Fungal Planet description sheets: 1550-1613

Novel species of fungi described in this study include those from various countries as follows: Argentina, Neocamarosporium halophilum in leaf spots of Atriplex undulata. Australia, Aschersonia merianiae on scale insect (Coccoidea), Curvularia huamulaniae isolated from air, Hevansia mainiae on dead spider, Ophiocordyceps poecilometigena on Poecilometis sp. Bolivia, Lecanora menthoides on sandstone, in open semi-desert montane areas, Sticta monlueckiorum corticolous in a forest, Trichonectria epimegalosporae on apothecia of corticolous Megalospora sulphurata var. sulphurata, Trichonectria puncteliae on the thallus of Punctelia borreri. Brazil, Catenomargarita pseudocercosporicola (incl. Catenomargarita gen. nov.) hyperparasitic on Pseudocercospora fijiensis on leaves of Musa acuminata, Tulasnella restingae on protocorms and roots of Epidendrum fulgens. Bulgaria, Anthracoidea umbrosae on Carex spp. Croatia, Hymenoscyphus radicis from surface-sterilised, asymptomatic roots of Microthlaspi erraticum, Orbilia multiserpentina on wood of decorticated branches of Quercus pubescens. France, Calosporella punctatispora on dead corticated twigs of Aceropalus. French West Indies (Martinique), Eutypella lechatii on dead corticated palm stem. Germany, Arrhenia alcalinophila on loamy soil. Iceland, Cistella blauvikensis on dead grass (Poaceae). India, Fulvifomes maritimus on living Peltophorum pterocarpum, Fulvifomes natarajanii on dead wood of Prosopis juliflora, Fulvifomes subazonatus on trunk of Azadirachta indica, Macrolepiota bharadwajii on moist soil near the forest, Narcissea delicata on decaying elephant dung, Paramyrothecium indicum on living leaves of Hibiscus hispidissimus, Trichoglossum syamviswanathii on moist soil near the base of a bamboo plantation. Iran, Vacuiphoma astragalicola from stem canker of Astragalus sarcocolla. Malaysia, Neoeriomycopsis fissistigmae (incl. Neoeriomycopsidaceae fam. nov.) on leaf spots on flower Fissistigma sp. Namibia, Exophiala lichenicola lichenicolous on Acarospora cf. luederitzensis. Netherlands, Entoloma occultatum on soil, Extremus caricis on dead leaves of Carex sp., Inocybe pseudomytiliodora on loamy soil. Norway, Inocybe guldeniae on calcareous soil, Inocybe rupestroides on gravelly soil. Pakistan, Hymenagaricus brunneodiscus on soil. Philippines, Ophiocordyceps philippinensis parasitic on Asilus sp. Poland, Hawksworthiomyces ciconiae isolated from Ciconia ciconia nest, Plectosphaerella vigrensis from leaf spots on Impatiens noli-tangere, Xenoramularia epitaxicola from sooty mould community on Taxus baccata. Portugal, Inocybe dagamae on clay soil. Saudi Arabia, Diaporthe jazanensis on branches of Coffea arabica. South Africa, Alternaria moraeae on dead leaves of Moraea sp., Bonitomyces buffels-kloofinus (incl. Bonitomyces gen. nov.) on dead twigs of unknown tree, Constrictochalara koukolii on living leaves of Itea rhamnoides colonised by a Meliola sp., Cylindromonium lichenophilum on Parmelina tiliacea, Gamszarella buffelskloofina (incl. Gamszarella gen. nov.) on dead insect, Isthmosporiella africana (incl. Isthmosporiella gen. nov.) on dead twigs of unknown tree, Nothoeucasphaeria buffelskloofina (incl. Nothoeucasphaeria gen. nov.), on dead twigs of unknown tree, Nothomicrothyrium beaucarneae (incl. Nothomicrothyrium gen. nov.) on dead leaves of Beaucarnea stricta, Paramycosphaerella proteae on living leaves of Protea caffra, Querciphoma foliicola on leaf litter, Rachicladosporium conostomii on dead twigs of Conostomium natalense var. glabrum, Rhamphoriopsis synnematosa on dead twig of unknown tree, Waltergamsia mpumalanga on dead leaves of unknown tree. Spain, Amanita fulvogrisea on limestone soil, in mixed forest, Amanita herculis in open Quercus forest, Vuilleminia beltraniae on Cistus symphytifolius. Sweden, Pachyella pulchella on decaying wood on sand-silt riverbank. Thailand, Deniquelata cassiae on dead stem of Cassia fistula, Stomiopeltis thailandica on dead twigs of Magnolia champaca. Ukraine, Circinaria podoliana on natural limestone outcrops, Neonematogonum carpinicola (incl. Neonematogonum gen. nov.) on dead branches of Carpinus betulus. USA, Exophiala wilsonii water from cooling tower, Hygrophorus aesculeticola on soil in mixed forest, and Neocelosporium aereum from air in a house attic. Morphological and culture characteristics are supported by DNA barcodes. Citation: Crous PW, Costa MM, Kandemir H, et al. 2023. Fungal Planet description sheets: 1550-1613. Persoonia 51: 280-417. doi: 10.3767/persoonia.2023.51.08.

Fusarium and allied fusarioid taxa (FUSA). 1

Seven Fusarium species complexes are treated, namely F. aywerte species complex (FASC) (two species), F. buharicum species complex (FBSC) (five species), F. burgessii species complex (FBURSC) (three species), F. camptoceras species complex (FCAMSC) (three species), F. chlamydosporum species complex (FCSC) (eight species), F. citricola species complex (FCCSC) (five species) and the F. concolor species complex (FCOSC) (four species). New species include Fusicolla elongata from soil (Zimbabwe), and Neocosmospora geoasparagicola from soil associated with Asparagus officinalis (Netherlands). New combinations include Neocosmospora akasia, N. awan, N. drepaniformis, N. duplosperma, N. geoasparagicola, N. mekan, N. papillata, N. variasi and N. warna. Newly validated taxa include Longinectria gen. nov., L. lagenoides, L. verticilliforme, Fusicolla gigas and Fusicolla guangxiensis. Furthermore, Fusarium rosicola is reduced to synonymy under N. brevis. Finally, the genome assemblies of Fusarium secorum (CBS 175.32), Microcera coccophila (CBS 310.34), Rectifusarium robinianum (CBS 430.91), Rugonectria rugulosa (CBS 126565), and Thelonectria blattea (CBS 952.68) are also announced here. Citation: Crous PW, Sandoval-Denis M, Costa MM, Groenewald JZ, van Iperen AL, Starink-Willemse M, Hernández-Restrepo M, Kandemir H, Ulaszewski B, de Boer W, Abdel-Azeem AM, Abdollahzadeh J, Akulov A, Bakhshi M, Bezerra JDP, Bhunjun CS, Câmara MPS, Chaverri P, Vieira WAS, Decock CA, Gaya E, Gené J, Guarro J, Gramaje D, Grube M, Gupta VK, Guarnaccia V, Hill R, Hirooka Y, Hyde KD, Jayawardena RS, Jeewon R, Jurjević Ž, Korsten L, Lamprecht SC, Lombard L, Maharachchikumbura SSN, Polizzi G, Rajeshkumar KC, Salgado-Salazar C, Shang Q-J, Shivas RG, Summerbell RC, Sun GY, Swart WJ, Tan YP, Vizzini A, Xia JW, Zare R, González CD, Iturriaga T, Savary O, Coton M, Coton E, Jany J-L, Liu C, Zeng Z-Q, Zhuang W-Y, Yu Z-H, Thines M (2022). Fusarium and allied fusarioid taxa (FUSA). 1. Fungal Systematics and Evolution 9: 161-200. doi: 10.3114/fuse.2022.09.08.

