic drugs on periodontitis, in order to identify new therapeutic strategies for preventing disease progression and reducing tooth loss. A technical expert panel (TEP) was established of 11 medical specialists, including periodontists and bone specialists that followed the PRISMA-ScR model to perform the scoping review and considered for eligibility both pre-clinical and clinical studies published in the English language up to September 2020. 716 items were initially found. After duplicate removal and screening of articles for eligibility criteria, 25 articles published between 2001 and 2019 were selected. Only studies concerning teriparatide, strontium ranelate, sclerostin antibodies and DKK1 antibodies met the eligibility criteria. In particular, only for teriparatide were there both clinical studies and experimental studies available, while for other bone anabolic drugs only animal studies were found. Available evidence about the use of bone anabolic drugs in periodontology demonstrates beneficial effects of these agents on biological pathways and histological parameters involved in periodontal tissue regeneration that suggest relevant clinical implications for the management of periodontitis.

Plasticity of the Root System Architecture and Leaf Gas Exchange Parameters Are Important for Maintaining Bottle Gourd Responses under Water Deficit

The evaluation of root system architecture (RSA) development and the physiological responses of crop plants grown under water-limited conditions are of great importance. The purpose of this study was to examine the short-term variation of the morphological and physiological plasticity of Lagenaria siceraria genotypes under water deficit, evaluating the changes in the relationship between the root system architecture and leaf physiological responses. Bottle gourd genotypes were grown in rhizoboxes under well-watered and water deficit conditions. Significant genotype-water regime interactions were observed for several RSA traits and physiological parameters. Biplot analyses confirmed that the drought-tolerant genotypes (BG-48 and GC) showed a high net CO₂ assimilation rate, stomatal conductance, transpiration rates with a smaller length, and a reduced root length density of second-order lateral roots, whereas the genotypes BG-67 and Osorno were identified as drought-sensitive and showed greater values for average root length and the density of second-order lateral roots. Consequently, a reduced length and density of lateral roots in bottle gourd should constitute a response to water deficit. The root traits studied here can be used to evaluate bottle gourd performance under novel water management strategies and as criteria for breeding selection.

New insights on metal allergy in total joint arthroplasty

Metal allergy is an uncommon and not completely understood cause of failure in total joint arthroplasty (TJA). However, either immunopathology neither histologic studies clarified the mechanisms through which the metal ions could lead to the complications related to them. The lack of evidence around this topic also reflects the difficulties to diagnose the MRP in TJA. In fact, the diagnosis is generally based on the exclusion of other causes. Currently, skin-patch testing and lymphocyte transformation test (LTT) are being commonly used to investigate about metal hypersensitivity and a delayed type-IV hypersensitivity is the immuno-histologic response to metals involved in TJA loosening. A review of the recent publications about this topic has been made focusing on immunology, histopathology, and clinics to better understand a still debated topic in orthopedic practice.

Two-stage reimplantation in periprosthetic knee infection

OBJECTIVE

The increasing number of total knee arthroplasties performed yearly worldwide has resulted in a concomitant rise in bacterial infections. Two-stage reimplantation has been reported as the most successful method of treating periprosthetic knee infections. The purpose of this study was to describe all the phases of the two-stage reimplantation and to review the literature regarding the topic.

MATERIALS AND METHODS

Most significant and recent papers about the management of periprosthetic knee infection through a two-stage reimplantation protocol were carefully analysed and reviewed. Our personal experience, previously published, with two-stage-reimplantation protocol was also briefly reported.

RESULTS

Two-stage reimplantation has been reported as the most successful method of treating periprosthetic knee infections. The strategy of using an antibiotic-loaded cement spacer and intravenous antibiotics with delayed exchange arthroplasty is actually considered the state-of-the-art, with a reported success rate of 88-96%. The two-stage protocol has been reported as a viable option also for patients with a periprosthetic knee infection by multidrug-resistant organisms. On the other hand, open debridement with polyethylene exchange and single-stage reimplantation have been reported effective only in selective case series involving acute infections by low-virulence organisms.

CONCLUSIONS

The strategy that involves the use of cement spacer, intravenous antibiotic therapy, and successive revision total knee implantation is nowadays considered the gold standard for the management of the periprosthetic knee infection. This treatment is actually considered the first choice not only for chronic but also for acute infections, especially in the presence of resistant bacteria.

