Kinetic and hydrogen production analysis in the sequential valorization of a Populus clone by cold alkaline extraction and pyrolysis

This work employed a two-step biorefining process, consisting of a hemicellulose-rich liquor production through ultrasound-assisted cold alkaline extraction (CAE), followed by thermochemical treatment of the resultant solid phase. The post-CAE solid phase's pyrolytic potential was assessed by application of thermogravimetric analysis (TGA) and Friedman's isoconversional method, and also from hydrogen production. The solid phases remaining after the CAE treatment were more reactive than the untreated raw material. Notably, the alkali concentration employed in the first step was the individual variable most pronounced influence on their activation energy (Ea). Thus, at a degree of conversion α = 0.50, Ea ranged from 109.7 to 254.3 kJ/mol for the solid phases, compared to 177 kJ/mol for the raw material; this value decreased with rising glucan content. At maximal degradation, the post-CAE solid phases produced up to 15.57% v/v more hydrogen than did the untreated raw material.

Biological mesh reconstruction versus primary closure for preventing perineal morbidity after extralevator abdominoperineal excision: a multicentre retrospective study

AIM

The aim of the study was to compare the incidence of perineal hernia and the perineal wound morbidity following extralevator abdominoperineal excision (ELAPE) between two groups - primary perineal closure and reconstruction with a biological mesh.

METHOD

One hundred and forty-seven consecutive patients who underwent ELAPE for primary rectal cancer between January 2007 and December 2018 in two tertiary referral centres were retrospectively identified from prospective databases. Perineal closure was carried out via primary closure or with a biological mesh (porcine dermal collagen mesh). Outcome measures were perineal hernia and perineal wound morbidity (infection, dehiscence, persistent sinus and chronic pain).

RESULTS

A total of 139 patients were included in the study. A prophylactic mesh was used in 80 (57.5%) and primary closure was practised in 59 (42.4%) patients. The median follow-up was 30 (interquartile range 46.88) months. Thirty patients (21.6%) developed perineal hernia. No significant differences were found between prophylactic mesh and primary closure (16.3% vs 23.3%, P = 0.07). The median period between surgery and hernia diagnosis was 8 months in the primary closure group and 24 months in the mesh group (P < 0.01). Perineal wound morbidity was significantly higher in the prophylactic mesh group (55% vs 33.9%, P < 0.01).

CONCLUSION

In our study, the use of a biological mesh did not reduce the rate of perineal hernia, although it did delay its appearance. Perineal closure using a biological mesh may increase perineal morbidity, both acute and chronic.

Effect of a Therapeutic Strategy Guided by Lung Ultrasound on 6-Month Outcomes in Patients with Heart Failure: Randomized, Multicenter Trial (EPICC Study)

INTRODUCTION AND OBJECTIVES

Pulmonary congestion (PC) is associated with an increased risk of hospitalization and death in patients with heart failure (HF). Lung ultrasound has shown to be highly sensitive for detecting PC in HF. The aim of this study is to evaluate whether lung ultrasound-guided therapy improves 6-month outcomes in patients with HF compared with conventional treatment.

MATERIALS AND METHODS

Randomized, multicenter, single-blind clinical trial in patients discharged from Internal Medicine Departments after hospitalization for decompensated HF. Participants will be assigned 1:1 to receive treatment guided according to the presence of lung ultrasound signs of congestion (semi-quantitative evaluation of B lines and the presence of pleural effusion) versus clinical assessment of congestion. The primary outcome is the combination of cardiovascular death and readmission for HF at 6 months.

CONCLUSIONS

The results of this study will provide more evidence about the impact of lung ultrasound on treatment monitoring in patients with chronic HF.

Isolation and characterization of Flavobacterium columnare strains infecting fishes inhabiting the Laurentian Great Lakes basin

Flavobacterium columnare, the aetiological agent of columnaris disease, causes significant losses in fish worldwide. In this study, the prevalence of F. columnare infection was assessed in representative Great Lakes fish species. Over 2000 wild, feral and hatchery-propagated salmonids, percids, centrarchids, esocids and cyprinids were examined for systemic F. columnare infections. Logistic regression analyses showed that the prevalence of F. columnare infection varied temporally and by the sex of the fish, whereby females had significantly higher prevalence of infection. A total of 305 isolates of F. columnare were recovered. Amplification of the near complete 16S rRNA gene from 34 representative isolates and subsequent restriction fragment length polymorphism analyses demonstrated that all belonged to F. columnare genomovar I. Phylogenetic analysis of near complete 16S rRNA gene sequences also placed the isolates in genomovar I, but revealed some intragenomovar heterogeneity. Together, these results suggest that F. columnare genomovar I is widespread in the Great Lakes Basin, where its presence may lead to mortality.

Amino-terminal pro-B-type natriuretic peptide, inferior vena cava ultrasound, and biolectrical impedance analysis for the diagnosis of acute decompensated CHF

BACKGROUND

Both Framingham criteria and natriuretic peptides (NPs) may worsen their diagnostic validity for acute decompensated heart failure (ADHF) in elderly patients with comorbidities, mainly renal failure. Ultrasound of inferior vena cava (IVCu) and bioelectrical impedance analysis (BIA) are useful tools for detecting ADHF, although their utility compared with NP is not fully established.