Selective Laser Melting of Ti6Al4V sub-millimetric cellular structures: Prediction of dimensional deviations and mechanical performance

Ti6Al4V sub-millimetric cellular structures arise as promising solutions concerning the progress of conventional orthopedic implants due to its ability to address a combination of mechanical, physical and topological properties. Such ability can improve the interaction between implant materials and surrounding bone leading to long-term successful orthopedic implants. Selective Laser Melting (SLM) capability to produce high quality Ti6Al4V porous implants is in great demand towards orthopedic biomaterials. In this study, Ti6Al4V cellular structures were designed, modeled, SLM produced and characterized targeting orthopedic implants. For that purpose, a set of tools is proposed to overcome SLM limited accuracy to produce porous biomaterials with desired dimensions and mechanical properties. Morphological analyses were performed to evaluate the dimensional deviations noticed between the model CAD and the SLM produced structures. Tensile tests were carried out to estimate the elastic modulus of the Ti6Al4V cellular structures. The present work proposes a design methodology showing the linear correlations found for the dimensions, the porosity and the elastic modulus when comparing the model CAD designs with Ti6Al4V structures by SLM.

The family of a child with chronic illness and its social relationships

Introduction

The family life of a child with chronic illness is marked by several determinants and demands for care. Within that context, the greater the support received, the greater the resources available to face vulnerability, and to respond positively to guidance and care.

Objectives

describing the social network of families of children with chronic illness, and understanding the meaning of the relationship of the family caregiver with the members of his/her social network.

Methods

Qualitative research with nineteen relatives of children with chronic diseases at a rehabilitation center in the city of Rio de Janeiro, Brazil. The theoretical framework of Sanicola's social network was used. Data were collected in November 2019 by semi-structured interviews and analyzed using the content analysis technique. The research was approved by the Ethics and Research Committee of the participating institutions. The social network map showed the presence of few members and mothers as the main caregivers. The main problems among children were: autism, Down syndrome, cognitive disorders and cerebral palsy. Among the most involved people with the caregivers, friends, sisters and grandparents stood out as the ones who offered material, financial and emotional support. Rehabilitation unit support (secondary level) and dissatisfaction with the primary health unit were mentioned.

Conclusions

The social network of children with chronic illness is a small family network marked by social vulnerability and the female gender as responsible for care. It is noteworthy that the weakness in the relationship with health professionals at primary care level can compromise care continuity. Therefore, it is recommended to professionals to know the social network of the clientele served, as well as interacting and strengthening this network in order to provide more effective actions for health protection, rehabilitation and supported self-care strategies.

Key messages

Chronic childhood disease is a major public health problem. Being aware of social network favors the implementation of more actions toward health protection, rehabilitation and supported self-care strategies.

Tribological behavior of bioactive multi-material structures targeting orthopedic applications

The following study proposes a multi-material solution in which Ti6Al4V cellular structures produced by Selective Laser Melting are impregnated with bioactive materials (hydroxyapatite or β-tricalcium phosphate) using press and sintering technique. To assess the tribological response of these structures, an alumina plate was used as a counterpart in a flat-on-flat reciprocating sliding test. Ti6Al4V cellular structures impregnated with bioactive materials displayed the highest wear resistance when compared with the unreinforced structures. Among the bioactive structures, Ti6Al4V cellular structures impregnated with βTCP were the ones with higher wear resistance, having the lowest weight loss. Hence, these structures are promising multifunctional solutions for load-bearing applications by gathering suitable mechanical properties (strength and stiffness); bioactive properties and in addition an improved wear performance.

Moraxella bovis, Moraxella ovis and Moraxella bovoculi: biofilm formation and lysozyme activity

AIMS

This study aimed to verify the formation of biofilms by Moraxella bovis, Moraxella ovis and Moraxella bovoculi isolates from ruminants. In addition, the lysozyme activity against the isolates of M. bovis, M. ovis and M. bovoculi in free form and in biofilms was determined.

METHODS AND RESULTS

In this study, 54 isolates of Moraxella sp. obtained from bovine and ovine clinical samples were evaluated in vitro for capacity of biofilm formation and lysozyme susceptibility in planktonic and sessile cells. In addition, biofilms produced by four Moraxella sp. isolates were visualized under scanning electron microscope (SEM). It was possible to demonstrate, for the first time, the ability to form biofilms by M. ovis and M. bovoculi. The isolates of Moraxella sp. have the capacity to form biofilms in different intensities, varying among weak, moderate and strong. It was verified that the lysozyme shows activity on Moraxella sp. in planktonic form. However, on biofilms there was a reduction in the production, but without impairing its formation, and on consolidated biofilms the lysozyme did not have the capacity to eradicate the preformed biofilms.

CONCLUSIONS

This work shows the capacity of biofilm formation by Moraxella sp. of veterinary importance. The lysozyme susceptibility of Moraxella sp. in planktonic form shows that this enzyme has bacteriostatic activity on this micro-organism and it reduced the production of biofilms.

SIGNIFICANCE AND IMPACT OF THE STUDY

Based on the results, it is possible to infer that the biofilm formation capacity by Moraxella sp. and the resistance to lysozyme concentrations equal to or greater than the physiological levels of the ruminant tear may be linked not only to the capacity to colonize the conjunctiva, but also to remain in this place even after healing of the lesions, being a reservoir of Moraxella sp. in a herd.

Turbot (Scophthalmus maximus) Nk-lysin induces protection against the pathogenic parasite Philasterides dicentrarchi via membrane disruption

P. dicentrarchi is one of the most threatening pathogens for turbot aquaculture. This protozoan ciliate is a causative agent of scuticociliatosis, which is a disease with important economic consequences for the sector. Neither vaccines nor therapeutic treatments are commercially available to combat this infection. Numerous antimicrobial peptides (AMPs) have demonstrated broad-spectrum activity against bacteria, viruses, fungi, parasites and even tumor cells; an example is Nk-lysin (Nkl), which is an AMP belonging to the saposin-like protein (SAPLIP) family with an ability to interact with biological membranes. Following the recent characterization of turbot Nkl, an expression plasmid encoding Nkl was constructed and an anti-Nkl polyclonal antibody was successfully tested. Using these tools, we demonstrated that although infection did not clearly affect nkl mRNA expression, it induced changes at the protein level. Turbot Nkl had the ability to inhibit proliferation of the P. dicentrarchi parasite both in vivo and in vitro. Moreover, a shortened peptide containing the active core of turbot Nkl (Nkl71-100) was synthesized and showed high antiparasitic activity with a direct effect on parasite viability that probably occurred via membrane disruption. Therefore, the nkl gene may be a good candidate for genetic breeding selection of fish, and either the encoded peptide or its shortened analog is a promising antiparasitic treatment in aquaculture.