Short-Term Weekly Neoadjuvant Chemotherapy in the Treatment of Locally Advanced Cervical Cancer

Twenty patients with locally advanced cervical cancer (FIGO stage Ib-IIa “bulky”/VIIb) were treated with three courses of weekly PVB (day 1: cisplatin, 50 mg/m2; vincristin, 1 mg/m2; bleomycin, 30 IU over 24-hr) in a neoadjuvant setting. Toxicity was generally mild (no grade 3-4 toxicity was observed), and the treatment was well tolerated without reduction of programmed dose intensity. Fourteen patients (70%) experienced a clinical response and underwent surgery within 20 days after the third course of chemotherapy. Six patients (30%) with stable disease were treated with salvage radiotherapy. Two of the 14 responders experienced a pathologic complete response (14.2%); microscopic disease was detected in one patient with clinical complete response. Pelvic node metastases were found in 4/14 patients (28.5%) and microscopic parametrium involvement in 3/14 (21.4%). All 14 patients had free margins of resection. A short-term weekly platinum-based chemotherapy is highly effective, has little toxicity, and allows a prompt salvage therapy for nonresponding patients.

Waterlogging tolerance, tissue nitrogen and oxygen transport in the forage legume Melilotus siculus: a comparison of nodulated and nitrate-fed plants

Background and Aims

Soil waterlogging adversely impacts most plants. Melilotus siculus is a waterlogging-tolerant annual forage legume, but data were lacking for the effects of root-zone hypoxia on nodulated plants reliant on N2 fixation. The aim was to compare the waterlogging tolerance and physiology of M. siculus reliant on N2 fixation or with access to NO3-.

Methods

A factorial experiment imposed treatments of water level (drained or waterlogged), rhizobia (nil or inoculated) and mineral N supply (nil or 11 mm NO3-) for 21 d on plants in pots of vermiculite in a glasshouse. Nodulation, shoot and root growth and tissue N were determined. Porosity (gas volume per unit tissue volume) and respiration rates of root tissues and nodules, and O2 microelectrode profiling across nodules, were measured in a second experiment.

Key Results

Plants inoculated with the appropriate rhizobia, Ensifer (syn. Sinorhizobium) medicae, formed nodules. Nodulated plants grew as well as plants fed NO3-, both in drained and waterlogged conditions. The growth and total N content of nodulated plants (without any NO3- supplied) indicated N2 fixation. Respiration rates (mass basis) were highest in nodules and root tips and lowest in basal root tissues. Secondary aerenchyma (phellem) formed along basal root parts and a thin layer of this porous tissue also covered nodules, which together enhanced gas-phase diffusion of O2 to the nodules; O2 was below detection within the infected zone of the nodule interior.

Conclusions

Melilotus siculus reliant on N2 fixation grew well both in drained and waterlogged conditions, and had similar tissue N concentrations. In waterlogged conditions the relatively high respiration rates of nodules must rely on O2 movement via the aerenchymatous phellem in hypocotyl, roots and the outer tissue layers of nodules.

Cloning and spatiotemporal expression of RIC-8 in Xenopus embryogenesis

RIC-8 is a highly conserved protein that promotes G protein signaling as it acts as a Guanine nucleotide Exchanging Factor (GEF) over a subset of Gα subunits. In invertebrates, RIC-8 plays crucial roles in synaptic transmission as well as in asymmetric cell division. As a first step to address further studies on RIC-8 function in vertebrates, here we have cloned a ric-8 gene from Xenopus tropicalis (xtric-8) and determined its spatiotemporal expression pattern throughout embryogenesis. The xtric-8 transcript is expressed maternally and zygotically and, as development proceeds, it shows a dynamic expression pattern. At early developmental stages, xtric-8 is expressed in the animal hemisphere, whereas its expression is later restricted to neural tissues, such as the neural tube and the brain, as well as in the eye and neural crest-derived structures, including those of the craniofacial region. Together, our findings suggest that RIC-8 functions are related to the development of the nervous system.

Effects of saliva substitutes on oral status in patients with Type 2 diabetes

AIMS

To assess oral status in a sample of Type 2 diabetic patients before and after therapy with saliva substitutes and oral status in a control group of diabetic patients who were not given saliva substitutes.

METHODS

Salivary flow rate was determined in 134 patients (mean age 47.9 ± 2.9 years) with Type 2 diabetes. Mean salivary rate was significantly low compared with a healthy control group. The sample of 134 patients was randomly divided into two groups of 67 people each. One group was given immunologically active salivary substitutes for 6 months, the other group was given nothing. Each patient of the two groups underwent a dental and periodontal examination at the beginning of the study and 6 months later.