METHODS AND RESULTS

We conducted a prospective study with 96 patients who presented at the emergency department with dyspnea and were classified as ADHF and non-ADHF groups. Inferior vena cava ultrasonography measured maximum and minimum inferior vena cava diameters and collapsibility index (CIx), whereas BIA calculated resistance (Rz) and reactance (Xc). The primary goal was to compare amino-terminal pro-B-type NP (NT-proBNP), IVCu, and BIA for identifying ADHF. The ADHF group showed significantly (P<.001) higher NT-proBNP values (5801 vs 599 pg/mL), higher maximum IVC diameter (2.26 vs 1.58 cm), higher minimum IVC diameter (1.67 vs 0,7 cm), and lower CIx (27% vs 59%), as well as lower Rz (458.8 vs 627.1 Ohm) and lower Xc (23.5 vs 38.4 Ohm) compared with the non-ADHF group. The estimated area under the curve for ADHF diagnosis was 0.84 for NT-proBNP, 0.90 for maximum IVC diameter, 0.93 for minimum IVC diameter, and 0.90 for CIx, as well as 0.83 and 0.80 for Rz and Xc respectively, without finding significant difference. Cutoff values for diagnosis of ADHF with IVCu and BIA are proposed. Amino-terminal pro-B-type NP values significantly varied in patients with renal impairment, independently of ADHF status, whereas neither IVCu nor BIA did.

CONCLUSIONS

Inferior vena cava ultrasonography and BIA analysis are as useful as NT-proBNP to ADHF diagnosis, validated in an elderly population with kidney disease.

Biorefinery process for production of paper and oligomers from Leucaena leucocephala K360 with or without prior autohydrolysis

Lignocellulosic material from Leucaena leucocephala was subjected to a two-stage fractionation process to obtain a valorized effluent containing hemicellulose derivatives and a solid phase for producing cellulose pulp by conventional soda-anthraquinone delignification. This solid phase allows the production of cellulose pulp, under less rigorous conditions from NaOH-AQ process (177 °C, 21%, 120 min) than without pretreatment delignification (185 °C, 25%, 150 min) and better or similar properties in the paper sheets obtained (yield 27.6 and 34.0%, brightness 39.3 and 31.6% ISO, tensile index 7.8 and 10.5 N m/g, burst index 0.43 and 0.29 MPa m(2)/kg with and without previous autohydrolysis) have be found. Also, the first autohydrolysis stage allows up to 46.6% of the initial hemicellulose in the raw material to be extracted as xylooligomers, xylose and furfural into the liquid phase.

Optimization the soda-AQ process for cellulose pulp production and energy content of black liquor from L. leucocephala K360

A commercial variety of Leucaena leucocephala K360 was used for pulp production and papermaking employing the soda-anthraquinone process. Also, the chemical and energy contents of the resultant black liquors were determined to simultaneously optimize: pulp and paper production and energy generation. A process temperature of (185°C), an operating time of (120 min) and an active alkali concentration of (21%) provided sheets of paper with good strength (tensile index of 12.12 Nm/g, burst index of 0.38 kPa m(2)/g, tear index of 1.29 mN m(2)/g and a Kappa number of 20.5) and black liquor with a greater calorific value (14.1 MJ/kg) than that obtained with higher active alkali concentrations. However, reducing the active alkali concentration to a level in the low operation range led to less marked degradation of cellulose and allowed paper sheets with good properties to be obtained and energy to be optimally produced from the black liquor.

Exploitation of hemicellulose, cellulose and lignin from Hesperaloe funifera

This work seeks the integral use of all major components of Hesperaloe funifera, separating hemicelluose by hydrothermal treatments; cellulose by pulping processes; and exploitation of lignin of pulping liquor by pyrolysis and gasification processes. By using sulfuric acid in the hydrothermal treatment (150-190 °C, 0-20 min after reaching operating temperature, 6-10 liquid/solid ratio, 0.1-0.5% sulfuric acid), the glucose and xylose of liquid fraction increase from 1.5% to 5.9%, and 4.0% to 12.4%, respectively; the yields of solid fraction decrease from 91.6% to 79.5%, and the lignin content increase from 23% to 32%. Pulps and paper sheets obtained from solid fractions hydrothermal treatments and from raw material pulped with diethanolamine, are worse than those obtained with soda-anthraquinone (Yield 57.8%; kappa number 24.9; Viscosity 711 mL/g; Brightness 54.8%; Tensile index 73.6 Nm/g; Stretch 2.84%; Burst index 6.13 kN/g and Tear index 1.69 mNm2/g). By acidification (pH 6) of soda pulping liquor it separate lignin-rich solids, which by pyrolysis gave a gas containing 1.13% H2, 31.79% CO and 1.86% CH4 by weight. Gasification of the same sample provided a gas containing 0.18% H2, 24.50% CO and 17.75% CH4.

Integral valorization of tagasaste (Chamaecytisus proliferus) under hydrothermal and pulp processing

Tagasaste wood (Chamaecytisus proliferus L.F. ssp palmensis) was characterized, chemical and energy terms, and assessed its potential as a lignocellulosic raw material, and its integral fractionation by autohydrolysis and delignification with ethanol. The hydrothermal treatment of the raw material at 175-185 degrees C provided a liquor containing a substantially increased amount of oligomers (between 16.6% and 47.4% as percentages with respect to the content of the raw material in each polymer fraction). A cellulose pulp with autohydrolysis treatment increased yields (53-60%), reduced Kappa number (28.8-34.6) but also viscosity (755-857 mL/g), and decreased paper strength (2.97-5.22 kN m/kg). However, beating ethanol cellulose from tagasaste was found to improve its strength-related properties more markedly than in soda pulp from the same material (tensile index of 44 kN m/kg).