Effect of HAp and β-TCP incorporation on the tribological response of Ti6Al4V biocomposites for implant parts

Titanium and its alloys have been widely used in many engineering areas due to their properties. Despite having a high implant-tissue osseointegration time, Ti6Al4V has been extensively used in prosthesis and articular implants. To promote a faster bone ingrowth and consequently reduce the implant fixation time, the addition of a bioactive phase to form a biocomposite seems to be an excellent solution. Because of their bioactivity and similarity in composition with the human bone, HAp and β-TCP are two of the most widely used calcium phosphates in biomedical applications. To guarantee a strong adhesion of the previous bioactive materials in the implants surface, samples of Ti6Al4V, Ti6Al4V+HAp (10 vol %) and Ti6Al4V+β-TCP (10 vol %) TCP were processed by the hot pressing technique. Tribological tests against Al₂ O_3, lubricated in PBS at 37°C were carried out on a ball-on-flat reciprocating sliding geometry. Loads in the range of 3 N to 30 N were applied and their effect on the friction behavior and wear resistance of the tested materials was evaluated. Values of the coefficient of friction as well as the wear rate tend to increase with the addition of a bioactive phase to the Ti alloy. Micrographs of the worn surfaces showed that abrasion and plastic deformation are the prevailing wear mechanisms in the studied tribosystems. For biocomposites, particularly in the case of Ti6Al4V+HAp, pull-out of bioactive particle clusters has a determinant role on the tribological response, increasing both the friction coefficient and the specific wear rate. © 2017 Wiley Periodicals, Inc. J Biomed Mater Res Part B: Appl Biomater, 106B: 1010-1016, 2018.

Bioactive materials driven primary stability on titanium biocomposites

The Ti6Al4V alloy constitutes an alternative choice to the most common metal-polymer solutions for total hip arthroplasty (THA) due to good biocompatibility, optimal mechanical properties and high load bearing capacity. However, as Ti6Al4V is not bioactive in its conventional form, hydroxyapatite (HAp) and tricalcium phosphate (TCP) have been widely used as coatings of metal prostheses due to their osteogenic properties and ability to form strong bonds with bone tissue. A promising approach consists in creating a bioactive surface metal matrix composite Ti6Al4V+β-TCP or Ti6Al4V+HAp, obtained by hot pressing (HP) of powders. In this work, the tribological performance of Ti6Al4V+β-TCP and Ti6Al4V+HAp composites is studied to evaluate the frictional response and surface damage representative of prosthesis implantation, key factors in bone fixation. Biocomposites with 10vol% β-TCP and 10vol% Hap, as well as base titanium alloy, were prepared by HP with two surface finishing conditions - polished (Ra=0.3-0.5μm) and sandblasted (Ra=2.1-2.5μm) - for tribological testing against bovine cortical bone tissue. The static friction increases with surface roughness (from 0.20 to 0.60), whereas the kinetic regime follows an inverse trend for the biocomposites. In contrast with current knowledge, this study shows that an implant design solution based on Ti6Al4V+β-TCP or Ti6Al4V+HAp biocomposites with polished surfaces results in an improved primary stability of implants, when compared to traditional rough surfaces. Moreover, it is also expected that the secondary stability will improve due to the adhesion between bone and HAp/β-TCP, increasing the overall stability of the implant.

Musculoskeletal ultrasound in Paediatric Rheumatology: a retrospective analysis

OBJECTIVES

Musculoskeletal Ultrasound (MSK-US) has become increasingly important in the diagnosis and follow-up of children with rheumatic diseases. We describe the experience of a large Portuguese centre and study the added value of MSK-US in the clinical assessment of paediatric rheumatic diseases.

MATERIAL AND METHODS

Patients were observed by assistant Rheumatologists, a clinical diagnosis was assigned and MSK-US requested. 330 MSK-US exams were performed to 222 children with rheumatic inflammatory diseases. The children's ages were between 1 and 18 years (mean=11.7±4.7 years) and 67.6% were female. Synovial membrane proliferation, intra-articular effusion, cartilage abnormalities, erosions and periarticular affections were searched in each joint. Clinical and ultrasonography data were compared.

RESULTS

MSK-US detected synovitis in 100 of 194 exams (51.5%) of patients with that clinical information and in 36 of 136 exams (26.5%) of patients who presented other clinical findings. In those in which MSK-US did not confirm the clinical information of synovitis (94; 48.5%), we detected tenosynovitis/tendinopathy in 13 cases (13.8%) and synovial cyst in four (4.3%). The remaining patients had no ultrasonography changes and MSK-US helped to exclude synovitis. The sensitivity for arthritis clinical assessment was good (73.5%), with modest specificity (51.5%), an accuracy of 60.6% and precision of 51.5%. Ultrasonography synovitis was mostly found in the knee (37.5%), followed by the ankle (22.8%) and hip (10.3%). Overall, 39 exams showed ultrasonographic tenosynovitis/tendinopathy, 15 of which had the same clinical diagnosis. Tenosynovitis/tendinopathy was mostly found in the ankle (59.0%) and knee (23.1%) areas.

CONCLUSIONS

MSK-US is an important aid to clinical evaluation, allowing both the detection and exclusion of joint pathology in children, contributing to a better assessment.

The first characterization of two type I interferons in turbot (Scophthalmus maximus) reveals their differential role, expression pattern and gene induction

Type I interferons (IFNs) are considered the main cytokines directing the antiviral immune response in vertebrates. These molecules are able to induce the transcription of interferon-stimulated genes (ISGs) which, using different blocking mechanisms, reduce the viral proliferation in the host. In addition, a contradictory role of these IFNs in the protection against bacterial challenges using murine models has been observed, increasing the survival or having a detrimental effect depending on the bacteria species. In teleosts, a variable number of type I IFNs has been described with different expression patterns, protective capabilities or gene induction profiles even for the different IFNs belonging to the same species. In this work, two type I IFNs (ifn1 and ifn2) have been characterized for the first time in turbot (Scophthalmus maximus), showing different properties. Whereas Ifn1 reflected a clear antiviral activity (over-expression of ISGs and protection against viral haemorrhagic septicaemia virus), Ifn2 was not able to induce this response, although both transcripts were up-regulated after viral challenge. On the other hand, turbot IFNs did not show any protective effect against the bacteria Aeromonas salmonicida, although they were induced after bacterial challenge. Both IFNs induced the expression of several immune genes, but the effect of Ifn2 was mainly limited to the site of administration (intramuscular injection). Interestingly, Ifn2 but not Ifn1 induced an increase in the expression level of interleukin-1 beta (il1b). Therefore, the role of Ifn2 could be more related with the immune regulation, being involved mainly in the inflammation process.