RESULTS

As regards carious teeth and teeth loss, there was no statistical difference between the first group after 6 months of treatment with salivary substitutes and the control group (P>0.01). Salivary substitutes did not significantly reduce the periodontal disease (P>0.01). In the group treated with salivary substitutes, after 6 months of therapy, the average dental plaque index decreased from 2.3 ± 0.73 to 1.6 ± 0.56, patients with gingivitis decreased from 66 to 43% and patients with positive yeast counts decreased from 60 to 37%. These differences were statistically significant (P<0.01).

CONCLUSIONS

In Type 2 diabetes, in the case of hyposalivation, a therapy with immunologically active saliva substitutes can be of help in reducing the amount of plaque, gingivitis and positive yeast counts.

Primary angiitis of the central nervous system: report of five biopsy-confirmed cases from Colombia

INTRODUCTION

Primary (isolated) angiitis of the central nervous system (PACNS) is a rare cause of cerebrovascular disease (CVD), and few leptomeningeal and brain biopsy (LBB)-confirmed cases have been reported from South America.

METHODS

We retrospectively reviewed charts of patients with diagnosis of cerebral angiitis admitted between March 1991 and July 2001 to a single university hospital in Medellin, Colombia. Patients with definitive diagnosis of PACNS by Alrawi et al.'s LBB criteria were selected. We excluded other causes of cerebral angiitis as well as cases without LBB confirmation.

RESULTS

We report five patients, four men and one woman, with a mean age at onset of 24.4 years, and an average disease progression of 12.4 days. Four presented with headache and motor weakness, three had seizures, and two had alterations of consciousness. Cerebral MRI was abnormal in all five cases; brain CT in four, and cerebral angiography in two. The cerebrospinal fluid (CSF) was abnormal in two patients. Leptomeningeal and brain biopsies revealed mononuclear infiltration in the wall of small blood vessels in all. Three had concurrent meningeal and cerebral involvement, two had necrotizing angiitis, and one had vascular and encephalitic lesions. All received only steroid treatment; the 1-year follow-up revealed good prognosis without relapses.

CONCLUSION

We report five biopsy-proven cases of PACNS from Colombia associated with neurological and neuroimaging abnormalities; these patients presented a mild inflammatory disease that was correlated with few CSF abnormalities and good response to single steroid treatment without relapses. Leptomeningeal and brain biopsy is mandatory for a definitive diagnosis.

Cervical sarcoma botryoides treated with conservative surgery and adjuvant chemotherapy: a case report

A case of cervical sarcoma botryoides treated with conservative surgery and adjuvant monochemotherapy is presented.

Insecticide susceptibility in Anopheles pseudopunctipennis from Colombia: comparison between bioassays and biochemical assays

Anopheles pseudopunctipennis, one of the primary vectors of malaria in the southwest of Colombia, was evaluated for susceptibility to the 3 major insecticide groups (organophosphates, pyrethroids, and carbamates) by bioassay and biochemical assay. Larval populations, which were collected principally from irrigation channels in agricultural areas, where the intensity of insecticide use varied, were utilized to establish susceptibility for the 1st time in this species. The baselines for each population showed a range of biological susceptibility to the insecticides evaluated, but overall no resistance was detected according to standards established by the World Health Organization. The high sensitivity of biochemical microassays enabled the detection of a small proportion of mosquitoes with higher levels of nonspecific esterases and mixed-function oxidases from 2 areas where agricultural application of organophosphate and pyrethroid insecticides had been heavy. These differences were not sufficient to affect susceptibility as measured by bioassay. No evidence of insensitive acetylcholinesterase was observed. Absence of resistance in areas that have experienced heavy insecticide application could be explained by genetic drift, by gene flow from areas without insecticide pressure, by manner of exposure to the insecticides, or by recent changes in agricultural activities that decreased insecticide use. Baseline values were established that serve as provisional susceptibility thresholds for applying simple Centers for Disease Control and Prevention biochemical assay and bioassay methods to larvae of this anopheline species.

Colposcopy, cytology and histology in the diagnosis of squamous intraepithelial lesions of the cervix

OBJECTIVE

To compare colposcopic findings to cytologic and histological diagnoses in women with colposcopic reports of ANTZ and/or HPV infection.

METHODS

Among 791 hospitalized women referred for colposcopic examination, colposcopy showed ANTZ grade 0-2 and/or HPV infection in 271 patients (34.26%). Only 153 were fully investigated by colposcopy, cytology (under colposcopic observation) and histology (target punch biopsy: 109 patients; surgical specimens of hysterectomy: 42 patients; conization: 2 patients). Cytological and histological diagnoses were reported according to the Bethesda System.

