The PCR-based detection of Trypanosoma cruzi in the faeces of Triatoma infestans fed on patients with chronic American trypanosomiasis gives higher sensitivity and a quicker result than routine xenodiagnosis

In the xenodiagnosis (XD) of American trypanosomiasis (Chagas disease), Trypanosoma cruzi in the triatomine bugs fed on the patient can now be detected using PCR (XD-PCR) as well as by microscopy (XD-M). In a study to compare XD-PCR with XD-M, triatomine bugs were fed on 50 cases of chronic American trypanosomiasis, of whom only 25 were ever found positive by XD-M. Overall, the bugs fed on 34 of the patients (all 25 cases found positive by XD-M and nine of the other patients) were found PCR-positive, giving a 330-bp fragment corresponding to part of the hyper variable region of the kinetoplast DNA of T. cruzi. Of the 25 patients who were ever found positive by XD-M, 20 gave bugs that were smear-positive on day 90 and a similar number (24; P=0.125) gave bugs that were PCR-positive at this time. On day 30, however, the bugs fed on only 11 of these 25 patients were found positive by microscopy, whereas 23 of these patients were found positive by XD-PCR (P=0.0016). Thus, not only was XD-PCR more sensitive than XD-M but it was also quicker, revealing more cases within 30 days than detected using XD-M over a period of 90 days.

SNPs in human beta-defensin 1 gene (DEFB1): frequencies in a Mexican population and new PCR-RFLPs assays

Polymerase chain reaction-restriction fragment length polymorphism assays for two single nucleotide polymorphisms in the human beta-defensin 1 gene have been validated with real-time PCR in 101 healthy individuals from western Mexico. Allele frequencies were 52.5% (692-A) and 98.5% (1836-A). These assays can be confidently used as a cheaper alternative genotyping method for these sites.

Electron spin resonance and raman scattering spectroscopy of multi-walled carbon nanotubes: a function of acid treatment

We compare the fundamental transport mechanism in multi-walled carbon nanotubes (MWNTs) by means of electron spin resonance (ESR) and Raman spectroscopy as a function of acid treatment. The ESR and Raman results show that the acid treatment reduces the density of states at the Fermi level. Defects introduced through the acid treatment move the Fermi level closer to the K points in the valence band, and consequently conduction is reduced. These defects are identified as Stone-Wales type from the Raman results.

Forensic potential of the STR DXYS156 in Mexican populations: inference of X-linked allele null

The pentanucleotide STR (TAAAA)n DXYS156 offers advantages for genetic identity testing. In addition to establish the gender, DXYS156 expands the DNA profile and is able to indicate the possible geographic origin of the individual. We analyzed DXYS156 in 757 individuals of both sexes from Mexican populations. We studied the cosmopolitan Mestizo population and six Mexican ethnic groups: Tarahumaras, Purépechas, Nahuas, Mayas, Huicholes and Mezcala Indians. The six shorter (4-10) and the three larger alleles (11-13) were specific for the X and Y-chromosomes, respectively. A random distribution of alleles into genotypes was observed in males and females from each population. We estimated the power of exclusion for paternity testing according to the son's gender, and the power of discrimination in forensic casework. In addition, we detected a relatively high frequency of an X-linked allele null, principally in Mexican-Mestizos (3.6%), which must be considered when DXYS156 be applied for identification purposes.

Methylenetetrahydrofolate reductase C677T polymorphism and Factor V Leiden variant in Mexican women with preeclampsia/eclampsia

The etiology of preeclampsia is still a matter of controversy. An association between hyperhomocysteinemia and preeclamptic patients has been described. A common missense mutation in the methylenetetrahydrofolate reductase (MTHFR) gene is associated with increased plasma homocysteine concentrations. In addition, the polymorphism of gene encoding for Factor V Leiden G1691A is associated with a prothrombotic state in heterozygous subjects. Both mutations in these thrombophilic proteins appear to have different prevalence in the general population and in patients with preeclampsia/eclampsia (PE/E). We studied single nucleotide polymorphisms for MTHFR C677T and coagulation Factor V Leiden in 33 Mexican patients with PE/E as a genetic risk factor for these diseases, comparing with a normotensive pregnant control group. The genotype and allele frequencies of MTHFR C677T and Factor V Leiden mutations between Mexican women with PE/E and healthy controls were not different. We conclude that these polymorphisms do not contribute in the etiology of PE/E as it has been reported in other populations.

HLA-DQB1, -DQA1, -DRB1 linkage disequilibrium and haplotype diversity in a Mestizo population from Guadalajara, Mexico

HLA-DQB1, -DQA1, and -DRB1 genes were typed by polymerase chain reaction with sequence-specific primer (PCR-SSP) in 159 healthy volunteers from 32 families living in Guadalajara, Mexico. Three-locus genotype data from all family members were used to infer haplotypes in 54 unrelated individuals of the sample, from which estimate of segregating haplotype frequencies and linkage disequilibrium (LD) between loci were computed. Genotype distributions were concordant with Hardy-Weinberg expectations (HWE) for all three loci, and allele distributions were similar to the ones observed in other Latin-American populations. Of the 56 distinct three-site (DQB1-DQA1-DRB1) haplotypes observed in the sample, the five most common (i.e., with frequencies of five counts or more) were: *0302-*0301-*04, *0201-*0201-*07, *0301-*0501-*14, *0402-*0401-*08, and *0501-*0101-*01. These common three-locus haplotypes also contributed to the majority of the significant two-locus linkage disequilibria of these three sites.

Synthesis, pharmacology and pharmacokinetics of 3-(4-aryl-piperazin-1-ylalkyl)-uracils as uroselective alpha1A-antagonists

Predominance in the urethra and prostate of the alpha(1A)-adrenoceptor subtype, which is believed to be the receptor mediating noradrenaline induced smooth muscle contraction in these tissues, led to the preparation of alpha(1A)-selective antagonists to be tested as uroselective compounds for the treatment of benign prostatic hyperplasia. Thus, a number of selective alpha(1A)-adrenoceptor antagonists were synthesized and assayed in vitro for potency and selectivity. Dog pharmacokinetic parameters of 12 (RO700004) and its metabolite 40 (RO1104253) were established. The relative selectivity of intravenously administered 12, 40 and standard prazosin to inhibit hypogastric nerve stimulation-induced increases in intraurethral prostatic pressure versus phenylephrine-induced increases in diastolic blood pressure in anesthetized dogs was 76, 71 and 0.6, respectively.

