Mycobacterium marinum lymphocutaneous infection.

Mycobacterium marinum is a nontuberculous mycobacteria with worldwide distribution that lives in fresh or salt water and is responsible for infections in fish, and sometimes in humans. Human disease consists mainly of cutaneous nodules, but deep structure involvement may also occur. Diagnosis of M. marinum infection remains a challenge, with a considerable time delay between onset of symptoms and diagnosis. We present a 33-year-old man with no immunosuppressive history who was seen in our department with skin nodules over his hand and forearm, distributed in a sporotrichoid pattern. His hobbies included maintaining an aquarium of tropical fish. Histological examination of the patient's skin biopsy was compatible with the diagnosis of mycobacterial infection, and the Ziehl-Neelsen staining revealed acid-fast bacilli. Molecular techniques confirmed the suspicion of M. marinum infection. A necropsy was performed on one of the patient's fish, more specifically, a Poecilia reticulata, and resulted in identification of M. marinum from its gut. The patient was treated with clarithromycin, ethambutol, and rifampicin for 9 months, with clearance of infection.

Adaptability and stability analysis of the juice yield of yellow passion fruit varieties.

This study analyzed the genotype x environment interaction (GE) for the juice productivity (JuProd) of 12 yellow passion fruit varieties (Passiflora edulis Sims. f. flavicarpa Deg.) using additive main effects and multiplicative interaction (AMMI) model and auxiliary parameters. The experiments were conducted in eight environments of Bahia State, Brazil, using a randomized block design with three replications. Analysis of variance showed significant effects (P ≤ 0.01) for environments, genotypes, and GE interaction. The first two interaction principal component axes (IPCAs) explained 81.00% of the sum of squares of the GE interaction. The AMMI1 and AMMI2 models showed that varieties 09 and 11 were the most stable. Other parameters, namely, the AMMI stability value (ASV), yield stability (YSI), sustainability, and stability index (StI), indicated that other varieties were more stable. These varying results were certainly a consequence of methodological differences. In contrast, the ranking of varieties for each of the stability parameters showed significant positive correlations (P ≤ 0.05) between IPCA1 x (ASV, YSI), JuProd x (StI, YSI), YSI x ASV, and StI x YSI. Cluster analysis based on the genotypic profile of the effects of the GE interaction identified three groups that correlated with the distribution of varieties in the AMMI1 biplot. However, the classification of stable genotypes was limited because the association with the productivity was not included in the analysis. Variety 08 showed the most stable and productive behavior, ranking above average in half of the environments, and it should be recommended for use.

Use of morpho-agronomic traits and DNA profiling for classification of genetic diversity in papaya.

We examined the genetic diversity of papaya (Carica papaya) based on morpho-agronomic and molecular data. Twenty-seven genotypes grown in Brazil were analyzed with 11 AFLP primer combinations, 23 ISSR markers, 22 qualitative, and 30 quantitative descriptors. For the joint analyses, we used the Gower algorithm (Joint Gower) and the average value of the individual dissimilarity matrix for each type of data (Average-Joint Gower); 359 AFLP and 52 ISSR polymorphic bands were found. Approximately 29.2 and 7.7% of the AFLP and ISSR bands, respectively, were genotype-specific and may therefore be used for papaya variety protection. Although there was a significant correlation between the qualitative and quantitative descriptor dissimilarity matrices (r = 0.43), the morpho-agronomic data were not highly correlated with the molecular data. Moreover, correlation between AFLP and ISSR dissimilarity matrices was nearly null (r = -0.01). Joint Gower analysis of all data showed high correlations, especially for AFLP markers, most likely due to the larger number of bands, generating a strong bias in the diversity estimates. The Average-Joint Gower analysis allowed a better balance between the correlations for the continuous and the discrete variables. The results generated by clustering analysis distinguished 5 genetically distinct groups. While we found that papaya genotypes are significantly variable for many traits, we observed that Average-Joint Gower analysis allowed for genotype clustering based on the most widely used criterion for classifying papaya genotypes, which is fruit type ('Formosa' or 'Solo'). This information helps provide an accurate estimate of the genetic diversity and structure of papaya germplasm, which will be used for further breeding strategies.

[Crohn disease with unusual cutaneous expression]. / Doença de Crohn com expressão dermatológica invulgar.