RESULTS

132/153 Pap smears were estimable for sampling adequacy; 44/63 resulted as normal and were histologically positive for LSIL [1]. Five LSIL-positive Pap tests were negative on histology (false negative and false positive rate of 33.33% and 3.78%). The pap test was diagnostic for intraepithelial neoplasia in 34/65 cases (53.3%) and for invasive cancer in 6/11 cases (54.5%). In 67/132 cases (50.8%) adequate-for-sampling Pap smears could not predict the exact diagnosis. On the other hand, 108/141 patients with colposcopic evidence of ANTZ/cancer showed histological SIL or invasive neoplasm (76.59%): ANTZ 1 was associated to LSIL and HSIL in 74.1% and 2.4%; ANTZ 2 to LSIL, HSIL and invasive cancer in 41%, 30.76% and 10.3%. Colposcopic suspicion of invasive cancer in 8 patients was histologically demonstrated in 7 (87.5%); colposcopic diagnosis of HPV infection was confirmed in 10/12 (83.4%).

CONCLUSION

A better correspondance was shown between colposcopy and histology than between cytology and histology in the diagnosis of SIL. We suggest a routine colposcopy investigation for all patients admitted to a gynecological clinic and we believe it is very important to take Pap smears under colposcopic observation if colposcopy and cervical smears are performed in the same sitting.

[Hysteroscopic vs histologic diagnosis. Study of 222 cases of abnormal uterine hemorrhage]

BACKGROUND

AUB (abnormal uterine bleeding) is one of the most common pathologies. It is therefore important to use a method that is easy to carry out in order to ensure a rapid and reliable diagnosis. Hysteroscopy may represent the elective method for the study of the uterine cavity.

METHODS

A total of 222 women suffering from AUB were studied between January 1996 and June 1997 at the Department of Surgery, Gynecology Clinic of L'Aquila University. Their age ranged between 30 and 74 years old. The exclusion criteria for the study were as follows: presence of a genital infection in active or latent phase, pregnancy in progress or abortion. All patients underwent operative hysteroscopy with targeted biopsy accompanied, when necessary, by endometrial ablation. All biopsies underwent histological analysis and the results of hysteroscopic diagnosis and histological diagnosis were then compared.

RESULTS

There was a 85% correspondence between results. The main difficulties were encountered in the identification and selection of the characteristics of hyperplasia. Moreover, during the study it was found that hysteroscopy was both diagnostic and also therapeutic since it enabled the removal of polyps and intracavitary fibroma or endometrial ablation if required.

CONCLUSIONS

Hysteroscopy was therefore found to be a totally reliable method for the study of abnormal uterine bleeding compared to the histological tests carried out.

[Hormone substitution therapy during menopause. Increase of compliance]

BACKGROUND

Hormonal replacement therapy (HRT) is always of major employ in the practice. Unfortunately, a high percentage of women interrupt therapy after a few months.

METHODS

Two hundred menopausal women with intact uterus were studied. During the first consultation, they received an informative booklet regarding the menopause, without any verbal information. During the second visit, the gynaecologist discussed with the patient the information acquired and prescribed the HRT (50 mcg/die of transdermal estradiol, as continuous therapy, and 5 mg medroxyprogesterone acetate/os for 10 days/months) to those who required it. The compliance to treatment at 3, 6 and 12 months has been recorded.

RESULTS

Of the 200 women studied, 153 referred to have read the informative booklet: 112 requested further informations to their family doctor; 97 discussed the contents with the partner; 130 expected HRT. The 3 months, 6 months and 12 months compliance has been of 110 (84%), 97 (74%) and 68 women (52%) respectively. Causes of drop out: breast tension (12%); water retention and/or increase of weight (20%); headache (7%); vaginal blood loss (22%); others [fear of cancer, etc.] (54%).

CONCLUSIONS

According to personal opinion, three factors may condition the compliance to the HRT: 1) circumstantial information, not only verbal before the onset of therapy; 2) treatment protocols with low incidence of side effects; 3) frequent follow-up.

[Colposcopic monitoring of primary chemotherapy in patients with locally advanced cancer of the uterine cervix]

OBJECTIVE

To evaluate colposcopy in the monitoring of patients affected by locally advanced cervix cancer treated with primary chemotherapy.

