Mielinolisis central pontina e hiponatremia, un problema no resuelto: caso clínico / Central pontine myelinolysis and hyponatremia: report of 1 case

There is a controversy wheter central pontine myelinolysis can complicate either hyponatremia or its rapid correction. We report a 69 years old woman with a history of one month of vertigo, nausea, vomiting and diarrhea. She was admitted dehydrated ad stuporous, and initial laboratory values showed a serum sodium of 96 mEq/L She was treated with dextrose 5 percent and 3 percent NaCI. Serum sodium raised to 120 mEq/L at the next day and the level of consciousness improved. At the 4th day of admission, the patient was again stuporous and with spastic quadriplegia. A magnetic resonance imaging showed a central and symmetrical pontine lesion on T1 and T2 weighed images. Thereafter, the patient experienced a progressive improvement of her neurological condition and was discharged three months later, moving her lower limbs. Nine month later she was able to walk

Vagococcus fessus sp. nov., isolated from a seal and a harbour porpoise.

A polyphasic taxonomic study was performed on two strains of an unknown Gram-positive, catalase-negative, coccus-shaped bacterium isolated from a dead seal and a harbour porpoise. Comparative 16S rRNA gene sequencing demonstrated that the unknown bacterium represents a new subline within the genus Vagococcus close to, but distinct from, Vagococcus fluvialis, Vagococcus lutrae and Vagococcus salmoninarum. The unknown bacterium was readily distinguished from the three currently recognized Vagococcus species by biochemical tests and electrophoretic analysis of whole-cell proteins. Based on phylogenetic and phenotypic evidence, it is proposed that the unknown bacterium be classified as a new species, Vagococcus fessus. The type strain of Vagococcus fessus is CCUG 41755T.

Luteococcus peritonei sp. nov., isolated from the human peritoneum.

An unusual catalase-positive pleomorphic Gram-positive rod isolated from a human clinical specimen was subjected to a polyphasic taxonomic analysis. Comparative 16S rRNA gene sequence analysis revealed the unknown bacterium was a member of the high G+C branch of the Gram-positive bacteria (Actinobacteria), and was phylogenetically a member of the family Propionibacteriaceae, with Luteococcus japonicus as its nearest relative. Based on both phenotypic and phylogenetic evidence, it is proposed that the unknown bacterium be classified in the genus Luteococcus, as Luteococcus peritonei sp. nov. The type strain of Luteococcus peritonei is CCUG 38120T.

Porcine lung surfactant protein D: complementary DNA cloning, chromosomal localization, and tissue distribution.

Porcine organs and lung surfactant have medically important applications in both xenotransplantation and therapy. We have started to characterize porcine lung surfactant by cloning the cDNA of porcine surfactant protein D (SP-D). SP-D and SP-A are important mediators in innate immune defense for the lung and possibly other mucosal surfaces. Porcine SP-D will also be an important reagent for use in existing porcine animal models for human lung infections. The complete cDNA sequence of porcine SP-D, including the 5' and 3' untranslated regions, was determined from two overlapping bacteriophage clones and by PCR cloning. Three unique features were revealed from the porcine sequence in comparison to SP-D from other previously characterized species, making porcine SP-D an intriguing species addition to the SP-D/collectin family. The collagen region contains an extra cysteine residue, which may have important structural consequences. The other two differences, a potential glycosylation site and an insertion of three amino acids, lie in the loop regions of the carbohydrate recognition domain, close to the carbohydrate binding region and thus may have functional implications. These variations were ruled out as polymorphisms or mutations by confirming the sequence at the genomic level in four different pig breeds. Porcine SP-D was shown to localize primarily to the lung and with less abundance to the duodenum, jejunum, and ileum. The genes for SP-D and SP-A were also shown to colocalize to a region of porcine chromosome 14 that is syntenic with the human and murine collectin loci.

Dysgonomonas gen. nov. to accommodate Dysgonomonas gadei sp. nov., an organism isolated from a human gall bladder, and Dysgonomonas capnocytophagoides (formerly CDC group DF-3).

Results of a polyphasic taxonomic study on an unknown Gram-negative, facultatively anaerobic, coccobacillus-shaped organism isolated from an infected human gall bladder are presented. Phenotypic and molecular taxonomic studies revealed the organism to be close to, but distinct from, organisms designated CDC (Centers for Disease Control and Prevention) group DF-3. The unknown bacterium was readily distinguished from reference strains of Bacteroides, Prevotella, Porphyromonas and related taxa by 16S rRNA gene sequencing, biochemical tests, analysis of cellular long-chain fatty acids and electrophoretic analysis of whole-cell proteins. Based on the results of the present study, it is proposed that the unknown bacterium be classified in a new genus, Dysgonomonas, as Dysgonomonas gadei sp. nov. (type strain CCUG 42882T = CIP 106420T). In addition, a new species, Dysgonomonas capnocytophagoides sp. nov., is proposed to accommodate strains previously belonging to CDC group DF-3. The type species of the genus Dysgonomonas is Dysgonomonas gadei.