Acute interhemispheric subdural hematoma: two case reports and analysis of the literature

Interhemispheric subdural hematoma (ISH) had been considered extremely rare until identification with imaging studies. Its natural history is still quite unknown in terms of potential origin and course. As a consequence of various controversies, there is still no clearly established treatment, particularly in regard to medical or surgical management. The best decision requires tailoring treatment to the individual patient according to his or her clinical condition. Two patients with acute interhemispheric subdural hematomas are reported, the controversial management of this rare entity is analysed. In reviewing current published cases of interhemispheric subdural hematoma, it seems that the outcome of an individual patient is not related to the therapeutic approach, but to the level of consciousness and the neurological condition on admission. Surgical and medical treatment indications are taken into account for management. A patient with ISH developed an extension of the hematoma to the convexity at 2 weeks of his clinical course, with a decline of his neurological condition. The hematoma was then evacuated through a parietal craniotomy with an uneventful postoperative course. Another case of ISH presented as headache and TIA, with spontaneous clinical improvement at 12 hours and with no decline in the patient's neurological condition. Management was conservative. In both cases the neurological examination was normal after 6 months. As in previously reported cases, the clinical and neurological condition of the patient on admission is crucial for the course of an ISH. Treatment strategies are based on the individual neurological response of each case and the risk-benefit ratio to decide on a medical or surgical approach.

Genetic variation among four Mexican populations (Huichol, Purepecha, Tarahumara, and Mestizo) revealed by two VNTRs and four STRs

Allele distributions of two polymorphisms with variable number of tandem repeats (VNTR), D1S80 and APOB, and four polymorphisms with short tandem repeats (STR), VWA, TH01, CSF1PO, and HPRTB, were analyzed in three Mexican ethnic groups: Huichol, Purepecha, and Tarahumara. Genotype distribution was in agreement with Hardy-Weinberg expectations for each locus and ethnic group. Heterozygosity (H), power of discrimination, and probability of exclusion were estimated. The three groups presented some distinctive genetic features: (1) a diminished genetic diversity (H = 66.8% to 73.4%) and mean number of alleles by locus (5.8 to 6.3) in comparison with Mexican mestizos (H = 78.3%, 10.5 alleles/locus), and (2) uneven allele distributions as evidenced by "distinctive alleles" with high frequencies, especially in the Tarahumara and the Huichol. Genetic relatedness analysis included data from a previously typed mestizo population, the largest and most widely distributed population in Mexico. Allele distribution differentiation was observed among all four groups, except between mestizo and Purepecha (p > 0.05), which was interpreted as indicating a larger Spanish component in the Purepecha as a result of gene flow effects. Although intrapopulation inbreeding (FIS) was not significant, heterozygote deficiency in the total population (FIT) and divergence among populations (FST) were significant (p < 0.05). Genetic distances displayed a closer relationship among mestizos, Purepechas, and Huichols in relation to Tarahumaras. Correlation between the observed genetic features and the geographic isolation level points to genetic drift as the main cause of differentiation among these Mexican populations.

Selenium, zinc and copper plasma levels in intrahepatic cholestasis of pregnancy, in normal pregnancies and in healthy individuals, in Chile

BACKGROUND/AIMS

Low blood Se levels have been previously shown in normal pregnancies (third trimester) and significantly lower levels in patients with intrahepatic cholestasis of pregnancy (ICP), in Finland and in Chile, suggesting that a low or marginal dietary availability of Se may contribute to the pathogenesis of this disease. The aim of this study was to investigate whether a temporal change in plasma concentration of Se, and seasonal fluctuations in plasma concentrations of Se, Zn and Cu, could coincide with changes in the prevalence of ICP.

METHODS

A cross-sectional cohort study was done including 21 ICP patients, 98 women in the third trimester of a normal pregnancy, 29 non-pregnant women, and also 13 individuals (seven non-pregnant women and six men) who had been studied 9 years before. Plasma Se, Zn and Cu were measured by atomic spectroscopy. Plasma Se levels in the present study were compared to the results obtained 5 to 7 years before, employing identical methodology in similar population samples.

RESULTS

Plasma Se concentrations in non-pregnant women were higher than in the previous study: 1.43+/-0.34 micromol/l vs 0.85+/-0.13; p<0.001. In comparison to non-pregnant women, normal pregnancies near term had lower plasma levels of Se: 1.08+/-0.25 micromol/l; p<0.01, and Zn: 17.90+/-3.61 micromol/l vs 19.71+/-3.21; p<0.05, but higher plasma levels of Cu: 34.35+/-7.12 micromol/l vs 20.62+/-3.34; p<0.01. In normal pregnancies, plasma Se concentration was significantly higher in summer (1.34+/-0.19 micromol/l) than in the other seasons, while Zn and Cu diminished. Similar to previous studies, ICP patients had significantly lower Se plasma levels than normal pregnancies: 0.94+/-0.12 micromol/l, p<0.05, and Cu levels were significantly higher: 50.80+/-7.02 micromol/l, p<0.01. Cu plasma levels correlated with the biochemical severity of the disease. Zn did not change in ICP.

CONCLUSIONS

The present study shows that the decrease in the prevalence of ICP in Chile during the last decade coincides with an increase in plasma Se levels. Its lower incidence during summer coincides with a higher plasma Se concentration in summer than in other seasons, as observed in normal pregnancies.

The C677T polymorphism of the methylenetetrahydrofolate reductase gene in Mexican mestizo neural-tube defect parents, control mestizo and native populations

The C677T mutation of the methylenetetrahydrofolate reductase (MTHFR) gene, associated with the thermolabile form of the enzyme, has reportedly been found to be increased in neural-tube defects (NTD), though this association is still unclear. A group of 107 mestizo parents of NTD children and five control populations: 101 mestizo (M), 50 Huichol (H), 38 Tarahumara (T), 21 Purepecha (P) and 20 Caucasian (C) individuals were typed for the MTHFR C677T variant by the PCR/RFLP (HinfI) method. Genotype frequencies were in agreement with the Hardy-Weinberg expectations in all six populations. Allele frequency (%) of the C677T variant was 45 in NTD, 44 in M, 56 in H, 36 in T, 57 in P, 35 in C. Pairwise inter-population comparisons of allele frequency disclosed a very similar distribution between NTD and M groups (exact test, P=0.92). Among controls, differences between M and individual native groups were NS (0.06<P<0.21), as it was between M and C (P=0.29). A high frequency of the variant was found in H (56%) and P (57%). A similar allele frequency in groups M and NTD does not support a causal relationship between NTD and parental MTHFR C677T genotypes. Thus, the C677T variant cannot be regarded as a major genetic risk factor for NTD in Mexican mestizo parents. Otherwise, C677T in Mexico is very frequent, especially in Huichol and Purepecha natives, as compared with other groups world wide.

beta(A) globin gene haplotypes in Mexican Huichols: Genetic relatedness to other populations