MATERIALS AND METHODS

Eight patients (42-54 years old) affected by squamous cervical cancer locally advanced (stage FIGO IIa "bulky"/IIb/III) were treated with primary chemotherapy (cisplatin 50 mg/m2 vincristin 1 mg/m2 bleomicin 30 UI in 24 hours continuous infusion q 7 days for 3 cycles). Colposcopy was performed before chemotherapy, after the second cycle and at the end of chemotherapy.

RESULTS

Two pathological complete responses, 5 partial responses and one case of stable disease were observed. Patients with complete and partial response were treated with radical hysterectomy. In responding patients we observed a typical sequence of colposcopic findings. Regression of distinctive malignancy feature, reduction of atypical vessels, gradual disappearance of peripheral lesions and centripetal reepilization of the cervix were sequentially registered. At the end of treatment the cervix appeared with a colposcopy imaging as well as a centripetal squamous complete or incomplete metaplasia, open--for most part--glandular exit and weak acid-iodic positivity.

CONCLUSION

In responding patients we observed a typical sequence of colposcopy finding, useful in order to evaluate the effects of chemotherapy and to programme the surgical approach.

Parental attitude and practice regarding physical punishment of school children in Santiago de Chile

Four hundred and twenty-three parents from two free, nonconfessional, public schools placed in medium and low income areas, and 104 parents from a private, for-pay Catholic school in a medium and high income zone filled out an anonymous self-applied survey to learn attitudes and practices regarding child physical punishment. In the for-pay school parents declared better education. Child battering was admitted by 80.4% (public schools) and 56.7% (private school) despite that 34.1% (public schools) and 51.9% (at the private school) declared that battering should never be used. Females admitted and justified physical punishment in higher proportions than males. Poor school performance, defiance, and running away from home were the preferred reasons to justify battering at public schools, while defiance was preferred at the private school where poor performance was sent to the fourth place. To check parents data and get children's opinions, 192 seventh and eighth grades students were surveyed in one public school (n = 84) and the private school (n = 98). At the public school, 85.7% of children, and 54.1% of the children at the private school admitted to having been physically punished, with no sex differences. Stronger rejections to this punishment were found at the private school. Mother (87 [5%] at the public school and 77 [4%] at the private) and father (36 [1%], and 67 [9%], respectively) were singled out as leading users of physical punishment. Physical punishment differences according to social environment were detected while eradication seems difficult given its cultural basis.

[Parvovirus B19 infection: the general aspects and gestational problems]

Parvovirus B19 is a small, heat-stable, single-strained DNA virus (5.5 kb), with 23 nm icosahedral capsid discovered in 1975. Since its discovery, the virus has been shown to be a causative agent of erythema infectiosum (fifth disease). Under specific circumstances it can cause transient aplastic crisis, chronic anemia, arthritis and fetal death. Laboratory diagnosis of recent or past B19 infection usually relies on the demonstration of virus-specific IgM or IgG antibodies in patient's serum. The aim of this study was to evaluate the prevalence of Parvovirus B19 infection among 87 pregnant patients. Our study on anti-B19 antibody prevalence indicates that about 64% of pregnant women in our country lack specific antibodies and are at risk of B19 infection. One intrauterine death was encountered in a patient with specific IgM antibodies. The authors suggest the detection of IgG and IgM anti-B19 antibodies as a routine screening practice during pregnancy.

Natural history of spinal cord infarction caused by nucleus pulposus embolism

Nucleus pulposus embolism causing spinal cord infarction is exceptional. A 16-year-old girl was seen with sudden onset of interscapular pain and paraplegia from fatal ischemic transverse myelopathy due to arterial and venous occlusions by fibrocartilaginous embolism. In 32 cases of nucleus pulposus embolism, females predominated (69%) and age distribution was bimodal with peaks at 22 and 60 years (median, 38.5). Embolization was either arterial and venous (50%) or purely arterial (50%). Myelopathy predominated in cervical (69%) and lumbosacral (22%) segments. Schmorl's nodes, larger volume and vascularization of nucleus pulposus in the young, and spinal arteriovenous communications, trauma, and degenerative changes in older patients could be important pathogenetic factors. Diagnosis requires histopathologic confirmation. Nucleus pulposus embolism may be an underlying cause in cases diagnosed as transverse myelitis and ischemic infarction of spinal cord.