A genomic approach for the identification and classification of genes involved in cell wall formation and its regulation in Saccharomyces cerevisiae

Using a hierarchical approach, 620 non-essential single-gene yeast deletants generated by EUROFAN I were systematically screened for cell-wall-related phenotypes. By analyzing for altered sensitivity to the presence of Calcofluor white or SDS in the growth medium, altered sensitivity to sonication, or abnormal morphology, 145 (23%) mutants showing at least one cell wall-related phenotype were selected. These were screened further to identify genes potentially involved in either the biosynthesis, remodeling or coupling of cell wall macromolecules or genes involved in the overall regulation of cell wall construction and to eliminate those genes with a more general, pleiotropic effect. Ninety percent of the mutants selected from the primary tests showed additional cell wall-related phenotypes. When extrapolated to the entire yeast genome, these data indicate that over 1200 genes may directly or indirectly affect cell wall formation and its regulation. Twenty-one mutants with altered levels of beta1,3-glucan synthase activity and five Calcofluor white-resistant mutants with altered levels of chitin synthase activities were found, indicating that the corresponding genes affect beta1,3-glucan or chitin synthesis. By selecting for increased levels of specific cell wall components in the growth medium, we identified 13 genes that are possibly implicated in different steps of cell wall assembly. Furthermore, 14 mutants showed a constitutive activation of the cell wall integrity pathway, suggesting that they participate in the modulation of the pathway either directly acting as signaling components or by triggering the Slt2-dependent compensatory mechanism. In conclusion, our screening approach represents a comprehensive functional analysis on a genomic scale of gene products involved in various aspects of fungal cell wall formation.

Integral valorization of two legumes by autohydrolysis and organosolv delignification

Two woody legumes species (Chamaecytisus proliferus L.F. ssp. palmensis and Leucaena diversifolia) were evaluated for integrally exploitation. The raw material was subjected to autohydrolysis under variable operating conditions which provided a liquid phase rich in hemicellulose oligomers and a solid phase that was used to obtain cellulose pulp and paper sheets by using organosolv procedures. The chemical properties of both C. proliferus and L. diversifolia allow their integral exploitation by using a hydrothermal treatment prior to their organosolv pulping with ethanol. The pulp yields obtained are quite high (40.3% for L. diversifolia and 58.2% for C. proliferus), and so are the sugar concentrations in the liquors from the thermal pretreatment (viz. 16.1 and 20.0 g oligomers/l in C. proliferus and L. diversifolia, respectively, and 1.5 and 1.1g xylose/l, respectively, in the two raw materials). The strength-related properties of the paper sheets obtained are acceptable (tensile index 7.76 and 10.77 kN m/kg for C. proliferus and L. diversifolia, respectively and kappa index 31 and 12.5 for C. proliferus and L. diversifolia, respectively), but somewhat worse than those provided by other raw materials such as eucalyptus; however, they can be improved by mechanical refining of the pulp.

Human Anaplasmosis: The First Spanish Case Confirmed by PCR

We report a case of human anaplasmosis (HA) fulfilling the confirmation criteria: epidemiologic data and clinical picture compatible with HA; presence of a morulae within polymorphonuclear leukocyte; and positive PCR assay for Anaplasma phagocytophilum: This case report shows the presence of HA in Spain.

A comparative study of the effect of refining on organosolv pulp from olive trimmings and kraft pulp from eucalyptus wood

This paper examines the influence of the degree of refining of different pulps, produced from olive trimmings and eucalyptus wood, on various physical properties. Corresponding pulps were obtained by means of different cooking processes. Pulp from olive trimmings was obtained by means of an organosolv process and pulp from eucalyptus was obtained by means of a kraft process. Pulp from olive trimmings exhibited a lower specific surface area, water retention volume, breaking length, stretch and burst index, but a higher porosity, than eucalyptus pulp. On the other hand, the same degree of refining was achieved with less energy for olive pulp than for eucalyptus pulp. Mixed pulp from olive trimmings and eucalyptus provided paper sheets with acceptable physical properties but with reduced refining energy costs relative to eucalyptus pulp alone.

Squamous cell carcinoma of the oropharynx and esophagus in a Japanese bantam rooster

Squamous cell carcinoma of the oropharynx and esophagus was diagnosed in an adult Japanese bantam rooster. Grossly, a cauliflowerlike mass with irregular edges was found involving the ventrolateral surfaces of the caudal portion of the oropharynx and cervical portion of the esophagus. The large volume of the mass almost occluded the lumen of the alimentary passage. Histologically, the tumor consisted of irregular cords of pleomorphic epithelial cells that showed a disorganized pattern of growth and invaded the adjacent tissues. Keratinized epithelial cells and moderate numbers of keratin pearls were readily observed. The mitotic index was low, and, although the tumor was locally invasive, we found no evidence of vascular invasion or metastasis.