The haplotypes of 97 beta(A) independent chromosomes from a Mexican Huichol Native American group were analyzed. The analysis also included 87 beta(A) chromosomes from a Mexican Mestizo population previously studied. Among Huichols, eight different 5' beta haplotypes (5Hps) were observed, with types 1(+ - - - -), 13(+ + + - +) and 2(- + + - +) at frequencies of 0.794, 0.093, and 0.041, respectively. In Mestizos, 17 5Hps were found, types 1, 3(- + - + +), 2, 5(- + - - +) and 9(- - - - -) being the most common at frequencies of 0.391, 0.172, 0.092, 0.069, and 0.046, respectively. 3' haplotype (3Hps) frequency distributions were 0.443(+ +), 0.083(+ -), and 0.474(- +) in Huichols and 0.563(+ +), 0.149(+ -), and 0.287(- +) in Mestizos. Pairwise comparison for both haplotype distributions between the two populations showed significant differences. Pairwise distributions of 3Hps for Huichols were compared with nine worldwide populations, three African, two Asian, two Melanesian, one Caucasian, and one United States Native American. The distributions of the Huichol were different (P < 0.05) from all populations except the Native American. Nei's genetic distances showed the Huichols to be closer to the Native Americans, followed by Melanesians from Vanuatu and Asians; Africans were the farthest. The 5Hp distributions in Mexicans were also compared with 23 worldwide populations (including African, Native American, Asian, Caucasian, and Pacific Islanders). Huichol distributions were different (P < 0.05) from all other populations except Koreans. The Mestizo distribution was also different from the others, except three Caucasian groups. Nei's genetic distance between the same populations disclosed that the Huichols are in relatively close proximity to five out of six Asian populations considered. The same analysis with grouped worldwide populations showed Native Americans as population closest to the Huichols, followed by Pacific Islanders and Asians. Present observations are consistent with an important Asian contribution to the Huichol genome in this chromosomal region. Am. J. Hum. Biol. 12:201-206, 2000. Copyright 2000 Wiley-Liss, Inc.

[Diagnostic use of ELISA, IgG, IgM, IgA and ELISA IgG avidity in recent and chronic toxoplasmosis]

Toxoplasmosis, a world-wide zoonotic infection, is generally asymptomatic and benign in immunocompetent individuals, but it can be serious in immunodeficiencies particularly in patients with acquired immunodeficiency syndrome and in children infected in utero. So, it is important to dispose methods which permit discriminate between recent and chronic infections. In order to contribute to improve the diagnosis of toxoplasmosis ELISA IgG, IgM, IgA and ELISA IgG avidity were performed in 15 and 24 sera from patients suspected of having acute and chronic infection respectively, according dye test (DT) titres. ELISA IgG was positive in both groups, ELISA IgM was positive in 78.6 and 58.3% respectively, while ELISA IgA was positive in 85.7 and 33.3% of recent and chronic group respectively. In those sera with low IgG avidity (18.8%) we found specific IgM in 71.5 and 4.2% and IgA in 78.6 and 0.0% of recent and chronic groups respectively. Parallelling, 208 sera samples were classified according to the results of DT, indirect hemagglutination and complement fixation tests in the following groups: acute (97), intermediate (36), chronic (35) and negative (40). The results were: acute (96.9-64.9-55.6 and 65.9%); intermediate (97.2-63.8-44.4 and 47.2%); chronic (45.7-42.8-5.7 and 34.3%) for IgG, IgM, IgA and low IgG avidity respectively. The use of both acute markers, IgA and low IgG avidity in the diagnosis of toxoplasmosis is discussed.

inv(9)(p24q13) in three sterile brothers

Only nine non-polymorphic constitutional pericentric inversions of chromosome 9 have been described. We report on a familial inv(9)(p24q13) associated with sterility in three brothers. The mother's chromosomes were normal in blood lymphocytes (n=130); the father was already deceased and his karyotype unknown. However, the presence of any of the maternal chromosomes 9 (as assessed by C-banding) in her carrier children is inconsistent with the assumption of maternal mosaicism. Two single sisters were also carriers. The same rearranged chromosome 9 in the three sterile brothers can hardly be regarded as a fortuitous association, especially when the breakpoints are almost identical to those of the sole inversion previously found in an azoospermic male. If their father was a carrier, the observed sterility may be the result of 'chromosome anticipation', a phenomenon already invoked for certain familial chromosomal rearrangements.

[Antimicrobial resistance of different Acinetobacter baumannii biotypes isolated in the northern region of Chile]

BACKGROUND

Acinetobacter baumannii nosocomial outbreaks are common and the microorganism is frequently resistant to multiple antimicrobials. There is little information about Acinetobacter baumannii antimicrobial susceptibility in the northern region of Chile.

AIM

To identify different Acinetobacter baumannii biotypes isolated from clinical samples and to determine their antimicrobial susceptibility.

MATERIAL AND METHODS

One hundred twenty three Acinetobacter baumannii isolates were studied. The identification and typing of Acinetobacter baumannii was based on phenotypic characteristics. Antimicrobial susceptibility was investigated using agar dilution techniques.

RESULTS

Most Acinetobacter baumannii strains were isolated from wounds, urinary and respiratory infections. Seven biotypes were isolated, being biotype 9 the most frequent. Imipenem was the antimicrobial with the higher activity against the microorganism. Amikacin, cefoperazonesulbactam, ampicillinsulbactam and ceftazidime had a moderate activity. There were high resistance levels to ampicillin and older cephalosporins.

CONCLUSIONS

Acinetobacter baumannii is emerging as a significant nosocomial pathogen in Chile and shows high resistance rates to multiple antibiotics.

[Standardization of ELISA IgM and IgA for immunodiagnosis of human trichinosis]

An ELISA test for trichinosis using as antigen a larvae soluble fraction from Trichinella spiralis was carried out for the detection of IgM and IgA specific antibodies in 45 serum samples from patients confirmed or suspected to have trichinosis by strong clinical and epidemiological evidences. All the patients had positive serology detected by precipitin test, bentonite floculation test, indirect hemagglutination test and ELISA IgG test. The cut-off value was determined using two criteria. Criterion A was determined in each plate, using three positive controls and two negative ones; the average of the negative controls and the weakest positive control, multiplied by a 1.2 factor was, considered the cut-off value. Criterion B was determined using the average plus three standard deviations from 64 apparently healthy persons serum samples. In both cases, three serum dilutions (1:10, 1:100 and 1:500) were used. The sensitivity of ELISA IgM was 100.0, 93.3 and 82.2% using serum dilutions of 1:10, 1:100 and 1:500 respectively (criterion A) and 100.0, 97.8 and 95.6% for the same dilutions (criterion B), whereas the values for ELISA IgA were: 100.0, 91.1 and 86.7% (criterion A) and 100.0, 100.0 and 91.1% (criterion B). In order to find out the specificity of ELISA IgM and ELISA IgA, additional 118 serum samples from individuals with other parasitoses, such as cysticercosis (18) hydatidosis (39), fascioliasis (12), toxocariasis (30), Chagas' disease (12) and individuals with non-specific eosinophilia (7), were also tested. ELISA IgM presented a specificity of 92.3, 93.4 and 97.3% (criterion A) and 96.2, 97.8 and 97.8% (criterion B) whereas the results for ELISA IgA were 97.8, 98.9 and 99.4% (criterion A) and 98.4% for the 1:10 and 1:100 dilutions and 100.0% for the 1:500 dilution (criterion B). The positive predictive values of ELISA IgM were 76.3, 77.8 and 88.1% (criterion A) and 86.5, 91.7 and 91.5% (criterion B) whereas the negative ones were 100.0, 98.3 and 95.7% (criterion A) and 100.0, 99.4 and 98.9% (criterion B). The positive predictive values of ELISA IgA were 91.8, 95.3 and 97.5% (criterion A) and 93.8, 93.8 and 100.0% (criterion B) whereas the negatives ones were: 100.0, 97.8 and 96.8% (criterion A) and 100.0, 100.0 and 97.8% (criterion B). The use of ELISA IgM and ELISA IgA in the immunodiagnosis of trichinosis is discussed.