Septic arthritis: patients with or without isolated infectious agents have similar characteristics

PURPOSE

Septic arthritis can be disabling and life-threatening, requiring prompt diagnosis and treatment. The infectious agent is not always identified in these patients. We revaluate septic arthritis cases discharged from our department, describing the affected population, causative microorganisms and antibiotic therapy used, and characterised differences between patients with and without isolated pathogenic agents.

METHODS

Sixty-eight septic arthritis patients were included in this study. Diagnosis was based on clinical findings, and/or the presence of joint purulent material, and/or bacterial pathogen isolation from joint fluid/synovial membrane/blood cultures and response to antibiotics. Data analysis was performed using SPSS 20.

RESULTS

Patients had a mean age of 61.1 ± 18.8 years, without sex predominance. 26.5 % had an infection ≤ 15 days before septic arthritis diagnosis. Besides previous infection, 57.4 % had ≥ 1 risk factors for septic arthritis, most commonly pharmacological immunosuppression (20.6 %), diabetes mellitus type 2 (19.1 %) and rheumatoid arthritis (17.6 %). The knee was the most often affected (54.3 %). Only 39.7 % presented fever from clinical onset until hospital admission (mean 13.4 ± 18.9 days). Leucocytosis was present in 45.6 % of patients, elevated erythrocyte sedimentation rate (ESR) in 75 % and elevated C-reactive protein (CRP) in 97.1 %. 5.9 % had articular damage attributable to septic arthritis. An infectious agent was isolated in 41.2 % of patients, with Staphylococcus aureus being the most frequent. 38.7 % of synovial fluid and 23.5 % of synovial membrane cultures were positive. Patients with an identified infectious agent have no significant differences other than more days of hospitalisation (p = 0.003) and in-hospital antibiotic treatment (p = 0.017).

CONCLUSION

Synovial fluid and synovial membrane cultures more often identified pathogens compared to blood or urine cultures. Patients with and without an identified infectious agent have similar demographic, clinical, laboratory and radiographic characteristics.

The role of calcium stores in apoptosis and autophagy

The mechanisms that regulate programmed cell death, such as apoptosis, and the cellular "self-eating" phenomenon of autophagy, share many regulatory systems and common pathways. These mechanisms have been extensively investigated over the last few years. Some intracellular structures may determine and control the autophagic fate of the cell such as the endoplasmic reticulum, mitochondria, and lysosomes. The coordination and interrelation of these organelles are crucial in maintaining calcium levels and general cellular homeostasis, as well as in regulating cell life and death under physiological and pathological conditions, including cancer, neurodegeneration, and aging. In this review, we discuss the crosstalk between the aforementioned organelles and their influence in apoptotic and autophagic processes.

Antioxidant and anti-inflammatory effects of quercetin in functional and morphological alterations in streptozotocin-induced diabetic rats

The aim of this study was to investigate functional and morphological alterations caused by oxidative stress in streptozotocin (STZ)-induced diabetic rats and to evaluate the antioxidant effect of quercetin (QUE) in this disease. One hundred and thirty male Wistar rats, it were randomly distributed in 10 different experimental groups, with ten animals per group: Control Saline (CS), Control Ethanol (CE), Control QUE 5mg/kg (CQ5), Control QUE 25mg/kg (CQ25), Control QUE 50mg/kg (CQ50), Diabetic Saline (DS), Diabetic Ethanol (DE), Diabetic QUE 5mg/kg (DQ5), Diabetic QUE25 mg/kg (DQ25), Diabetic QUE 50mg/kg (DQ50). Therefore, hyperglycemia is directly involved in oxidative stress production, as well as in functional and morphological alterations caused by the excess of free radicals. QUE, specially at the dosage of 50mg/kg, can act as an antioxidant and anti-inflammatory agent, becoming a promising adjuvant in the treatment of diabetes mellitus.

Characterization and gene expression analysis of the two main Th17 cytokines (IL-17A/F and IL-22) in turbot, Scophthalmus maximus

This report describes the cloning, characterization and gene expression pattern of two Th17 cytokines, interleukin (IL)-17A/F and -22, in turbot Scophthalmus maximus. The turbot IL-17A/F cDNA contains a 516 bp open reading frame encoding a deduced IL-17A/F protein of 171 amino acid (aa) residues, containing a predicted signal peptide of 31 aa. Turbot IL-22 had a 564 bp ORF coding for a 187 aa protein with a 33 aa signal peptide. The turbot IL-22 protein contained a typical IL-10 family signature. Both cytokines had highest expression levels in the intestine followed by head kidney and gills. Stimulation with the Gram negative bacterium Aeromonas salmonicida was able to modulate IL-17A/F and IL-22 expression in head kidney, spleen and liver but not the intestine. PMA and PHA were also able to induce the expression of both cytokines, suggesting that, as expected, T-cells are likely the main producers of these molecules in turbot as in mammals.

Phylogenetic relationships of Brazilian isolates of Pythium insidiosum based on ITS rDNA and cytochrome oxidase II gene sequences

Pythium insidiosum is an aquatic oomycete that is the causative agent of pythiosis. Advances in molecular methods have enabled increased accuracy in the diagnosis of pythiosis, and in studies of the phylogenetic relationships of this oomycete. To evaluate the phylogenetic relationships among isolates of P. insidiosum from different regions of Brazil, and also regarding to other American and Thai isolates, in this study a total of thirty isolates of P. insidiosum from different regions of Brazil was used and had their ITS1, 5.8S rRNA and ITS2 rDNA (ITS) region and the partial sequence of cytochrome oxidase II (COX II) gene sequenced and analyzed. The outgroup consisted of six isolates of other Pythium species and one of Lagenidium giganteum. Phylogenetic analyses of ITS and COX II genes were conducted, both individually and in combination, using four different methods: Maximum parsimony (MP); Neighbor-joining (NJ); Maximum likelihood (ML); and Bayesian analysis (BA). Our data supported P. insidiosum as monophyletic in relation to the other Pythium species, and COX II showed that P. insidiosum appears to be subdivided into three major polytomous groups, whose arrangement provides the Thai isolates as paraphyletic in relation to the Brazilian ones. The molecular analyses performed in this study suggest an evolutionary proximity among all American isolates, including the Brazilian and the Central and North America isolates, which were grouped together in a single entirely polytomous clade. The COX II network results presented signals of a recent expansion for the American isolates, probably originated from an Asian invasion source. Here, COX II showed higher levels bias, although it was the source of higher levels of phylogenetic information when compared to ITS. Nevertheless, the two markers chosen for this study proved to be entirely congruent, at least with respect to phylogenetic relationships between different isolates of P. insidiosum.