Aprotinin mediated antioxidant effect in Cardiosurgery with mechanical cardiorespiratory support (CMCS)

BACKGROUND

Aprotinin has been used in cardiosurgery as a hemostatic agent. Considering the implication of oxygen reactive species and proteases in the pathogenesis of Systemic Inflammatory Response Syndrome, we hypothesized that aprotinin may exert an antioxidant effect. This work was designed to evaluate the antioxidant capacity of aprotinin in vitro and in vivo in child patients undergoing cardiosurgery with mechanical cardiorespiratory support.

METHODS

Colorimetric techniques and chemiluminiscent emission assays. A blind controlled clinical trial was performed with a control (G-1, n=14, without aprotinin) and treated with aprotinin (G-2, n=12) groups (both assessed by medical decision) of child patients undergoing cardiosurgery with mechanical cardiorespiratory support. Blood samples were taken at: T-0 (induction of anesthesia), T-1 (10 minutes after begining of perfusion), T-2 (5 minutes after anoxic heart arrest), T-3 (ending operation) and T-4 (24 hours after operation).

RESULTS

We proved that aprotinin has no hydroxyl radical, superoxide anion nor H2O2 scavenger capacity as well as its capacity for inhibiting in vitro activated-leukocyte chemiluminiscence. Malonildialdehyde levels were higher in G-1 than G-2 with the greatest difference at T-2 (7.2+/-3.6 nmol/ml in G-1 vs 4+/-1.65 in G-2). Phospholipase A2 activity showed a tendency of higher values in G-1 than G-2 although there was no statistical significance. Uric acid concentration was greater in G-2 at T-1, T-2, T-3 and T-4 than G-1 and catalase activity was higher in G-2 at T-0, T-2 and T-3 than G-1 with noteworthy difference only at 5 minutes after anoxic heart arrest. Low cardiac output, arrhythmias and sudden death in the early postoperative phase were less frequent in the treated group.

CONCLUSIONS

These results suggest that aprotinin exerts a primary antioxidant activity and its protective effects in cardiosurgery seem to be associated with reduction of systemic oxidative stress.

Influence of fitness on the integrated neuroendocrine response to aerobic exercise until exhaustion

A group of trained and sedentary men performed an incremental graded exercise-test to exhaustion in order to assess the organic response of the two main stress-activated systems: the sympathetic nervous system with its endocrine component (the adrenal medulla), and the hypothalamic-pituitary-adrenal (HPA) axis. Maximal plasma concentrations of ACTH, cortisol and endogenous opioids (beta-endorphins) were obtained at the end of the exercise-test in the trained group. Thus ACTH increased from basal value of 21.25 +/- 2.5 pg/ml to 88.78 +/- 11.8 pg/ml at the end of the exercise (p<0.01); cortisol, from 16.56 microg/dl +/- 4.94 microg/dl to 23.80 +/- 4.57 microg/dl in min 15 of the recovery period (p<0.001); and beta-endorphin from 21.80 +/- 8.33 pmol/ml to 64.36 +/- 9.8 pmol/ml in min 3 of the recovery period (p<0.05). Catecholamine levels were increased from initial values at the end of the effort test in both control and trained groups. Control subjects exhibited a higher responsiveness compared to trained and showed superior intrinsic stimulation of the sympathetic nervous system. These results reveal a different response according to fitness in a physical stress situation.

Influence of the operating conditions in the acetone pulping of wheat straw on the properties of the resulting paper sheets

A central composite factor design was used to examine the influence of independent variables in the acetone pulping of wheat straw (processing temperature, time, and acetone concentration) on the yield of the resulting pulp, and on various physical properties of paper sheets (breaking length, stretch, burst index, tear index and brightness) obtained from it. Equations that related each dependent variable to the different independent variables were obtained, and these reproduced the experimental results for the yield, breaking, stretch, burst index and brightness obtained at temperatures, times, and acetone concentratons over the ranges 140-180 degrees C, 60-120 min and 40-80%, respectively, with errors less than 20%. Obtaining the optimum breakinig length, stretch, burst index and tear index for the paper sheets (3,456 m, 1.42%, 1.36 kN/g and 3.86 mNm2/g, respectively) entails using a high temperature; the processing time and acetone concentration only influence stretch, optimization of which requires using a short time and a low concentration. The optimum brightness (30.44%) is achieved with a low temperature, a short time and a medium acetone concentration. In order to minimize losses of solvent during its recovery and recycling while ensuring acceptable levels of the properties of the paper sheets, a high temperature, a low acetone concentration and a short time can be used; the brightness level thus obtained is only 10% lower than the optimum value.

Influence of process variables in the ethanol pulping of olive tree trimmings

A central composition design was developed to study the influence of process variables (temperature, pulping time and ethanol concentration) on the properties of the pulp produced (yield and holocellulose, alpha-cellulose and lignin contents) and the pH of the resulting wastewater, in the ethanol pulping of olive tree trimmings. The proposed equations reproduce the experimental results for the dependent variables with errors less than 5% for the holocellulose and alpha-cellulose contents, yield and wastewater pH, and less than 15% for the lignin content. Obtaining pulp with acceptably high yield (37.6%), high holocellulose and alpha-cellulose contents (above 88.8% and 46.9%, respectively), and low lignin contents (below 7.2%), entails operating at a pulping temperature of 200 degrees C, using an ethanol concentration of 75% and a pulping time of 60 min.