[Human hydatidosis in Chile. Seroprevalence and estimate of the number of infected people]

Chile is located in the southwestern border of South America. The country is 4,329 km long and 96-342 wide. From north to south it is divided into five marked different biogeographical zones: deserts, steppes, bushes, forests (cattle raising) and austral (sheep raising). Population (June 1999) 15,017,760 (14.6% rural). Human hydatidosis is endemic in Chile. According to Ministry of Health information about 320 cases are registered each year. In order to find out the likely prevalence of human hydatidosis in Chile, a series of serosurveys was carried out in 1988-1997 throughout the total country. By using the indirect hemagglutination reaction and ELISA for hydatidosis (tests with good sensibility and specificity) 60,790 unselected apparently healthy persons: 41,399 from urban areas (16,428 blood donors, 13,894 delivering mothers and 11,077 middle grade schoolchildren) and 19,361 from rural areas--from randomly selected family groupings--were studied. A total individuals 82 (136/100,000) resulted positive: 36 (87/100,000) urban and 46 (241/100,000) rural, being the prevalence higher in rural areas, particularly in the southern austral zone (mean 1068/100,00). These figures agree with those observed in clinical epidemiological studies. In conformity with the present results, in the whole country 17,002 individuals should have hydatidosis: 10,318 urban and 6,784 rural. All these possible infected people, not necessarily should present pathology in the future, as it has been observed in autopsies from unselected individuals, performed at the Medico-Legal Service in Santiago, in whom 71.3% of diagnosed hydatosis with hydatid cysts in many different locations, was an autopsy finding.

[Seroepidemiological survey of human toxoplasmosis in Osorno, Region X, Chile, 1998]

A serological survey was carried out in Osorno X Region, Chile (40 degrees 21'-40 degrees 46' South lat, and 73 degrees 26' -72 degrees-46' West long.). An indirect hemagglutination test (IHAT) for toxoplasmosis was performed to 305 persons--160 blood donors and 145 with sexually transmitted disease (STD). The age of the surveyed persons (167 males and 138 females) varied between 10 and 72 years. IHAT titers > 16 were considered as positive. The general prevalence was 20.3%--21.2% in blood donors and 19.3% in persons with some STD--with no differences between males and females. However, significant differences between males and females with STD were found (35.6% and 8.1% respectively). No differences between urban and rural inhabitants were found with a slight higher prevalence in the urban ones. No antibodies against Toxoplasma gondii were detected in six AIDS patients. The importance of performing toxoplasmosis immunodiagnosis and individual prophylaxis to avoid the infection in high risk group are recommended.

Ursodeoxycholic acid in the treatment of cholestasis of pregnancy: a randomized, double-blind study controlled with placebo

BACKGROUND/AIMS

Intense pruritus and the risk of stillbirths and premature deliveries justify the search for an effective pharmacologic treatment of intrahepatic cholestasis of pregnancy. This study was designed to test the efficacy of ursodeoxycholic acid in maternal pruritus, the biochemical abnormalities and the outcome of pregnancy, in patients with intrahepatic cholestasis of pregnancy of early onset.

METHODS

Pregnant patients hospitalized in a secondary case-referral center with intense pruritus and abnormal serum levels of bile salts and aminotransferases, detected before week 33 of pregnancy, were randomly assigned to receive ursodeoxycholic acid, 1 g per day orally, or an identical placebo, until delivery, in a double-blind study. A 3-week trial period was chosen to compare drug and placebo effects. The follow-up was extended for 3 months after delivery.

RESULTS

Twenty-four patients entered the trial; eight had deliveries before 2 weeks of treatment and one dropped out. The study was then completed in 15 patients: eight received ursodeoxycholic acid and seven placebo. No adverse effects were detected in the mothers or in their babies. After 3 weeks of treatment, patients receiving ursodeoxycholic acid (mean daily dose 16 mg/kg body weight) had a significant improvement in pruritus (p<0.02), in serum bilirubin (0.36+/-0.19 mg/dl (mean+/-SD) versus 0.95+/-0.48 in patients receiving placebo, p<0.01), in aspartate aminotransferase (52+/-42 IU/l vs 98+/-44, p<0.05) and in alanine aminotransferase (54+/-50 IU/l vs 229+/-154, p<0.01); serum total bile salts also tended to be lower in patients receiving ursodeoxycholic acid (26.3+/-33.7 micromol/l vs 55.0+/-44.8, p N.S.). Deliveries occurred at or near term in all mothers who received ursodeoxycholic acid (mean week of pregnancy: 38), while they occurred before week 36 of pregnancy in five patients who received placebo, including one stillbirth. All babies born alive had birth weights adequate for gestational age and they were thriving normally 3 months after delivery.

CONCLUSIONS

Ursodeoxycholic acid is effective and safe in patients with intrahepatic cholestasis of pregnancy of early onset, attenuating pruritus and correcting some biochemical abnormalities in the mothers. Relevant aspects of fetal outcome were also improved in patients receiving ursodeoxycholic acid compared to placebo.

N-arylpiperazinyl-N'-propylamino derivatives of heteroaryl amides as functional uroselective alpha 1-adrenoceptor antagonists

Novel arylpiperazines were identified as alpha 1-adrenoceptor (AR) subtype-selective antagonists by functional in vitro screening. 3-[4-(ortho-Substituted phenyl)piperazin-1-yl]propylamines were derivatized with N,N-dimethyl anthranilamides, nicotinamides, as well as carboxamides of quinoline, 1,8-naphthyridine, pyrazolo[3,4-b]pyridine, isoxazolo[3,4-b]pyridine, imidazo[4,5-b]pyridine, and pyrazolo[1,5-a]pyrimidines. Strips of rabbit bladder neck were employed as a predictive assay for antagonism in the human lower tract. Rings of rat aorta were used as a "negative screen" for the test antagonists. Binding to alpha 1-ARs was relatively sensitive to size and electronic features of the arylpiperazine portion of the antagonists and permissive to these features on the heteroaryl carboxamide side. These structure-affinity findings were exploited to produce nicotinamides (e.g. 13ii and 25x) and pyrazolo[3,4-b]pyridines (e.g. 37f and 37y) ligands with nanomolar affinity at the alpha 1-AR subtype prevalent in the human lower urinary tract(pA2 values: 8.8, 10.7, 9.3, and 9.9, respectively) and displaying 2-3 orders of magnitude selectivity over the alpha 1D-AR.