Functional and molecular immune response of Mediterranean mussel (Mytilus galloprovincialis) haemocytes against pathogen-associated molecular patterns and bacteria

The effect of live bacteria (Micrococcus lysodeikticus and Vibrio anguillarum), and PAMPs (poly I:C, zymosan, LPS, LTA and CpG) on the production of intermediate toxic radicals (respiratory burst activity and production of nitric oxide) and mytilin B, myticin C and lysozyme gene expression was studied in vivo and in vitro. In vitro, bacteria were able to modulate the haemocytes' respiratory burst activity, being significantly increased after 6 h of incubation. The effect of pathogen-associated molecular patterns (PAMPs) was also studied. Zymosan produced an increase of the PMA-mediated response but an inhibition of the zymosan-mediated response. A significant increase of nitric oxide production was found at all the sampled time points (1, 3 and 6 h) in comparison with controls on both, the Gram-positive and Gram-negative bacteria. The in vivo responses measured on haemocytes after M. lysodeikticus injection were faster than those induced by V. anguillarum. However, V. anguillarum induced stronger in vitro effects. Mytilin B, myticin C and lysozyme in vitro gene expression, occurred at short times after infection. The maximum in vitro expression was detected 3 h post-infection. The differences between M. lysodeikticus and V. anguillarum in different measured parameters may suggest that different signalling pathways might be involved. Moreover, among all assayed PAMPs, LPS elicited the highest response.

Evidence of high individual diversity on myticin C in mussel (Mytilus galloprovincialis)

Several antimicrobial peptides (AMP) have been described in Mytilus galloprovincialis. However, only in myticin C a high variability on the nucleotide sequence was detected. To determine the individual variability of this AMP, the myticin C present in more than 100 mussels was analyzed by denaturing gradient gel electrophoresis (DGGE). This technique helped us to describe a very high myticin C diversity as compared with a non-immune related gene such as the beta-actin. Moreover, each mussel showed a specific and exclusive myticin C band pattern. Our results showed that the individual sequences of myticin C are unique for each mussel, independently of their geographic origin, age, sex, gonad maturation stage or aggregate where they group together on the wild. Only the animals belonging to the same family shared myticin C sequences. The comparative analysis of genomic DNA and cDNA sequences from the same individual showed that all detected variants shared a very high homology with the more frequent genomic isoforms, suggesting that all the variations were generated from the more common sequences, through a mechanism not yet determined. The fact that myticin C possesses characteristics of an immune gene, its potential antimicrobial effects, molecular diversity, as well as its early and ubiquitous expression, led us to suggest that myticin C might play an important role in innate immune defense in mussels.

High sequence variability of myticin transcripts in hemocytes of immune-stimulated mussels suggests ancient host-pathogen interactions

Small cationic antimicrobial peptides (AMPs) are host defense molecules detected in virtually all groups of organisms. To investigate the immune response mechanisms of Mytilus galloprovincialis, primary and suppression subtractive hybridization libraries were prepared from hemolymph of mussels injected with heat-inactivated bacteria or poly I:C, the latter mimicking viral infection. After DNA sequencing, sequence processing and similarity searching, a remarkable abundance of AMP mRNAs were identified. In detail, 25.9% and 32.4% AMP sequences from mussels infected with bacteria and 43.4% and 40.6% from mussels stimulated with poly I:C were detected by selective amplification of 180 differentially expressed genes and random sequencing of 967 cDNA clones, respectively. The 232 ESTs matching with myticin A and B (Mytilus spp.) displayed considerable sequence variability and revealed a third cluster proposed here as myticin C. Phenetic analysis of the translated myticin ESTs yielded 74 and 25 variants of the precursor and active peptide, respectively, and confirmed the high polymorphism of the new form. Myticin C shows typical features of the CSalphabeta AMP family (eight-cysteine array and secretory signal peptide) as well as amino acid variation, mainly in the anionic C-terminal region. The sequencing of one intronic region from genomic DNA, allowed us to detect 13 variants in 9 individual mussels referring them to one gene only. In addition to hemolymph, myticin C transcripts were detected in various mussel tissues, oocytes and early larval stages. The striking sequence variability and expression levels of myticins in mussels confirm the fundamental role of these natural antibiotics in the ancient host-pathogen interplay of mutual inhibition, evasion and adaptation strategies.

Turbot TNFα gene: Molecular characterization and biological activity of the recombinant protein

The tumor necrosis factor (TNF) superfamily is composed by several proteins with similar structure and functions. One of the main representatives of this family is TNF-alpha (TNFalpha), a proinflammatory cytokine which is produced by different immune cells and presents a wide variety of activities. Using the RACE technique, we have cloned and sequenced the turbot TNF cDNA. The analysis of its sequence showed several conserved motifs characteristic of members of the TNFalpha family. A phylogenetic tree constructed with different TNFs of fish and mammals grouped our sequence within the fish TNFalpha cluster. Therefore, the turbot TNF here studied was identified as TNFalpha. The complete TNFalpha gene was obtained by gene walking, and, similarly to the other known fish TNFalpha genes, presented three introns and four exons. A PCR was designed to study the turbot TNFalpha expression in vivo using as stimulus the bacteria Vibrio pelagius strain Hq222 and virus VHSV. The expression of the cytokine happened early after injection, and it was dependent on the pathogen injected and organ analyzed. Virus induced a higher TNFalpha expression, but this response was shorter in time than that induced by bacteria. In addition, TNFalpha expression was in general higher in kidney than in liver, as expected since the former is the haematopoietic organ of fish. The turbot recombinant TNFalpha (rTNFalpha) was obtained by IPTG induction of bacteria transformed with the pET15b-TNFalpha construct, and it was purified in native conditions. The recombinant protein was approximately 20 kDa in size, and its biological activity was assessed in vitro. No effect of the rTNFalpha neither alone nor in combination with LPS was observed on the chemiluminescence activity of turbot macrophages at any time tested. However, NO production was enhanced by the recombinant protein alone or with LPS 72 h after the addition of the treatments. Finally, turbot rTNFalpha was able to recruit and activate inflammatory cells when injected in gilthead seabream, although to a lesser extent than gilthead seabream rTNFalpha.

Long and short-term effect of prednisolone in hospitalized infants with acute bronchiolitis

OBJECTIVE

To assess long and short-term effect of prednisolone in hospitalized infants with bronchiolitis.

METHODOLOGY

A randomized and controlled trial was carried out at the Federal University of Rio Grande, Rio Grande-RS, Brazil. Twenty-eight patients were randomly allocated prednisolone (1 mg/kg/day for 5 days) plus standard care, and 24 patients allocated standard care alone. The primary endpoint was the prevalence of post-bronchiolitis wheezing at 1, 3, 6 and 12 months after hospital discharge. The secondary endpoints were: length of hospital stay, duration of oxygen therapy and time to clinical improvement during the hospitalization.