Perianal fistula is a frequent complication of Crohn's disease. The diagnosis of the later may be difficult if cutaneous disease is dominant, and sometimes an important clinical challenge. The authors report a case of a 34 year old male complaining of painful perianal nodules for the three last years. Cutaneous histopathological examination was inespecific and colonoscopy normal. Pelvic CT scan and fistulography showed an intercommunicated fistular system invading both isquiorectal fossae, without intestinal communication. Repetition of colonoscopy showed normal mucosa, but in two of the biopsy samples noncaseous granulomas were found at the submucosa. The authors explain their main difficulties to reach the diagnosis of Crohn's disease and discuss the investigation and the evolution of the patient.

Cervical thymoma.

CONTEXT: Cervical thymoma is a primitive thymic neoplasia. It is very rare. This disease presents higher incidence in female patients in their 4th to 6th decade of life. We present a case report of a cervical thymoma. CASE REPORT: 54-year-old female patient, caucasian, with no history of morbidity, presenting a left cervical nodule close to the thyroid gland. During the 30 months of investigation a left cervical nodule grew progressively next to the thyroid while the patient showed no symptoms, making accurate diagnosis difficult. Tests on her thyroid function did not show changes, nor were there changes in any subsidiary tests. The diagnosis of the disease was made intra-operatively through total thyroid individualization. The results were confirmed by the histological findings from the ressected material. Cervical thymoma is a very rare disease, with difficult preoperatory diagnosis. Some additional study methods which are employed today are thallium 201, technetium 99 and iodine 131 scintigraphy, magnetic nuclear resonance and especially histopathological findings and classification.

Oxidative stress in Adamantiades-Behçet's disease.

BACKGROUND: Adamantiades-Behçet's disease is a chronic systemic disorder associating oral and genital ulcerative lesions with ocular and cutaneous manifestations. Previous publications report increased superoxide production by neutrophils and macrophages, increases in cytokines and malondialdehyde (MDA), as well as low levels of enzymatic antioxidant defenses. AIM: We looked for another marker of oxidative stress in Adamantiades-Behçet's disease: the presence of clastogenic factors (CF) in patients' plasma. In addition, we determined plasma endproducts of lipid peroxidation (MDA). PATIENTS AND METHODS: We studied 20 patients and 20 controls. The clastogenic activity was evaluated by means of cytogenetic methods. This test (CF test) detects circulating prooxidants, due to their clastogenic effects after exposure of lymphocyte cultures of healthy persons to plasma ultrafiltrates from patients. The clastogenic prooxidants are lipid peroxidation products and cytokines, in particular TNF-alpha. Lipid peroxidation was evaluated by the Yagi method. RESULTS: The CF test was positive in 18 out of 20 patients, while it was negative in all 20 control persons. The mean increase in chromosomal breaks was 10.6 +/- 3.8 in cultures exposed to patients' plasma and 1.3 +/- 2.4 for cultures receiving control plasma (p <0.001). The clastogenic effect of patients' plasma ultrafiltrates was significantly inhibited by superoxide dismutase (EC 1.15.1.1), suggesting an important role of the superoxide radical in the clastogenic pathway. Thiobarbituric-acid-reactive substances (expressed as nanomoles MDA per milliliter) were also significantly increased in these patients: 10.6 +/- 3.2 for patients and 6.6 +/- 1.4 for controls (p <0.001). CONCLUSION: The presence of CF in the plasma of patients, indicating the presence of circulating prooxidants with chromosome-damaging effects, confirms an oxidative stress in Adamantiades-Behçet's disease. The anticlastogenic effect of superoxide dismutase in vitro suggests the implication of the superoxide radical. MDA levels were also significantly increased in patients.

Lipid peroxidation in type 2 normolipidemic diabetic patients.