[Immunodiagnosis in 647 suspected clinical cases of toxoplasmosis]

Though Toxoplasma gondii can cause severe pathology in human, in most of the cases it produces only asymptomatic infection. So, it is important to dispose some methods capables to discriminate between acute and chronic infections. An indirect hemagglutination test (IHAT), dye test (DT) and complement fixation test (CFT) were performed in 647 sera from patients suspected of having toxoplasmosis infection. IHAT and DT titer > or = 4 and CFT > or = 5 were considered positive. Titers were classified as follows: low (4-16), median (64-512) and high (> or = 1000) for IHAT and DT. The pathologies for demanding these serological tests were: adenopathies (58), nephropathies (72), neuropathies (30), obstetrical problems (65), opthalmopathies (147), AIDS (237) and miscellaneous (37). Global positivity of 49.5% and 4.5% for IHAT/DT and CFT respectively were found. The positivity for the different groups were: adenopathies (48.3% and 13.8%), nephropathies (43.1% and 1.4%), neuropathies (26.7% and 3.3%), obstetrical problems (40.0% and 0.0%), ophthalmopathies (59.9% and 8.2%), AIDS (52.1% and 2.5%) and miscellaneous (40.5% and 2.7%) for IHAT/DT and CFT respectively. Low and median titers for IHAT/DT were found in 81.3% of cases. A high agreement in frequency of concordant and discordant titers of IHAT/DT and CFT, indicating a recent or acute infection was observed. This fact was more relevant in adenopathies, ophthalmopathies (uveitis) and AIDS groups.

Neutrophil superoxide and hydrogen peroxide production in patients with acute liver failure

Defects in superoxide and hydrogen peroxide production may be implicated in the high incidence of bacterial infections in patients with acute liver failure (ALF). In the present study, oxygen radical production in patients with ALF due to paracetamol overdose was compared with that of healthy volunteers. Neutrophils from 14 ALF patients were stimulated via the complement receptors using zymosan opsonized with ALF or control serum. Superoxide and hydrogen peroxide production by ALF neutrophils stimulated with zymosan opsonized with ALF serum was significantly reduced compared with the control subjects (P < 0.01). This defect persisted when zymosan opsonized by control serum was used (P < 0.05). Superoxide and hydrogen peroxide production in neutrophils stimulated with formyl-methionyl-leucyl-phenylalanine (fMLP) from a further 18 ALF patients was unaffected compared with control neutrophils. Serum C3 complement levels were significantly reduced in ALF patients compared with control subjects (P < 0.0005). These results demonstrate a neutrophil defect in ALF due to paracetamol overdose, that is complement dependent but independent of serum complement, possibly connected to the complement receptor.

Repertoire cloning of lupus anti-DNA autoantibodies

To investigate the autoantibody repertoire associated with SLE, we have created phage display IgG Fab libraries from two clinically active SLE patients and from the healthy identical twin of one of these patients. The libraries from the lupus discordant twins were found to both include unusually large representations of the V(H)5 gene family. By panning with DNA, the SLE libraries each yielded IgG anti-double-stranded (ds) DNA autoantibodies, which are characteristic of lupus disease. These included a V(H)5 autoantibody from the affected twin, that has a targeted cluster of mutations that potentially improves binding affinity. The recovered IgG anti-dsDNA autoantibodies expressed the same idiotypes associated with the in vivo IgG anti-dsDNA response of the respective SLE donor. Heavy-light chain shuffling experiments demonstrated a case in which the in vitro creation of anti-dsDNA binding activity required restrictive pairing of a heavy chain with Vlambda light chains similar to those in circulating anti-dsDNA autoantibodies. By contrast, IgG anti-ds autoantibodies could not be recovered from the library from the healthy twin, or from shuffled libraries with heavy chains from the healthy twin. These repertoire analyses illustrate how inheritance and somatic processes interplay to produce lupus-associated IgG autoantibodies.

Seroepidemiology of human toxoplasmosis in Chile

A series of already published and unpublished seroepidemiological surveys for toxoplasmosis, carried out in Chile in 1982-1994, is reviewed, expanded and analyzed. The surveys included 76,317 apparently healthy individuals of different ages (0.57% of the country's total population), from 309 urban and rural-periurban localities. Urban groups were integrated by blood donors, delivering mothers and middle grade schoolchildren, while rural-periurban individuals corresponded to unselected family groups. Blood samples were collected in filter paper. The presence of antibodies to Toxoplasma gondii was determined by the indirect hemagglutination test (IHAT), titers > or = 16 were considered positive. The test resulted positive in 28,124 (36.9%) of the surveyed people. Two hundred and six (0.3%) individuals presented IHAT titers > or = 1000, probably corresponding to acute or reactivated infections. A progressive increase of positive IHAT from northern to southern regions of the country was noted, phenomenon probably related to geographical conditions and to a higher production and consumption of different types of meat in the latter regions. It is postulated that ingestion of T gondii cysts by humans is epidemiologically as important as ingestion of oocysts. The result presented stress the epidemiological importance of toxoplasmosis in humans, and warn about eventual implications in immunocompromised patients and in transplacental transmission, organ transplants and transfusions.

[Diagnosis of human neurocysticercosis by ELISA-IgG using a purified antigen]

An analysis of immunodiagnosis data for human neurocysticercosis (NC) by ELISA-IgG, complement fixation test (CFT) and indirect hemagglutination test (IHAT) in 67 serum samples and 54 cerebrospinal fluids (CSF) from confirmed cases of different hospitals from the Metropolitan Area of Santiago, Chile, was performed. The cut-off value was determined by using serum samples from 60 apparently healthy persons, whose absorbance values were the mean plus three standard deviations. The sensitivity of ELISA was 97.0% and 100% for serum samples and CSF respectively. This assay was considered of statistical significance (p < 0.05) when it was compared with CFT. Specificity was established by testing a purified antigen over 109 different helminthiasis serum samples, 185 neurological affections other than NC and 60 control samples. A 98.3% of global specificity was found. The use of ELISA-IgG and a purified antigen in the approach of immune diagnosis of NC is considered a useful assay, particularly if it is performed on paired serum/CSF samples.