RESULTS

There were no significant differences between the prednisolone and control group in the prevalence of post-bronchioltis wheezing at 1 month (73.1 vs 83.3%, P = 0.5), 3 months (73.1 vs 79.2%, P = 0.7), 6 months (65.4 vs 66.7%, P = 0.9) and 12 months (50.0 vs 58.3%, P = 0.5) after hospital discharge. No reduction was observed in the prednisolone group, compared with the control group, in terms of length of hospital stay (6.0 vs 5.0 days, P = 0.7), duration of oxygen therapy (24.0 vs 24.0 h, P = 0.4) and time to clinical resolution (4.0 vs 4.0 days, P = 0.8).

CONCLUSIONS

Prednisolone has no significant effect on reducing the prevalence of post-bronchiolitis wheezing and on improving the acute course of illness in hospitalized infants with bronchiolitis.

Phenotypic and molecular characterization of bovine Campylobacter fetus strains isolated in Brazil

The objective of the present study was to characterize the phenotypic and molecular aspects of Campylobacter fetus strains isolated from bovine herds with reproductive problems. Thirty-one Brazilian field isolates, together with one reference strain of each subspecies of C. fetus, were analyzed. The strains were submitted to phenotypic identification followed by subspecies characterization using the polymerase chain reaction (PCR) and numeric evaluation of restriction fragment length polymorphism (RFLP) separated by pulsed-field gel electrophoresis (PFGE). Phenotypically, 4 isolates (12.1%) were classified as C. fetus subsp. fetus, and 29 isolates (87.9%) were classified as C. fetus subsp. venerealis. However, according to molecular analysis, only 1 isolate (3.0%) was classified as C. fetus subsp. fetus (the reference strain), whereas 32 isolates (97.0%) were considered C. fetus subsp. venerealis. SalI digestion of C. fetus genomic DNA, obtained from the 33 strains, yielded 7-10 DNA fragments ranging in size from 40 to 373kb, with 12 distinct patterns. Furthermore, the numeric analysis by neighbor-joining of the DNA from the 33 strains resulted in a dendrogram in which 2 distinct groups were identified. It was concluded that phenotypic characterization of C. fetus subspecies might lead to erroneous classification of field isolates. Although RFLP-PFGE is a powerful and reliable technique to characterize C. fetus, it has the inconvenience of being time consuming and laborious. Whereas PCR, besides providing rapid results, was found to be reliable and convenient for the characterization of field isolates of C. fetus.

DHEA treatment of Alzheimer's disease: a randomized, double-blind, placebo-controlled study

OBJECTIVE

To compare the efficacy and tolerability of dehydroepiandrosterone (DHEA) vs placebo in AD.

METHOD

Fifty-eight subjects with AD were randomized to 6 month's treatment with DHEA (50 mg per os twice a day; n = 28) or placebo (n = 30) in a multi-site, double-blind pilot trial. Primary efficacy measures assessed cognitive functioning (the AD Assessment Scale-Cognitive [ADAS-Cog]) and observer-based ratings of overall changes in severity (the Clinician's Interview-Based Impression of Change with Caregiver Input [CIBIC-Plus]). At baseline, 3 months, and 6 months, the ADAS-Cog was administered, and at 3 and 6 months, the CIBIC-Plus was administered. The 6-month time point was the primary endpoint.

RESULTS

Nineteen DHEA-treated subjects and 14 placebo-treated subjects completed the trial. DHEA was relatively well-tolerated. DHEA treatment, relative to placebo, was not associated with improvement in ADAS-Cog scores at month 6 (last observation carried forward; p = 0.10); transient improvement was noted at month 3 (p = 0.014; cutoff for Bonferroni significance = 0.0125). No difference between treatments was seen on the CIBIC-Plus at either the 6-month or the 3-month time points.

CONCLUSIONS

DHEA did not significantly improve cognitive performance or overall ratings of change in severity in this small-scale pilot study. A transient effect on cognitive performance may have been seen at month 3, but narrowly missed significance.

Functional importance of conserved domains in the flowering-time gene CONSTANS demonstrated by analysis of mutant alleles and transgenic plants

CONSTANS promotes flowering of Arabidopsis in response to long-day conditions. We show that CONSTANS is a member of an Arabidopsis gene family that comprises 16 other members. The CO-Like proteins encoded by these genes contain two segments of homology: a zinc finger containing region near their amino terminus and a CCT (CO, CO-Like, TOC1) domain near their carboxy terminus. Analysis of seven classical co mutant alleles demonstrated that the mutations all occur within either the zinc finger region or the CCT domain, confirming that the two regions of homology are important for CO function. The zinc fingers are most similar to those of B-boxes, which act as protein-protein interaction domains in several transcription factors described in animals. Segments of CO protein containing the CCT domain localize GFP to the nucleus, but one mutation that affects the CCT domain delays flowering without affecting the nuclear localization function, suggesting that this domain has additional functions. All eight co alleles, including one recovered by pollen irradiation in which DNA encoding both B-boxes is deleted, are shown to be semidominant. This dominance appears to be largely due to a reduction in CO dosage in the heterozygous plants. However, some alleles may also actively delay flowering, because overexpression from the CaMV 35S promoter of the co-3 allele, that has a mutation in the second B-box, delayed flowering of wild-type plants. The significance of these observations for the role of CO in the control of flowering time is discussed.

Betainium trifluoroacetate

The title compound, C5H12NO2+*C2F3O2- or BET+*CF3COO- [BET is trimethylglycine (betaine); IUPAC: 1-carboxy-N,N,N-trimethylmethanaminium inner salt], contains pairs of betainium and trifluoroacetate ions forming a dimer bridged by a strong hydrogen bond between the carboxyl and carboxylate groups of the two ions. The molecular symmetry of the cation is close to Cs, with protonation occurring at the carboxy O atom positioned anti to the N atom. The trifluoroacetate anions are disordered over two positions. In one, the conformation of the CF3 group is staggered with respect to the carboxylate group, in the other, it is close to an eclipsed conformation. The sole hydrogen bond present in the structure is the strong O-H...O bond between the anion and the cation.

Volumetric quantification of the gastric emptying: computer-based method for generation of volumetric index from fluoroscopic images

We developed an automated software-based procedure for estimation of the volume variation of the stomach using videofluoroscopic analysis of the gastric emptying. We used radiological images with postero-anterior incidence of eight healthy volunteers and in vitro experimental tests, with different volumes and concentrations of the contrast medium. This computational method generates an index that measures, in the three dimensions, the dynamic behaviour of gastric emptying. Using adequate contrast concentration (barium sulphate solution), it is possible to determine volume behaviour from density variations. This software can automate this computation, facilitating the amount of work, avoiding mistakes and improving reproducibility.