Autologous stem cell transplantation for clinically aggressive non-Hodgkin's lymphoma: the role of preparative regimens

We investigated the impact of the most commonly used preparative regimens on the outcome of 395 patients with diffuse large cell lymphoma (DLCL), consecutively reported to the registry of the Spanish GEL/TAMO. Among them, 139 (35%) were autografted in 1st CR, 86 (22%) in 2nd/3rd CR, 124 (31%) had chemosensitive disease and 46 (12%) had chemoresistant disease. Conditioning consisted of chemotherapy-only in 348 patients (BEAM, 164; BEAC, 145; and CBV, 39) and radiochemotherapy with CY and TBI in 47. Median times to granulocyte, platelet recovery and to discharge were significantly shorter in the chemotherapy-only group. Early transplant-related mortality was significantly higher when using CY-TBI. After a median follow-up of 28 months, overall survival (OS) at 8 years of patients conditioned with BEAM or BEAC (58% (95% CI 50-66%)) was more favorable than with CBV (40% (95% CI 24-56%)), and significantly better than with CY-TBI (31% (95% CI 18-44%)). Multivariate analysis revealed that patients conditioned with chemotherapy-only regimens had improved OS, disease-free (DFS) and relapse-free survival (RFS) when compared to those conditioned with CY-TBI. Status at transplant was also a powerful prognostic indicator. We conclude that preparative regimens consisting of chemotherapy-only seem more efficacious than CY-TBI as conditioning for DLCL, because of faster engraftment and greater anti-lymphoma effect, as indicated by improved OS, DFS and RFS.

Depletion of brain glutathione potentiates the effect of 6-hydroxydopamine in a rat model of Parkinson's disease

In order to examine the possible role of rat brain glutathione depletion by diethyl maleate (DEM) in the potentiation of 6-hydroxydopamine (6-OHDA) neurotoxicity, the relationships between both effects were evaluated using the circling behavior test (CBT), and determining striatal glutathione S-transferase (GST)-specific activity. There were significant differences between the two studied groups: 6-OHDA and DEM + 6-OHDA lesioned animals in striatal glutathione (GSH) concentration at the moment of the lesion with 6-OHDA and also at the end of the experiment (30 d after 6-OHDA lesion). The circling behavior test following the administration of amphetamine was qualitatively different between both groups of simple- and double-damaged animals. In accordance with our results, DEM injury makes the animals more susceptible to brain-oxidative damage by 6-OHDA, which can indicate that in the double-damaged animal group, DEM could induce potentiation of the toxicity through striatal glutathione depletion.

Beekeeper' arthropathy

OBJECTIVE

To describe the clinical, analytical, and radiological features of an observed arthropathy affecting beekeepers.

METHODS

Prospective study of 34 patients (32 male, 2 female), mean age 42 years (range 16 to 66 years), evaluated for the presence of acute or chronic arthritis related to beekeeping. All patients were working and living in the same village, Fuenlabrada de los Montes (1300 habitants), where there is a census of 180 beekeepers. An epidemiologic inquiry reported that > 50% of them reported episodes of arthritis on the hands during the month of August, at the time of honey collection.

RESULTS

Acute arthritis was observed in 10 patients. Pain, tenderness, joint swelling, and warmth were present in most cases. Chronic arthropathy was noted in 32 patients. Tenderness was present in 16 cases, synovial thickening in 12, limited joint mobility in 8, bony swelling in 15, and joint deformities in 13 patients. Radiological study showed periarticular soft tissue swelling, bone sclerosis, periostitis, bony erosions, subchondral cysts, geodes, osteophytes, and joint narrowing.

CONCLUSION

Beekeepers have joint disease apparently related to bee stings. Etiopathogenesis is unknown. Mechanical trauma, venom compounds, infection, and foreign body synovitis are factors that are thought to influence the pathogenesis of this syndrome. We designate the condition "beekeepers' arthropathy," and consider it an occupational disorder.

Metabolic and hormonal changes during aerobic exercise in distance runners

A group of long-distance runners is studied in order to clarify aspects concerning neuroendocrine mechanisms regulating organic adaptation to maximum effort, with special interest in the function of the growth hormone in fat metabolism and the possible use of ketone bodies as an alternative source of energy. A test is designed on a treadmill with a gradient of 3% and progressive increases in speed of 2 Km/h every 10 min, starting at 6 Km/h, and continuing until exhaustion. Masks are worn to enable the breath by breath measurement of expired gases and the subjects are monitored electrocardiographically using V5. For blood sample collection an antecubital vein is catheterized with a system enabling the replacement of the blood volume extracted by means of perfusion with physiological saline solution, and the increasing concentration of hormones in the blood is evaluated. The results obtained, indicate that epinephrine as well as GH hormones increase significatively from 20 min of exercise in runners promoting changes from carbohydrates to lipids as fuels to carry out exercise. The concomitant variations in energy substrates support the former hypothesis of work. Moreover, the muscle could employ acetylCoA originating from acetoacetate as an alternative metabolic source of fuel during maximum effort.