Alpha-1,4-glucosidase activity and the presence of germinal epithelium cells in the semen for differential diagnosis of obstructive and nonobstructive azoospermia

Among azoospermics, the activity of seminal alpha-glucosidase (alpha G) is low in obstruction (OBS) cases, but there is no agreement regarding its value in others. With the hypothesis that a more marked decrease in alpha G activity occurs in OBS than in spermatogenesis arrest (SA), the enzyme was measured in the following groups: (1) vasectomized males (n = 15), (2) azoospermics with OBS (n = 7), (3) azoospermics with SA (n = 11), and (4) fertile males (n = 15). Patients within groups 2 and 3 had a testicular volume > or = 15 mL, no clinical evidence of abnormal epididymis, normal serum gonadotropins, and histological diagnosis. alpha G activities (mU/g protein, means +/- SD) by group were (1) 131 +/- 60, (2) 312 +/- 186, (3) 728 +/- 303, and (4) 1176 +/- 374. All between-group differences were significant (t test, p < .01), except for groups 1 vs. 2 comparison (.05 > p > .01). These results support the notion that SA is associated with a decrease in alpha G that is less marked that seen in OBS. The search for germinal epithelium cells in semen also allows discrimination between these two azoospermic groups.

[Epidemiology of Chagas disease in Chile. Frequency of human Trypanosoma cruzi infection by age groups and regions]

Chagas' disease is endemic in rural-periurban sections of the northern half of Chile which includes the first seven political-administrative regions of the country (18 degrees 30'-34 degrees 36' South lat.). Data concerning to the results of an indirect hemagglutination test for Chagas' disease performed to 15,418 rural-periurban and 45,119 urban inhabitants fron the chagasic endemic regions are presented. Migrations from rural-periurban to urban areas have contributed to the dissemination of Trypanosoma cruzi infection. General rates of infection for rural-periurban (r-p) and urban (u) sections were 16.7% and 1.9% respectively. The higher prevalence rates were detected in Region III with 27.2% (r-p) and 3.9 (u) and Region IV with 24.7% (r-p) and 3.5% (u), while the lower prevalence rates corresponded to Region VI with 7.0% (r-p) and 0.8% (u). Serological positivity increased parallelly with age in all regions.

[Diagnostic valve of ELISA-IgG for trichinosis using Melcher's antigen]

An enzyme-linked immunosorbent assay (ELISA) for trichinosis using a Melcher's antigen was developed for the detection of IgG antibodies in 41 serum samples from patients confirmed or suspected to have trichinosis by strong clinical and epidemiological evidences. ELISA- IgG was compared with a precipitin test (PT), a bentonite floculation test (BFT) and an indirect hemagglutination test (IHAT). The cut-off value was determined using serum samples from 67 apparently healthy persons employing two serum dilutions (1:100 and 1:500) with three standard deviations (SD). The sensitivity of ELISA- IgG was 97.6% and 95.2% using serum dilutions of 1:100 and 1:500 respectively, whereas the values for the other tests were: PT (92.7%), BFT (63.4%) and IHAT(85.4%). According to MacNemar test, ELISA-IgG did not present statistical significance (p > 0.05) compared with PT and IHAT, whereas all of them were different compared with BHT (p > 0.01). In order to find out the specificity of ELISA-IgG, additional 124 serum samples from individuals with other parasitoses, such as cysticercosis (31), fascioliasis (17), hydatidosis (51) and toxocariasis (25) were also tested. ELISA-IgG presented a specificity of 99.5% with both serum dilutions. The positive predictive values were 97.6 and 97.5%, whereas the negative one were 99.5 and 99.0% for 1:100 and 1:500 serum dilutions respectively. The use of ELISA-IgG and Melcher's antigen in the diagnosis of human trichinosis is discussed.

Patch-clamp study of vascular plant chloroplasts: ion channels and photocurrents

This article presents direct measurements of large-conductance cation channel (G = 730 pS in 100/50 mM KCl; PK+/PCl- = 2.8) and light-induced current (photocurrent) in chloroplasts from C4 plants, Amaranthus hybridus and Zea mays, using the conventional patch-clamp technique. It was shown that preillumination of chloroplast gave rise to a fast decaying transient (tau approximately equal to 6 ms) in the light-induced current for the second and following light pulses. This transient increase of photocurrent was interpreted as a consequence of photoreducing of the redox pool between photosystems.

[Epidemiology of trichinosis in Chile. Prevalence study by immunodiagnostic reactions]

In the period 1983-1994 a series of seroepidemiological surveys, by using immunodiagnostic tests for trichinosis, was carried out in 138 localities and health institutions from the 13 regions of the country. Thus, a total of 12,882 randomly selected persons, with different sex and age distribution, were submitted to precipitin test and indirect hemagglutination test for trichinosis. One hundred and ninety one (1.5%) persons resulted positive for trichinosis. Higher rates of infection were observed in central and southern Chile. No differences of positivity, according to age sex, but constant increase parallel to age of the individual were detected. The general prevalence rate of infection of 1.5% is in a reasonable accordance with the prevalence of 2.0% found in human corpses in 1992.

[Trichinosis outbreak in Purranque County, X Region, Chile. October-November, 1992]

An outbreak of trichinosis occurred in Purranque County, X Region, Chile, between october and november of 1992, which involved 36 persons. The incubation period, determined by the clinical picture and laboratory assays, fluctuated between 10 and 12 days. Myalgias (88.9%) and palpebral oedema (86.1%), were the most important symptoms, followed by fever (44.4%) and headache (33.3%). Eosinophils count ranged from two to 42% the first week, and this value raised to 55% the second week of the outbreak. Anti-Trichinella spiralis antibodies were determined by some serological tests such as: precipitin test (PT), bentonite flocculation test (BFT) and indirect hemagglutination test (IHAT) in sera from 28 patients at the beginning of the outbreak. PT was positive in 46.4% of the cases, followed by IHAT (21.4%) and BFT (3.6%). After 15 days, the three tests were performed in sera from 12 patients. At that time, the positivity was elevated in all of them: PT (100.0%), BFT (66.7%) and IHAT (91.7%). It is believed that the outbreak had its origin in infected pork meat that was consumed raw or insufficiently cooked without a previous veterinary inspection.

[Evaluation of ELISA-IgG test using a purified antigen in the diagnosis of human hydatidosis]

An enzyme-linked immunosorbent assay (ELISA) was developed for the detection of IgG antibodies to purified sheep hydatic cyst fluid antigen in 56 sera of confirmed cases of hydatidosis. The cut-off value was determined using serum samples from 80 healthy persons, employing two serum dilutions (1:100 and 1:500) with two and three standard deviations (SD). This assay was compared with the indirect hemagglutination test (IHAT). The sensitivity of ELISA-IgG was 94.3% for hepatic cysts and 92.9% for pulmonary cysts, whereas the values for IHAT were 77.1 and 64.3% respectively. According to Mac Nemar test, both method presented statistical significance (p < 0.05). In order to find out the specificity, additional 70 serum samples from individuals with other parasitoses, such as cysticercosis (30), trichinosis (26) and fascioliasis (14) were also tested. IHAT presented a specificity of 92.7% and for ELISA-IgG the specificity using a cut-off of mean + 3 SD was 99.3 and 100.0% with sera dilution of 1:100 and 1:500 respectively when a cut-off of mean + 2 SD was considered, we found a specificity of 91.3 and 97.3% for 1:100 and 1:500 dilutions. The use of ELISA-IgG and purified antigen in the diagnosis of human hydatidosis is discussed.