Conformation of cationic N,N-dimethylglycine in dimethylglycinium trifluoroacetate

In the title compound, C(4)H(10)NO(2)(+).C(2)F(3)O(2)(-), the main N-C-COOH skeleton of the protonated amino acid is nearly planar. The C=O/C-N and C=O/O-H bonds are syn and the two methyl groups are gauche to the methylene H atoms. The conformation of the cation in the crystal is compared to that given by ab initio calculations (Hartree-Fock, self-consistent field molecular-orbital theory). The trifluoroacetate anion has the typical staggered conformation with usual bond distances and angles. The cation and anion form dimers through a strong O-H.O hydrogen bond which are further interconnected in infinite zigzag chains running parallel to the a axis by N-H.O bonds. Weaker C-H.O interactions involving the methyl groups and the carboxy O atoms of the cation occur between the chains.

Sarcosinium trifluoroacetate

The title compound, C(3)H(8)NO(2)(+).C(2)F(3)O(2)(-), crystallizes in space group C2/c. The main N-C-COOH skeleton of the protonated sarcosine molecule is almost perfectly planar. The trifluoroacetate anion has a staggered conformation and typical bond distances and angles. The CF(3) group is probably slightly disordered. The structure is stabilized by an extensive network of strong O-H.O hydrogen bonds and weaker N-H.O bonds.

[Qualitative and quantitative evaluation of gastric emptying using a videofluoroscopic method]

We studied the gastric emptying of 21 healthy volunteers using a standard contrasted diet composed of a lipid, carbohydrate, protein and barium sulfate solution homogenate. We did six one-minute videofluoroscopic recordings in a 12-minute interval for the first hour, and in a 30 minute interval until the complete emptying. We selected eight exams for the emptying quantification. We could observe and estimate subjectively the functional behavior and the gastric emptying. Digital representative images of each emptying time point we were able to quantify those observations and describe them as a mathematical function. We developed a macro procedure using the Media Cybernetics ImagePro-Plus software for this quantification. We conclude that: 1--The videofluoroscopic method provides better resolution than the other methods in the analysis of the gastric motility and emptying. 2--It is possible to computationally quantify the morphological differences observed with the sequential registration radiological methods, specially the videofluoroscopic method that generates 30 frames per second. 3--Our results generate a gastric emptying index, based on the area of a gastric projection in radiological images obtained in a standing position over a one-hour period (T1/2). 4--The quantitative analysis should not exclude the qualitative analysis.

Estrogen replacement therapy and cognitive decline in memory-impaired post-menopausal women

BACKGROUND

Estrogen replacement therapy (ERT) may delay dementia-related cognitive decline in post-menopausal women, but few studies have longitudinally examined this relationship and none has controlled for baseline functioning or concurrent medication.

METHODS

We report the results of a 1-year retrospective longitudinal study examining cognitive functioning in female estrogen and nonestrogen users (n = 3128) who presented to the state of California memory disorder clinics in a naturalistic multisite study of senile dementia, Alzheimer's type (SDAT), and other cognitive impairments.

RESULTS

At baseline, estrogen users had significantly lower rates of SDAT diagnoses (possible and probable) than nonestrogen users, and significantly higher rates of the lesser diagnoses of "cognitive impairment" and "no dementia." ERT was significantly associated with higher cognitive functioning at baseline and at 1 year follow-up (n = 358). Nonestrogen users deteriorated significantly from baseline to follow-up; estrogen users did not. Results were similar in groups matched on baseline Blessed-Roth Dementia Rating Scale (BRDRS) ratings (n = 32) and in a variety of subpopulations.

CONCLUSIONS

These findings are consistent with estrogen acting as a protective factor against cognitive deterioration in post-menopausal women with SDAT and other cognitive impairments, and may suggest an increased effect in earlier stages of cognitive impairment.

[Trends in hospital admissions for pediatric asthma in childrenduring a period of eighteen years]

OBJECTIVE: To study trends in hospital admissions for acute pediatric asthma in the Hospital da Santa Casa do Rio Grande during the period of 1979 to 1996. METHODS: This is a study of a series of cases. We reviewed all the discharge records of pediatric patients with diagnosis of acute asthma, pneumonia, and bronchiolitis within the period mentioned above. The main variable in this study was the percentage of admissions for acute asthma in relation to the total amount of hospital admissions. The percentages of admissions for bronchiolitis and pneumonia in relation to the total amount of hospital admissions were also calculated as reference values. RESULTS: There were 3,493 admissions for acute asthma in 3,122 patients during the studied period, with an average of 194 admissions per year. The percentage of admissions for acute asthma to total hospital admissions increased from 5,5% to 14,7% between 1983/84 and 1991/92. Half of this increase occurred during the period 1987-1992 in which hospitalizations for bronchiolitis and pneumonia were stable. This percentage decreased from 14,7% to 10,6% in the period of 1991/92 - 1995/96. CONCLUSIONS: There was a significant increase in hospital admissions for acute pediatric asthma in the Hospital da Santa Casa do Rio Grande during the period of 1983 - 1992. From then on, hospital admissions for asthma showed downward trends.

Reason, myths and fantasies: preliminary data and reflections about the Portuguese experience with LNG-IUS-induced hypomenorrhea

OBJECTIVE

To evaluate the efficacy and tolerance of the levonorgestrel-releasing intrauterine system (LNG-IUS) among Portuguese women, with particular emphasis on the implications of changes in bleeding pattern.

STUDY DESIGN

Forty healthy premenopausal women (average age 42.7 +/- 4.5 years) were recruited in each one of the three Portuguese centers (a total of 120) where the LNG-IUS was used as a contraceptive method during a maximum period of 5 years. All women had previously given their informed consent and were informed about the eventual changes in bleeding pattern. Serum ferritin levels and hemogram measurements were performed before and 1 year after the introduction of the IUS. The results were analyzed by the Student t test (raw data and paired test).

RESULTS

Preliminary data showed a continuation rate of 70% with an excellent efficacy rate (no pregnancies) 1 year after the introduction of the IUS. The hypomenorrhea rate was 35% while 12.5% of the women had amenorrhea. The average increase in serum ferritin level was 13 ng/ml and of hemoglobin 0.4 g/dl. The comparisons of hemoglobin results were statistically significant (p = 0.05, t raw data and p = 0.028, t paired test). Most complaints were related to cultural difficulties in accepting the changes in menstrual bleeding pattern.

CONCLUSION

In order to minimize and control the most common menstrual bleeding side-effects that occur when using this IUS, as well as to improve the continuation rate, clinicians must make a judicious choice of potential users, owing to the psychological and cultural implications that menstrual bleeding changes can have, mainly among women of low socioeconomic levels. Moreover, non-contraceptive therapeutic benefits should be emphasized.