Modifications in the distribution of met-enkephalin in the pons of the cat, following the intravenous administration of clonidine: an immunocytochemical experimental study

The distribution of met-enkephalin in the cat and its modifications following the stimulation by intravenous clonidine, was studied with indirect immunocytochemical techniques. We observed a decrease in the immunoreactivity of met-enkephalin following the administration of clonidine, relative to the controls, in the following structures: locus coeruleus, nucleus cuneformis, formatio reticularis, nucleus gigantocellularis, nucleus reticularis lateralis, nucleus reticularis, nucleus reticularis parvocellularis, nucleus sensorius superior n. trigemini, nucleus raphes, substantia grisea periventricularis, nucleus eminentiae teretis, colliculus inferior, nucleus motorius n. trigemini, nucleus tracto spinalis n. trigemini, tractus spinalis n. trigemini and nucleus tracto mesencephalici n. trigemini. These experimental observations link the immunoreactivity changes to the structures that are associated with the direct action of clonidine and conclude that the pars metencephalinergicus of the efferent pontine pathway of pain is in morpho-functional relationship with the analgesia produced by clonidine; an analgesic of an endogenous opiate character.

[Indicators of oxidative stress and the effect of antioxidant treatment in patients with primary Parkinson disease]

INTRODUCTION AND OBJECTIVE

Parkinson's disease (PD) is characterized by a progressive, slow loss of dopaminergic neurones in the substance nigra. Although the cause of this neurone loss is unknown, at the present time many papers suggest oxidative stress (OS), secondary to dopaminergic metabolism, as an aetiopathogenic factor of PD. Therefore study of the part played by OS in this would permit the use of antioxidants (AO) as another possibility for treatment of the disease. It would also be a major step forward in the search for possible biological markers.

MATERIAL AND METHODS

A study using spectrophotometric techniques was made of the serum levels of four biochemical indicators: catalase (CAT), malonyl aldehyde (MDA), phospholipase A2 (PLA2) and Vitamin C (VITC) in controls and in patients with PD. We found the average value for each of the variables studied in controls and in patients, taking AO treatment into account.

RESULTS

The effect of clinical variables on serum levels of CAT, MDA, PLA2 and VITC was analyzed. It was seen that only the clinical state of Hoen and Yahr was related to the biochemical indicators. The CAT activity and VITC concentration showed statistically significant differences between patients (independently of their AO treatment) and controls. The CAT activity was significantly less in those treated with AO. The patients with PD did not all have the same degree of OS. The effect of AO treatment on plasma markers showed changes only in one subgroup of Parkinson patients.

CONCLUSIONS

Our study suggests that AO treatment in this condition should be tailored to the individual patient according to the degree of OS present.

Maintenance of the threshold/maximum heart rate quotient in swimmers

The anaerobic threshold (AT) was calculated in 23 swimmers by field methods: MADER (MM) and modified exponential MADER (EM) and laboratory methods: SKINNER (SM), ROBERGS (RM), CONCONI (CM), and ventilatory (VM). Two types of test were designed. The first in a swimming pool (test 1), performing four series of increasing intensity swims, and the second on a cycle ergometer increasing until exhaustion (test 2). In both tests the heart rate (HR) was recorded in beats per minute by telemetry. Despite the different HR at the AT: 180.0 +/- 2.7 (MM), 179.1 +/- 2.4 (EM), 166.0 +/- 2.9 (SM), 157.0 +/- 2.8 (RM), 167.6 +/- 2.7 (VM) and 168.8 +/- 2.2 (CM), and the different maximum HR (HRmax) in the two tests: 201.6 +/- 2.0 in Test 1 and 188.5 +/- 1.6 in Test 2; the percentage HR in the AT/HRmax proved to be similar for all the methods except RM (88.0%-89.2%). The mechanism of organic control in progressive exercise can therefore have, in this test, a "threshold" zone at a given percentage of the maximum capacity of adaptation, both when the exercise is carried out in a pool and also on a cycle ergometer.

Fixed drug eruption induced by lidocaine and patch testing

Fixed drug eruption (FDE) is a peculiar drug-induced cutaneous reaction, that characteristically reappears at the same site when the etiologic drug is readministered. We present a case of a 27-year old male who was referred to us after two episodes of erythema on the palms, soles, and genital areas with posterior desquamation after receiving local anesthetics. Skin tests with lidocaine, mepivacaine and bupivacaine were negative. Eight hours after challenge with lidocaine the lesions reoccurred. Patch tests with lidocaine on healthy skin and residual lesions were negative, but 48 hours later the lesions reappeared on the same areas as before. Challenge with mepivacaine and bupivacaine were negative.

IgE binding proteins in honey: discussion on their origin

Pollen proteins, most frequently from Compositae plants, and glandular enzymes from Hymenoptera insects are the only honey allergens involved in every case of honey sensitization reported so far. Surprisingly, we found three patients, all showing the same pattern of honey sensitization with clinical history, cutaneous test and specific IgE clearly positive to honey crude extract but not to the aforementioned components. IgE binding bands, mainly at 54, 46, 17 and 16 kDa, were recognized by the sera of the three patients on blots following electrophoretic separation of a local honey extract under dissociating conditions. Attempts to identify these proteins with the most common honey allergens by means of SDS-PAGE immunoblotting failed, leaving open the question on the origin of protein allergens in cases of honey allergy. Thus, if bee-derived components are not proven to be involved in honey sensitization, other protein sources, such as nectar, should not be disregarded.