Acute fatty liver of pregnancy: a clinical study of 12 episodes in 11 patients

Twelve episodes of acute fatty liver of pregnancy (AFLP) were diagnosed in 11 patients during the past 18 years in a general hospital in Santiago, Chile, with a prevalence of 1 per 15,900 deliveries. Acute fatty liver of pregnancy started between the 31st and 38th weeks of pregnancy, with malaise, vomiting, jaundice, and lethargy as the main clinical manifestations. Polydipsia (in nine episodes) and skin pruritus (in seven episodes) were unusual clinical findings. In two patients, pruritus started two and four weeks before AFLP, suggesting that an intrahepatic cholestasis of pregnancy preceded AFLP in those patients. Considering the current prevalence of both diseases in Chile, their association should be considered fortuitous. In another patient, two consecutive pregnancies were affected by AFLP, raising to three the number of reported patients with recurrent AFLP. In 11 episodes, liver biopsies supported the diagnosis of AFLP by showing small and midsized vacuolar cytoplasmic transformation as the most prominent histopathological feature. Positive intracellular fat staining was found in the four samples analysed. Studies by electron microscopy showed megamitochondria with paracrystalline inclusions in four samples. All the mothers survived, but fetal mortality was 58.3%. Several extrahepatic complications delayed maternal recovery for up to four weeks after delivery. This study confirms an improvement in maternal prognosis in AFLP, discusses the possibility of an epidemiological association with intrahepatic cholestasis of pregnancy, and increases the number of patients reported with recurrent AFLP.

[Comparison of the frequency of electrocardiographic changes in groups of apparently healthy persons with a positive serology for Chagas' disease, for toxoplasmosis or for both parasitoses]

In order to compare the frequency of electrocardiographical abnormalities among apparently healthy persons with Trypanosoma cruzi and Toxoplasma gondii infections, electrocardiogram (EKG) and the corresponding indirect hemagglutination tests (IHAT) were performed to 13,444 randomly selected rural and suburban inhabitants from the seven first regions of Chile which are located in the geographic area of distribution of Chagas' disease in the country. The IHAT for each parasitosis resulted positive (titers > or = 1:16) for Chagas' disease alone in 1,289 (9.6%), for toxoplasmosis alone in 3,519 (26.2%) and for the two infections in 994 (7.4%). EKG abnormalities of all type (AAT) and suggestive of a chagasic etiology (ASChE) were found in 18.5 and 8.3% respectively of the T. cruzi infected group, in 10.9 and 3.2% of the T. gondii infected group, in 18.9 and 4.8% of the group simultaneously infected by the two parasites, whereas AAT and ASChE were found in 7.9 and 1.8% of the IHAT negative group. All the corresponding percentage differences between abnormal EKG had a statistical significance (p < 0.05). Besides the increasing of the IHAT positivity, for each infection parallels to the age grouping of the studied persons, a similar situation was observed in the frequence of the AAT and ASChE mainly among people aged > or = 50 years. As T. cruzi and T. gondii infections sometimes isoletely adopt a high virulence and overlap in a proportion higher than 43.0% in Chagas' disease endemic areas, it is advisable to consider these etiologic possibilities in the presence of patients with a myocardiopathy of dubious interpretation, particularly when AIDS is involved.

[Frequency of electrocardiographic alterations in apparently healthy persons with indirect hemagglutination reaction positive for toxoplasmosis]

An indirect hemagglutination test (IHAT) for toxoplasmosis and electrocardiogram (EKG) were performed to 11,161 apparently healthy inhabitants with negative IHAT for Chagas' disease, from 259 rural and periurban localities sited in the first seven regions of Chile (geographic area of distribution of Chagas' disease in the country). The age of the 11,161 examined people ranged between 5 and 94 years, being 4,518 males and 6,643 females. The IHAT for toxoplasmosis was considered positive with titers > or = 1:16. This test resulted positive in 3,519 (31.1%) persons (30.8% in males and 32.0% in females). Positivity of the IHAT increased from 21.2%, in the youngest group (< 10 years) up to 46.9% in the oldest group (> or = 60 years). Different types of EKG alterations were observed in 10.9% of the IHAT positive individuals and in 7.9% of the IHAT negative ones. In both groups the percentages of altered EKG increased parallel with age. The overall difference of percentages of altered EKG in IHAT positive and IHAT negative persons has a statistical significance with p < 0.001. This study suggest the convenience to consider toxoplasmosis as a cause of chronic myocardiopathy in epidemiological studies on Chagas' disease, because a possible Toxoplasma gondii infection may contribute to overincrease the magnitude of the impact of Trypanosoma cruzi in the generation of the quoted myocardiopathy.

[Electrocardiographic alterations in persons with a positive serology for toxoplasmosis]

To each of 11,161 randomly taken people from urban and peri-urban localities of the first seven regions of Chile (geographic area of distribution of Chagas' disease in the country), with negative serology for Chagas' disease, an indirect hemagglutination test (IHAT) for toxoplasmosis and an EKG were practiced. The IHAT for toxoplasmosis resulted positive in 3,519 individuals (31.5%). The EKG showed alterations in 10.9% of the IHAT positive individuals and in 7.9% of the IHAT negative ones. This difference between the proportion of altered EKG in IHAT positive people and altered EKG in those with negative IHAT is statistically significative with p < 0.001. These results suggest the convenience of considering toxoplasmosis as a cause of chronic myocardiopathy in epidemiological studies on Chagas' disease, since not discard the presence of Toxoplasma gondii infection should overvaluete the magnitude of the impact of Trypanosoma cruzi in the genesis of such a myocardiopathy.

[Chagasic infection in blood donors from hospitals in endemic regions of Chile (1982-1987). Epidemiological impact of the problem]

Chagas' disease, produced by Trypanosoma cruzi and transmitted by hematophagous triatomine bugs, exists in the Western Hemisphere from the south-western United States to central Chile and Argentina. It exists in rural and periurban sections of the northern half of Chile, with a prevalence of 16.9%. Constant rural-urban migrations have contributed to its spreading to urban sections. In order to investigate the impact of these migrations on the population susceptible of being blood donors and the probable increasing of the risk of T. cruzi transmission by blood transfusion, epidemiological surveys were carried out in donors from 22 hospitals located in the northern half of Chile. By means of an indirect hemagglutination test for Chagas' disease 16,841 blood donors were examined, arising a 2.7% of positivity, percentage that permitted to estimate that 126,477 potential blood donors infected with T. cruzi should be in the urban sections studied. These facts strengthen the need that serology for Chagas' disease must be routinely performed in endemic regions of the country, to adopt or reinforce the pertinent preventive measures.