Vascular complications, as a consequence of atherosclerosis, are the main causes of morbidity and mortality in diabetes. Low density lipoprotein (LDL) oxidation is accepted as a relevant pathogenic mechanism in atherogenesis. The aim of this work was to study the relationship between lipid peroxidation (LPO) and metabolic control. LPO was evaluated in 40 type 2 normolipidemic diabetic patients by measuring thiobarbituric acid reactive substances (TBARS), in the plasma, using malondialdehyde (MDA), end product of the oxidation of polyunsaturated fatty acids, as a standard. Fast blood glucose (FBG), serum total cholesterol (TC) and serum triglycerides (TG) were evaluated by routine methods. Fructosamine (FR) was measured by the nitroblue tetrazolium (NBT) colorimetric test. An elevated level of lipid peroxides (P < 0.001) was observed in the plasma of diabetic patients (4.51 +/- 1.29 nmol/ml) as compared to normal subjects (3.54 +/- 1.00 nmol/ml). Lipid peroxides did not correlate with the FR levels, nor with FBG, TC and TG. These results show an increase of LPO in type 2 normolipidemic diabetic patients. Probably the mechanism for higher lipid peroxide levels in diabetes is multifactorial. Our study supports the hypothesis of a role of oxidative stress in diabetes independently of the lipid serum content.

[Effect of silibinin on oxidative damage of blood constituents]. / Effet de la silibinine sur la lésion oxydante des constituants du sang.

Silibinin (SDH) is a flavonoid with ascertained hepatoprotective effects, which have been partially attributed to its antioxidant properties. Oxidation of blood constituents could have a role in atherogenesis and interfere with the rheologic properties of the blood. In this study we investigated, whether SDH could protect some blood constituents against oxidative modification. In human plasma we measured TBARS and fluorescence generation as indicators of copper or azobis amidinopropane hydrochloride (AAPH) at 760 mm Hg PO2-induced lipid peroxidation. SDH at 50 microM inhibited copper-induced TBARS formation by 25% and fluorescence by 47%. SDH also inhibited AAPH-induced lipid peroxidation, but at 175 microM concentration only. Oxidative modification of albumine was evaluated by fluorescence generation. SDH at 50 microM inhibited copper/hydrogen peroxide fluorescence generation by 54% and at 2.5 microM it inhibited EDTA-Fe (II)/hydrogen peroxide fluorescence generation by 31%. The protection of albumin by SDH was confirmed by SDS-PAGE electrophoresis. Copper-induced red-cell lipid peroxidation was evaluated by TBARS formation. SDH at 250 microM inhibited copper-induced lipid peroxidation and hemolysis by 45% and 94%, respectively. SDH also inhibited hemolysis in red-cell suspensions exposed to hydrogen peroxide, but not lipid peroxidation. Our results show that SDH may protect blood constituents from oxidative damage.

[Glycosylation and lipid peroxidation in skin and in plasma in diabetic patients]. / Glycation et peroxidation lipidique dans la peau et le plasma de patients diabétiques.

Glycation and free radical reactions may play a role in complications of diabetes. Vascular complications, as a consequence of atherosclerosis, are the main causes of morbidity and mortality in diabetes. The aim of this work was to study glycation and lipid peroxidation (LPO) in plasma and skin of type 2 diabetic patients. The levels of advanced glycation endproducts (AGEs) in skin collagens are considered as the sum of accumulated glycation over time. We studied 20 subjects with type 2 diabetes and 20 controls. Glycated proteins were quantified in skin and plasma by affinity chromatography in aminophenyl boronate gels. AGEs were determined on skin collagen by fluorimetry. LPO was evaluated by fluorimetry measuring TBARS in the skin and plasma. Skin collagen-linked fluorescence (CLF) was higher in diabetics (p < 0.01). CLF in diabetics with retinopathy was higher than that of diabetics without retinopathy (p < 0.02). There was a positive correlation between duration of diabetes and skin CLF (p < 0.01). TBARS were higher in skin (p < 0.01) and plasma (p < 0.001) of diabetic patients. We did not find any correlation between CLF and TBARS. This is not surprising taking into account the complexity and multifactorial aspects involved in LPO, while in glycation the main determinant factor is hyperglycemia.

[Dermatitis artefacta]. / Dermatite artefacta.

We report a case of a 29-year-old man presenting skin ulcerations on both sides of the mandible. The diagnosis of dermatitis artefacta was based on the morphology and evolution of the lesions, on the patient's borderline personality, on the objects found in his possession, and a later admission of having an involvement in the aggravation of the lesions.

[Fluorescent products in the crystalline lens of type ii diabetic patients]. / Productos fluorescentes no cristalino de diabéticos tipo II.