[Seroepidemiologic study of hepatitis C virus infection in a general population from the region of La Rioja, Spain]

BACKGROUND

To assess the prevalence of hepatitis C virus (HCV) infection in a general population and to identify risk factors for acquiring infection. POBLATION AND METHODS: A cross section of the general urban population of La Rioja aged between 14 and 65, was studied by choosing a random sample (n = 890). Serum samples were screened for HCV antibodies by second-generation enzyme-linked immunosorbent assays and recombinant immunoblot assays. We investigated the relationship between HCV serostatus and age, intravenous drug use, tattoos, blood transfusion, history of hepatitis, previous surgical operations, the administration of parenteral treatment and the number of sexual partners.

RESULTS

The overall prevalence of anti-HCV antibodies was 2%. The logistic regression analysis confirmed a statistically significant association between anti-HCV positivity and intravenous drug use (OR = 169.67; CI 95%: 21.1-1,364.75), exposure to a blood transfusion (OR = 10.41; CI 95%: 3.03-35.75); tattoos (OR = 9.04; CI 95%: 1.25-65.36), and male sex (OR = 5.35; CI 95%: 1.34-21.42). However, that 38% of subjects had no risk factors for HCV infection.

CONCLUSIONS

These results show a high proportion of people were found to have anti-HCV antibodies. The possible mode of infection in one third of these subjects is not known. In the half of these cases the infection was found have been acquired by an intravenous mechanism: blood transfusion or drug use.

[Acute right ventricular insufficiency reversible following anthracycline treatment]

Anthracyclines are very effective antineoplastic agents for the treatment of acute leukemia. Early and late dose-related cardiotoxicity can occur. We present a 33 year old women who developed a reversible right heart failure fifteen days after receiving a treatment with doxorubicine. Severe regional wall motion abnormalities were appreciated through two-dimensional and Doppler-flow echocardiography, there was no evidence of impaired systolic or diastolic left ventricle function. Two weeks later, remission of acute right ventricle failure was obtained, echocardiographic assessment was normal at this time. Incidence of right ventricle abnormalities after treatment is discussed.

[Amebic liver abscess and amebic colitis in a couple]

Amebiasis is a disease commonly extended all around the world, its prevalence depending on the population under study. In Spain, most cases published are of exotic acquisition. We present the case of a married couple from Venezuela presenting two different forms of invasive amebiasis: acute colitis and hepatic abscess. In our environment, once the diagnosis of amebiasis is established, a close follow-up of the patients must be made, including the evaluation of the closest contacts. Regarding the treatment, we think that the asymptomatic forms must be treated with a luminal amebicidal and the symptomatic forms, with hystic amebicidal followed by luminal amebicidal.

Monoamine metabolites in normal human cerebrospinal fluid and in degenerative diseases of the central nervous system

Measurement of monoamine metabolites in cerebrospinal fluid (CSF) has been one of the few methods available to study monoamine transmitter function in the human central nervous system (CNS). It has steadily proved to be of much use in clinical research of neurological and psychiatric diseases, in which altered functions of central monoamine neurotransmitters have been identified. In this work 3-methoxy-4-hydroxyphenylethylglycol (MHPG), 3,4-dihydroxyphenylacetic acid (DOPAC), homovanillic acid (HVA) and 5-hydroxyindoleacetic acid (5-HIAA) were quantified in normal CSF and in patients with untreated Parkinson's disease (PD) and olivopontocerebellar atrophy (OPCA). Normal CSF was obtained from 162 patients at the time of spinal anesthesia for surgery. Reference values for monoamine metabolites were established for normal adult lumbar CSF. Up to the age of 70 years no relation of monoamine metabolite concentration with age or sex were encountered. In individuals above 70 years of age higher levels of MHPG, HVA, and 5-HIAA were present in women, while in men only higher levels of MHPG could be detected. A strong correlation between 5-HIAA and HVA concentrations were observed in all groups. PD patients exhibited normal CSF metabolite levels, but an altered 5-HIAA/HVA ratio, favoring 5-HIAA. Dominant and recessive OPCA differed essentially in HVA concentration-diminished in the first group and elevated in the last. Comparing the results obtained in PD and dominant OPCA, we suggest that the decrease of CSF HVA in the latter group might not reflect nigrostriatal degeneration as we previously thought. Possibly another factor influencing dopamine function in the CNS is involved.

[Function of growth hormone in the human energy continuum during physical exertion]

A study has been carried out in 18 healthy sedentary males (controls) and 15 trained handball players. It was programmed two different tests on cycle-ergometer: Test 1 aerobic of progressive increments of load (1 W/kg/3 min) and Test 2 (A) anaerobic (4 W/kg, during 1.5 min) and after resting 10 min., Test 2 (B) till exhaustion. The blood samples were 10 ml each collected by antecubital vein catheterization. Before, during and post-exercise recovery period HG hormone, glycemia, lactate, and FFA were measured. It was found a correlation between HGH levels and substances of the energetic metabolism. The only exception was trained subjects test-2 possibly due to slower response of HGH. However FFA variation levels are correlated at the beginning with the increasing levels (p less than 0.001). It is concluded that HGH can play an important role on the turn-over to get fuel to contractile process from carbohydrates to free fatty acids.