[Videofluoroscopic evaluation of the functional significance of the epiglottis in adults]

Our intention was to define the functional role of the epiglottis. Accordingly, we analysed its movements and correlation in 53 videofluroscopic exams: 26 were good health volunteers, 25 were patients with dysphagia and two were persons with pharyngeal diverticula. The exams register the rest phase, chewing, and the swallowing movements during the intake of the saliva, water, barium solution and different volumes of mass made with crumbled bread mixed with barium powder. We can see three sequential stages in epiglottic movement during swallowing. The first stage involves an upward epiglottic shift determined by hioepiglottic ligament, associated with a simultaneous bending caused by the tongue backward projection. The second stage is a posterior rotation of the epiglottis, limited by the adjustment of the epiglottic tubercle to the vestibular fold, determined by laryngeal upward shift against hyoid bone. The third stage in which occurs an eversion of the free extremity of the epiglottis beyond the horizontal plane can be absent in slow pressure swallowing. All stages of the epiglottic dynamics are passive. We have shown that the epiglottis has a protective action on the repiratory airways not limited to swallowing. It participates, during swallowing and regurgitation (vomica), through the passive adjustment of the intralaryngeal posterior surface of the epiglottis (epiglottic tubercle) to the vestibular folds. Both before and after swallowing, when frequently there are escapes of residues and small volumes out of the oral cavity, the epiglottis protects the repiratory airways, through its participation in the formation of the valleculae and as an insertion point for the aryepiglottic folds. In association with epiglottis participation there is a stretching of the aryepiglottic folds that allow a definition of the lateral channels. The upward and forward movements of the larynx associated with the opening of the pharyngoesophageal transition, that occurs synchronously with the ejection of the swallowed bolus, has been shown to be an important factor in the protective laringeal mechanism. The increase in the laryngeal resistance, in which the epiglottis takes part, is only efficient when there is wide and synchronous opening of the pharyngoesophageal transition. In this context the epiglottis is a secondary element in the protection of the respiratory airways.

[Swallowing apnea in adults]

We have studied the swallowing apnea in 66 persons. Five were laryngectomized. We analysed 1916 breathing/swallowing correlation charts, 109 in laryngectomized and 1807 in not laryngectomized persons. The correlation charts were done using a piezoelectric and thermistor register coupled to a manometric system developed by Synetics Medical interfaced to a microcomputer running software Polygram upper 4.21. Our observation allows us to conclude that: 1. the swallowing apnea has not the same reflex path of the breathing interruption that occurs when a foreign body stimulates the laryngeal receptors; 2. the swallowing apnea installation is not dependent on the laryngeal structures; 3. the swallowing apnea and rima glottidis closure, that occur in the same moment, are correlated phenomena, but are a distinct part of the airway protective mechanisms; and 4. even though the swallowing apnea can occur in every moment of the breathing cycle, it occurs more frequently at the end of expiratory and beginning of the inspiratory phase of breathing cycle; it is usually continued by a complementary expiration. We believe that the less lung volume is the basic condition to the establishment of the more frequent kind of swallowing apnea reflex.

[Swallowing defects determined by tracheostomy]

We have studied the interference on swallowing of the skin-tracheal fixation determined by tracheostomy. We have analyzed this interference by videofluoroscopy. One hundred and twelve patients with complain of dysphagia have been studied by videofluoroscopy at the Hospital Universitário "Clementino Fraga Filho", Rio de Janeiro, RJ. Four have undertaken tracheostomy. One (female, 52 years) had already a metal cannula in the trachea, three others (two females and one male/40 to 66 years) exhibited a longitudinal anterior depressed scar, for more than five years. Two patients had also a neurological disease. In the videofluoroscopic observation it was used liquid medium (barium solution) and also solid and soft contrast media made of barium powder mixed with a bread dough. We have found a correlation between skin-tracheal fixation and swallowing defects. The skin-tracheal fixation interference occurs basically by opposition to the hyo-larynx free displacement. This limited displacement determines a small amplification of the laryngo-pharyngeal space, a restrictive opening of the pharingo-esophageal segment and also determines that the laringeous aditus remains near the pharingo-esophageal limit. We have observed swallowing defects in all the four tracheostomized patients. The observed defects relative to tracheostomy was the penetration of contrast medium in the airway. This penetration was cleared by forced expiration. In three patients the swallowing defects was clearly linked to tracheostomy. We can admit that the skin-tracheal fixation, without any other pathology, can determine dysphagia. In association with other diseases this fixation can increase the disturbance: On the other hand it can run unnoticed due to more evident pathology. The consequence of skin-tracheal fixation is better determined by videofluroscopy.

[Nonalcoholic steatohepatitis]

The authors present a case of a nonalcoholic steatohepatitis, with progression to liver cirrhosis in an obese female patient. A review of the literature, possible evolution, and principle pathological processes involved is made. Attention is drawn to obesity as a risk factor in the progression of steatohepatitis and the advantage of performing liver biopsies in selected cases as a fundamental technique of diagnosis.

Splenic lymphoma with villous lymphocytes in two sisters

Splenic lymphoma with villous lymphocytes is a new entity characterised by the presence of atypical lymphocytes in the peripheral blood and bone marrow, and splenic infiltration in the white and red pulp. Cell membrane markers are those of a B mature cell, and no particular chromosomal abnormalities have been associated with this disease. A case of this rare lymphoma occurred in two sisters. Histological examination of splenic tissue was identical in both cases, with the same immunological surface markers, although the clinical and laboratory features were different. Karyotype analysis showed an abnormal pattern in one case; no environmental causative factor could be detected. Familial cases of other lymphoproliferative disorders have been reported, but no consistent common link has been found. It is suggested that further reports of this lymphoma, including cytogenetic and molecular studies, may provide a better understanding of the aetiology.

[Structural changes in pulmonary vessels and coronary arteries in hypoplastic left heart syndrome]

In order to correlate gross morphological features with pulmonary and coronary vasculature changes in hypoplastic left heart syndrome (HLHS) 15 heart-lung necropsy specimens from neonates were analysed. Histology of left atrium wall, lung vessels with pulmonary arteriolar disease morphometric grading, study of intra and extra pulmonary wall veins and coronary arteries were recorded. Classic HLHS was observed in 11, and DORV with mitral atresia in 4, the foramen ovale (FO) being the only left atrium outflow tract in all. All specimens had increased % of thickness and muscular extension of arterioles and increased wall thickness of pulmonary veins, but severer arteriolar and venous changes with left atrium fibrosis were noticed in 8 specimens with either closed FO (3 cases) or mean FO diameter (d) of 5 mm when compared with specimens with mean FOd of 9 mm. Coronary arteries histology disclosed in 4 of 8 specimens with opened but hypoplastic mitral valve, intima proliferative changes with lumen narrowing, not observed in 7 specimens with mitral valve atresia. We concluded that in HLHS closed or restrictive FO and permeable mitral valve may predispose neonates to respiratory complications, right ventricle abnormal function and arrhythmias, specially after cardiac surgery.

Rarities in breast pathology. Bilateral Paget's disease of the breast--a case report

A case of bilateral Paget's disease of the breast in a 74-year-old woman is reported. The clinicopathological features of the case are presented and the rarity of this clinical entity is reviewed.