A body of evidence suggests that glycation of proteins and the resulting fluorescent products take part in the late complications of diabetes. The purpose of this study was to analyse the fluorescence of lens soluble proteins from diabetic patients. Soluble proteins were obtained from lens with cataract from 20 type II diabetic patients and from 21 non diabetic controls with similar age. The fluorescence of the soluble fraction (EX-360 nm, EM -454 nm) was quantified as a parameter for glycation end products. The glycation of plasma proteins was quantified by fructosamine levels. The fluorescence mean in the group of diabetics was about twice the non diabetic value (p < 0.01). The fluorescence in the diabetics with retinopathy was higher than that of diabetic without retinopathy (p < 0.01). Fructosamine levels were: diabetics 3.1 +/- 1.1 mM, non diabetics 1.9 +/- 0.8 mM (p < 0.001). The results suggest the involvement of fluorescent products, resulting from glycation of proteins, in lens opacification in diabetic patients.

Hyaluronic acid in progressive systemic sclerosis.

BACKGROUND: The glycosaminoglycans metabolism is disturbed in progressive systemic sclerosis (PSS). Serum hyaluronic acid (HA) is elevated in this disease. OBJECTIVE: This study was conducted to determine the HA plasma concentrations of patients with PSS according to the different stages of the disease. METHODS: We studied 48 patients divided into three subgroups: subgroup 1 (n = 10), with skin compromise without evidence of other organ involvement; subgroup 2 (n = 21), with skin and esophagus involvement; subgroup 3 (n = 17), with skin, lung and other internal organ involvement. A radiometric assay was performed for quantification of HA. RESULTS: Our results confirm the increase in plasma HA in patients with PSS. They also suggest that lung involvement is the main feature responsible for high plasma concentrations of HA. The plasma HA levels were elevated in patients compared to normals (p <0.001). Significant differences were observed between subgroups 1 and 3 (p <0.01) and between subgroups 2 and 3 (p <0.01). A positive correlation between disease severity scores and plasma HA values was observed (p <0.01). CONCLUSION: An important elevation of HA plasma levels could be a serologic marker of disease severity, progression and degree of visceral involvement.

Different effects of thiol and nonthiol ace inhibitors on copper-induced lipid and protein oxidative modification.

Differences among angiotensin-converting enzyme inhibitors (ACEI) in scavenging reactive oxygen species were described and mainly attributed to the presence or absence of a thiol group. Plasma constituents and red cells are known targets for oxidative damage. Transition metals, like copper, are well known catalizers of free radical generation. In the present study we compared the abilities of captopril (a thiol ACEI), enalaprilat, and lisinopril (two nonthiol ACEI) for inhibiting copper-induced thiobarbituric acid reactive substances (TBARS) formation and fluorescence generation in whole human plasma and low-density lipoprotein. The effects of those ACEI on copper/hydrogen peroxide-induced fluorescence development and electrophoretic mobility modification in albumin and on copper-induced TBARS formation and hemolysis in human red cells were also compared. Captopril was more effective than the two nonthiol ACEI in inhibiting plasma and LDL lipid peroxidation, but it was ineffective in inhibiting the albumin oxidative modification that was moderately inhibited by enalaprilat and lisinopril. On the contrary, the inhibitory effects of the three ACEI on copper-induced lipid peroxidation and hemolysis in red cell suspensions were more uniform. This as yet unreported red cell protective effect may deserve pharmacological evaluation. Our results show that captopril is a more effective antioxidant than the nonthiol ACEI in some systems. However, the nonthiol ACEI also have the ability to partially protect some targets against oxidative damage. These observations suggest that the presence of a thiol group in the ACEI structure is not the only determinant for the antioxidant properties.

Pentoxifylline. A hydroxyl radical scavenger.

Pentoxifylline (PTX), a tri-substituted purine and xanthine derivative, has been used for several years to improve microcirculation because of its hemorheological properties. PTX has also antifibrotic and anti-inflammatory effects. We studied the reaction of PTX with the hydroxyl radical and superoxide anion. Hydroxyl radical was generated by a mixture of ascorbic acid, H2O2 and Fe(III)-EDTA. We evaluated the iron-dependent degradation of deoxyribose, mediated by hydroxyl radical, in the presence of different concentrations of PTX (from 0.05 to 3 mM), measuring the degradation products of deoxyribose that react with 2-thiobarbituric acid (TBA). The reaction of PTX with hydroxyl radical occurred with a rate constant of (1.1 +/- 0.2) x 10(10) M-1/s. These results support the properties of PTX as a hydroxyl radical scavenger. Some authors verified that PTX decreases the release of superoxide anion from activated neutrophils. We studied the effect of PTX as a scavenger of superoxide generated in vitro by a hypoxanthine-xanthine oxidase system. PTX was not a superoxide anion scavenger in this system.