Effect of ethanol on the specific transport system for L-lysine in Saccharomyces cerevisiae

Preincubation of resting cells of Saccharomyces cerevisiae double mutant can1 gap1 (with a single transport system for L-lysine) with metabolic substrates stimulated subsequent uptake of lysine. While in the wild type the stimulation is connected primarily with carrier protein synthesis (delayed, cycloheximide-inhibitable effect) in the mutant an immediate tapping of an energy source (antimycin-inhibited) is practically solely involved.

Uptake of L-lysine by a double mutant of Saccharomyces cerevisiae

A gap1 can1 mutant of Saccharomyces cerevisiae with a single lysine transport system remaining was used to study detailed kinetics of this transport. Its half-saturation constant was 78 mumol per litre, its maximum rate of transport was 0.29 mumol L-lysine per g dry matter per minute, both parameters being lower by more than an order of magnitude in comparison with the GAP system. The pH optimum lay at very acid values of about 3, the temperature dependence without any transition point showed an activation energy of 48 kJ/mol. The transport was inhibited by common metabolic inhibitors (3'-chlorophenylhydrazonomalononitrile, antimycin, 2-deoxy-D-glucose, sodium arsenate) as well as by a membrane-active one (uranyl nitrate). The specificity of the system was extremely high, none of the natural amino acids acting as competitor to L-lysine. The maximum accumulation ratio attained (at about 5 mg dry matter per mL) was 100: 1-120: 1, in agreement with the measured protonmotive force under the assumption of 1 H+ ion being transported with 1 lysine molecule. The ratio decreased with increasing external concentration of lysine to as little as 4: 1 at 1 mmol lysine per litre. It also decreased with increasing suspension density and it was at extremely low suspension densities (0.2 mg dry matter per mL) that ratios of as much as 500: 1 were reached. Application of group-specific inhibitors showed that the active site of the carrier contains an essential histidine residue.

The use of isosorbide in the treatment of severe, uncontrolled hypertension

Isosorbide dinitrate was administered sublingually and compared with placebo in a double-blind, randomized fashion to determine its effectiveness and safety in the rapid control of severe arterial hypertension. In 11 patients who received 10 mg of isosorbide dinitrate, blood pressure (BP) dropped from 205 +/- 8/131 +/- 3 to 166 +/- 9/106 +/- 5 mm Hg at 120 minutes. In eight patients who received placebo, BP dropped from 203 +/- 8/130 +/- 3 to 193 +/- 11/122 +/- 5 mm Hg at 120 minutes. When 10 mg of isosorbide dinitrate was administered sublingually after 120 minutes to placebo-pretreated patients, their BP dropped to 161 +/- 7/105 +/- 6 mm Hg at 240 minutes. Our study group (19 patients) was compared with a "control" group (six patients) whose BP (203 +/- 12/132 +/- 8 mm Hg) was treated only with conventional antihypertensive medications and bed rest; five (83%) of the six controls achieved steady BP control at 24 hours vs nine (47%) of the 19 study patients pretreated with isosorbide. There were no side effects, including hypotension, orthostatic effect, and reflex tachycardia. Sublingual isosorbide safely and effectively lowers systolic and diastolic BP in patients with severe, uncontrolled arterial hypertension.

Effect of sodium orthovanadate on renal renin secretion in vivo

The effect of vanadate (0.5 mumol/min) on renin secretory rate (RSR) of the kidney has been studied in nembutal-anesthetized, volume-expanded dogs. Intrarenal vanadate infusion caused a 69.3 +/- 8.8% decrease in RSR. This was accompanied by marked decreases in renal blood flow (RBF), glomerular filtration rate (GFR) and fractional excretion of sodium (FENa). Renal vascular resistance rose from 1.3 +/- 0.09 to 6.1 +/- 2.3 mm Hg/ml/min (P less than .0005). Papaverine infusion partially blunted the effect of vanadate on RSR (RSR only fell to 42. +/- 10% of basal values). The decreases in RBF and GFR were also less and FENa slightly higher than normal. Acetylcholine prevented the effects of vanadate more fully. There was no fall in RBF, GFR or FENa and it basically abolished the fall in RSR which fell only 19.4 +/- 25.3 of control (P = N.S.). Nifedipine (a slow Ca++ channels blocker) also prevented the fall in RBF, GFR and FENa induced by vanadate. RSR did not change significantly (7.8 +/- 10.9%). These results clearly demonstrate that vanadate is a potent inhibitor of renin secretion and suggest that inhibition of smooth muscle Na+, K+, adenasine triphosphatase and changes in the cystosolic concentration of Na and Ca are involved in its mechanism. Changes in perfusion pressure and sodium delivery to the macula densa appear to have little if any role in the inhibition.

Profile of medical education in Latin America

Preliminary results of a study on medical education in Latin America carried out by the Department of Human Resources Development of the Pan American Health Organization are given in this article. Each of the Latin American schools of medicine existing at the end of 1967 and at the beginning of 1968 was visited by a researcher for approximately seven days. During this period specially prepared questionnaires were completed.

An analysis of the data reveals the presence of three types of imbalances: (1) imbalance between the system of secondary education and that of medical education, (2) internal imbalance between the system of higher education and medical education, and (3) imbalance between the system of health services and that of medical education.

The study of the data compiled may serve as a basis for the proposal of activities leading to harmonious development of the health manpower sector.