[Physical punishment in children: opinions and behaviors of adults]

Five hundred twenty seven parents and tutors from three schools of Santiago were surveyed, using anonymous inquiry, to know behaviors and opinions towards child abuse. Sixty three percent of the sample judged physical punishment useless as an educational tool. However, 75% tacitly admitted to hit children, when they were asked a question about the ways they used to punish them. This question was answered by a significantly higher proportion of women. The principal reasons to use physical punishments were defying attitudes, lack of study and running away from home. The principal ways of physical punishment were hand blows (49%), lashes with belts (13%) and shaking (19%). The principal punitive restrictions were restrains from going out of home (70%) or watching television (46%) and not talking to children (14%). Sixty six percent of parents reminded physical punishments during their childhood. This background was associated with a higher frequency of actual battering. It is concluded that there is incoherence between real behavior and opinions towards child battering among parents and that the magnitude of this problem precludes its short term eradication.

[Synchronous associations of tumors in the pelvic organs of the female genital tract]

The Authors report their findings concerning the synchronous associations of tumours involving pelvic organs in the female genital tract observed at the Gynecological Clinic, Aquila. From January 1980 to December 1991, 9 cases (4.28%) of synchronous tumours were found in a total of 210 cases of womb, ovary and vagina tumours. The paper examines the clinical problems and questions of anatomopathological characterisation raised by these associations.

[Effects of estradiol on in vitro cultures of human fibroblasts]

This paper assesses the effect of estradiol on the in vitro growth of fibroblast taken from human breast skin. It was observed that estrogens stimulate the proliferation of phenotypically adult fibroblasts; that there is a threshold increase of hormonal concentration which can trigger off this process; and that the size of the single dose is more important than the number of doses of hormone received.

Herpetic brainstem encephalitis

A fatal case of brainstem encephalitis presented as an acute lateral medullary syndrome. Pathologic examination showed a focal encephalitis along the roots and the intramedullary portion of the right vagus and glossopharyngeal nerves. Herpesvirus particles were demonstrated by electronmicroscopy of formol-fixed material. This is the second known case of herpetic brainstem encephalitis confirmed by postmortem examination and the only one in which the infection was limited to the brainstem. This case and a review of previously reported cases suggest that the viral infection could proceed to the brainstem through the vagus and glossopharyngeal nerves, probably from a source of latent herpetic infection in the respective ganglia.

Cerebral malaria. A disseminated vasculomyelinopathy

Neuropathologic examination of 19 fatal cases of cerebral malaria and a review of the literature showed that the epidemiologic, clinical, and pathologic features of this entity suggest consideration of cerebral malaria as a form of disseminated vasculomyelinopathy, a hyperegic reaction of the CNS to the antigenic challenge of Plasmodium falciparum infection. Experimental evidence also substantiates this view The initial event seems to be vasculopathy, with alteration of the endothelial permeability, followed by brain edema, perivascular infiltrates and ring hemorrhages, perivascular demyelination, and gliosis (malarial granuloma) in the late stages. This chain of events could be interrupted early in its course by corticosteroids. Parenteral dexamethasone should then be seriously considered at the first signs of involvement of the CNS during P falciparum malaria along with the standard forms of antimalarial therapy.

Neuroparalytic accidents of antirabies vaccination with suckling mouse brain vaccine. Clinical and pathologic study of 21 cases

Twenty-one cases of neuroparalytic accidents of rabies vaccination (with suckling mouse brain vaccine), 11 of them fatal, were observed, occurring predominantly in men; the mean age of the patients was 29 years. On the average, 13 doses of the vaccine were used. Only three patients received less than seven doses. The mean latent period was 14 days (range, 4 to 24 days). In 16 patients (76%), a Guillain-Barré syndrome occurred that was moderate in three, severe in seven, and fatal in six. Pathologically, this was shown to be a typical polyradiculoneuritis. Five patients had fatal involvement of the central nervous system. Three had an acute disseminated perivenous leukoencephalopathy, with concurrent rabies encephalitis in one case. One patient had a perivenous myeloradiculopathy and one a chronic encephalomyelopathy of six years' duration with demyelinating plaques in the periventricular white matter, cerebellum, and spinal cord. Since the reduction of postexposure rabies vaccination to seven doses, no new cases have been observed in Colombia.

Blood Lipids in Young and Old Individuals

We find, then, an increase in cholesterol serum level with age up to about 50 in the males and 60 in the females and decrease with further increase in age to values close to that of young individuals; there is a somewhat similar change in the total fatty acids and a less marked change in the poly-unsaturated fatty acids. The ratio of either the cholesterol or poly-unsaturated acids does not show this change but is relatively constant for the cholesterol and shows a steady decrease with age for the unsaturated fatty acids. The data indicate that ratios are more dependent upon the absolute lipid values than on age per se.