[Seroepidemiological study of human hydatidosis and trichinosis, with the indirect hemagglutination reaction, in San Juan de la Costa County. Osorno, X Region, Chile. 1990-1991]

San Juan de la Costa County (40 degrees 45' South lat., 73 degrees 19' West long.) is located in the Osorno province, South of Chile. Its population is 8,486 inhabitants. The basic economic activities are agriculture, cattle raising, timber production and manufacture of wood and coal. According to official reports, the incidence of human hydatidosis and trichinosis in this locality in 1989 were 24 and 59 per 100,000 respectively. In order to contribute to a better knowledge of the epidemiology of human hydatidosis and trichinosis in San Juan de la Costa County, an indirect hemagglutination test (IHAT) for these parasitoses was performed to 511 randomized people. Nine (1.8%) individuals resulted positive for hydatidosis and twenty four (4.7%) were positive for trichinosis. Some considerations on the corresponding prophylactic measures are proposed.

Synchronization of tumor and normal cells from G1 to multiple cell cycles by lovastatin

Synchronization of mammalian cells is essential for investigations involving cell proliferation. A simple method for obtaining synchrony in all types of cells, through several cycles and with minimal overall metabolic perturbations, has not yet been available. We describe a procedure for synchronizing normal as well as tumor cells reversibly in the G1 phase of the cell cycle using Lovastatin, an inhibitor of 3-hydroxy-3-methylglutaryl-coenzyme A reductase. This method of synchronization was successful with all cell lines tested, including normal and tumor cells of mouse, hamster, and human origins. For example, when MCF-7 human breast cancer cells were synchronized with Lovastatin and released by the addition of mevalonic acid (the product of the reaction catalyzed by 3-hydroxy-3-methylglutaryl-coenzyme A reductase), 3 phases of accelerated thymidine incorporation into DNA corresponding to 3 S phases of the cell cycle occurred during a 90-h period of cell replication. Thymidine incorporation was decreased to less than or equal to 4% during the initial lag of 18 h before the first S phase, and maximum incorporation was then achieved after only 6 h. The antibody Ki-67, which detects a nuclear antigen associated with proliferation, was present in cells arrested with Lovastatin. This fact, together with the lack of thymidine incorporation during the initial lag time, indicates that the cells were arrested in the G1 and not in the G0 phase of the cell cycle. Furthermore, in synchronized tumor-derived human breast epithelial cells, histone H4 RNA was low after Lovastatin release and increased with the onset of DNA synthesis. Concomitant synthesis of DNA and histone H4 RNA expression could be observed for 2 cycles. Minimal perturbations of general metabolic functions occurred since the rate of RNA, protein, and initial DNA synthesis were unaffected by Lovastatin, as evidenced by [3H]uridine, [3H]leucine, and initial [3H]thymidine incorporation. Finally, while the Lovastatin-induced synchronization was overcome by mevalonic acid, addition of squalene or cholesterol-ethanol had no such effect. Thus, Lovastatin appears to prevent formation of an early intermediate in the cholesterol pathway that is essential for progression of cells through early G1 phase.

[Overview of the epidemiology of Chagas' disease in Chile]

Chile is a long and narrow country located in the south western coast of South America. Chagas' disease exists in the seven first (18 degrees 30'-34 degrees 36' South lat.) of the total of thirteen administrative regions of the country. In the 1982-1990 period a series of studies considering different epidemiological aspects of this parasitic zoonosis has been carried out with the following results: 5,601 rural of periurban dwellings were surveyed for the presence of Triatoma infestans (the most important and almost exclusive vector of Trypanosoma cruzi in Chile). 37.4% of the dwellings were infested according to the inhabitants and 29.4% were found infested according to the presence of tracks or insects captured. In 659 (17.2%) out of 3,822 T. infestans captured and examined T. cruzi was found in their abdominal contents. The most common sources of T. infestans feeding were mammals (89.0%), including man, and birds (9.5%). An indirect hemagglutination test (IHAT) for Chagas' disease, a very sensitive and specific reaction, was performed to 5,050 domestic mammals, resulting positive 7.9% of cats, 7.0% of dogs, 7.0% of goats, 4.9% of sheep and 4.1% of rabbits. 2,579 (16.9%) out of 15,418 persons were positive for the IAHT for Chagas' disease. The rates of infection were rather similar in males (17.5%) and females (16.2%) with an increase in infection rates in accordance with increase of age of individuals. The overall frequency of ECG abnormalities in positive IHAT persons was 18.7% against 8.8% in those with negative IHAT, whereas ECG abnormalities considered as suggestive of a chagasic etiology were 6.8% and 2.2% respectively. The esophageal motility in 311 persons with a positive IHAT and in 150 with a negative IHAT was found altered in 42.8% and 18.7% respectively. In the corresponding urban sectors of the 7 regions mentioned 2.7% of blood donors, 2.3% of delivering mothers, 2.6% of newborns and 0.6% of school children had positive IHAT. 646 chagasic women and 709 non-chagasic women in their reproductive span of life, and the products of the pregnancies that they had in a 6-year period were followed-up. No significant differences were found neither in the number nor in the evolution of pregnancies in both groups of mothers. Xenodiagnosis of children from chagasic mothers resulted positive in 6.3-8.9%, showing the transmission of T. cruzi by the placental route. Recently, 3 cases of congenital Chagas' disease of second generation have been demonstrated.(ABSTRACT TRUNCATED AT 400 WORDS)

[Chronic hemodialysis in children]

The clinical features of eight patients, four females, aged 4 to 15 years under chronic hemodialysis for terminal renal failure (creatinine clearance 10 ml.min.1,73 m2 or less) are reported. Initial diseases were Alport syndrome, systemic lupus erythematosus, chronic glomerulonephritis (n = 2), bilateral polycystic kidney, prune belly syndrome and reflux nephropathy (n = 2). Distal vascular approach by means of arteriovenous fistulas was preferred for these patients and the kinetic urea model was used to evaluate the performance of the procedure. Patients required nine to twelve hours of hemodialysis per week for optimal results. Mean weight decreases of 1 to 3 kg and reductions in blood urea nitrogen and serum potassium of 40 mg.dl and 2,5 mEq.1, respectively, were observed. The main complications of hemodialysis were the disequilibrium syndrome, infections at the site of insertion of the arteriovenous fistulae and congestive heart failure. Three patients were submitted to renal transplantation with live donors homografts: one died and the other two remain alive but under chronic hemodialysis. Five children are attending school regularly, and two of them are waiting a kidney donor for transplantation. Despite encouraging results chronic hemodialysis in children constitutes only primary supportive therapy prior to renal transplantation.