[Potential antioxidative effects of pentoxifylline]. / Effets antioxydants potentiels de la pentoxifylline.

Pentoxifylline (PTX) is a methylxanthine derivative with hemorrheologic properties. PTX decreases neutrophil degranulation and tumor necrosis factor production. We investigated the properties of the drug as a hydroxyl radical scavenger. The aim of this study was to assess the ability of PTX to inhibit visible fluoroescence generation in albumin incubated with 50 microM cupric chloride and 880 microM hydrogen peroxide for 3 h at 37 degrees C. PTX inhibited visible fluorescence generation (ex 360, em 454 nm) by 11% at 50 microM, 13% at 100 microM and 22% at 200 microM. In conclusion, PTX inhibited fluorescence generation in proteins induced by copper/hydrogen peroxide and has potential beneficial effects by protecting proteins against oxidative damage by reactive oxygen species.

[Lipid peroxidation, production of PGE2 and cellular mortality induced by UV in cultured human skin fibroblasts]. / Peroxydation lipidique, production de PGE2 et mortalité cellulaire induites par les UV dans des fibroblasts cutanés humains en culture.

UV irradiation induces lipid peroxidation (LPO) and cell damage. The aim of the present work was the study of UVB radiation effects on cultured human skin fibroblasts, concerning LPO, prostaglandine E2 (PGE2) formation and cell viability. The cells were exposed to 50, 100, and 150 mJ/cm2 of UVB irradiation. Cellular TBARS and supernatant fluorescent substances were measured spectrofluorimetrically. PGE2 was measured using an immunoenzymatic method. Cell viability was evaluated by the MTT test. All determinations were done after a 2 h incubation period post-irradiation. TBARS were increased for all doses of irradiation (p < 0.001). Fluorescent substances differed from controls at 50 mJ/cm2 (p < 0.001). UVB at 100 and 150 mJ/cm2 decreased cellular viability (p < 0.001). An increase of PGE2 was observed with UVB at 150 mJ/cm2 (p < 0.001). These results confirm the occurrence of LPO and cytotoxicity after UV irradiation; on the other hand, this study showed the formation of PGE2 induced by UV light on cultured human skin fibroblasts. We propose a relationship between these phenomena.

[Neurologic manifestations of Behçet disease. Review of the caseload of the Neurology and Dermatology services at the Santa Maria Hospital]. / Manifestações neurológicas na doença de behçet. Revisão da casuística dos serviços de Neurologia e Dermatologia do Hospital de Santa Maria.

Neurological involvement in a series of patients with Behçet's disease, evaluated at the Departments of Neurology and Dermatology, St. Maria Hospital is reported. Meningoencephalytic or encephalytic were the most common clinical forms, while headache, cerebellar and pyramidal signs were the most prevalent symptoms/signs. On follow-up (range 2-13 years) the majority of the patients had either a progressive or a remitting-progressive course. Magnetic ressonance imaging was the most valuable method of detecting central nervous system lesions.

Behçet's disease in Portugal.

During the last decades 156 patients with Behçet's disease were diagnosed and studied in Portugal. Until 1966 only two cases were referred in Portugal. In 1978 we reported 23 cases (18 males and 5 females) with multisystemic involvement, not different from that reported in other publications elsewhere. In 1987, 17 cases were reported from the Oporto region, diagnosed during a period of 5 years. In the region of Coimbra 15 cases were diagnosed (6 males and 9 females). In the Lisbon area from 1969 until 1990, 123 cases were studied altogether, 76 during the last decade (35 males and 41 females). All the cases studied had oral ulcerations and a high incidence of ocular involvement (clinical and sub-clinical, 87%). HLA-B5 was detected in 50% of the patients. At least four cases were fatal, three died with neuro-Behçet. Steroids, colchicine and thalidomide were the main form of treatment, for the patients in the Lisbon area, but in some cases chlorambucil, cyclophosphamide, azathioprine, cyclosporine-A, fibrinolytic therapy, plasmapheresis and isovolemic hemodilution were also used.