Trastorno conductual del sueño REM en dos casos documentados con polisomnogragía / REM sleep behavior disorder: report of two cases

We report a 69 years old male with a parkinsonian syndrome and a 50 years old female without neurological problems who showed violent behavior during REM sleep. Polysomnography showed that both had tonic or phasic muscular activity during REM sleep and a REM sleep behavior disorder was diagnosed. Clonazepam was used in both, with good clinical response. This condition is frequently unrecognized and confused with nightmares, nocturnal delirium or other parasomnias

Evolución electroclínica del status convulsivo secundariamente generalizado prolongado / Electroclinical evolution of prolonged secondarily generalized convulsive status epilepticus

El status convulsivo secundariamente generalizado (SCSG) es la más común de las formas de status epiléptico (SE), a la vez que el más peligroso ya que con mayor frecuencia es causa de secuelas neurológicas y muerte, si no se trata adecuadamente. SCSG es un estado dinámico, las manifestaciones clínicas y electroencefalográficas varían en el tiempo si las convulsiones persisten al fracasar el tratamiento. Existe una progresión de status manifiesto a status sutil en el SCSG, y de acuerdo a reportes previos tambien existe una progresión o secuencia en la actividad eléctrica en los casos de evolución prolongada. Para verificar lo anterior analizamos las variaciones clínicas y electromagnéticas de cinco pacientes que cumplían criterios de SCSG. En ellos efectivamente pudimos confirmar la mayoría de los cambios o patrones descritos en otras publicaciones. Sin embargo no identificamos ninguna progresión o secuencia definida en estos patrones

High-energy magnetic compton scattering from iron.

The magnetic Compton profile of Fe [111] was measured using circularly polarized synchrotron radiation at incident energies of 84.4, 167.2 and 256.0 keV on the high-energy beamline at the European Synchrotron Radiation Facility. It was found that the momentum resolution of these experiments, which use semiconductor detectors, improves by almost a factor of two over what was previously possible by this technique at photon energies of approximately (1/10)mc(2). It was also observed that all three spectra reduced to the magnetic Compton profile, describing the spin-dependent ground-state momentum density, and that within the experimental error the integrated intensity of the magnetic effect scaled as predicted by the cross section derived in the limit of energies much less than the rest energy of the electron. The magnetic Compton profile of Fe [111], measured using 167.2 keV incident energy and with momentum resolution of 0.42 a.u., was compared with the prediction from a full-potential linearized augmented-plane-wave model profile. The fine structure predicted by theory was confirmed by the experimental profile at this improved resolution.

Squamous cell carcinoma of the distal urethra in a patient with congenital hypospadias.

A previously well 43-yr-old man with congenital hypospadias presented with a fungating lesion of 2 mths duration and surrounding the ventral urethral opening. After biopsy showed this to be a squamous cell carcinoma, a definitive procedure of partial penile amputation and urethroplasty was performed. This is believed to be the first reported case of squamous cell carcinoma of the distal urethra in conjunction with hypospadias.

Criteria for consistent and high sensitivity of DNA in situ hybridization on paraffin sections: optimal proteolytic enzyme digestion.

It is technically challenging for the detection of target DNA in low abundancy, such as viral DNA sequences in latently infected cells by nonisotopic in situ hybridization (ISH). Consistent result is even more difficult to achieve on routine paraffin sections. Proteolytic enzyme digestion is most critical for both consistency and sensitivity of the technique. We here have investigated the effect of enzyme digestion on cell morphology, protein and DNA reduction, and hybridization efficiency. The results demonstrated that enzyme digestion improves efficiency of ISH through a process involving partial DNA purification on sections. There is a clear relationship between proteolytic enzyme digestion, morphology changes, and hybridization efficiency. Although detection of DNA sequences in abundance can be achieved within a relatively wide range of digestion levels, maximum hybridization efficiency was always related to the cells, which showed morphology of nuclear swollen, weak homogeneous chromatin staining with hematoxylin and loss of visible nuclear membrane. Detection of viral DNA in low copy number critically depends on the creation of the morphologic changes by enzyme digestion. The morphological changes would therefore serve as important criteria for optimal digestion, result interpretation, and comparison.

Diagnosis of Clostridium difficile associated diarrhea: comparison of three rapid methods employing different markers for detection.

Latex agglutination and the enzyme immunoassays Cytoclone (EIA-C) and VIDAS (EIA-V) were compared with a cytotoxicity assay for the diagnosis of Clostridium difficile associated diarrhea. Among patients with discrepant results, the cytotoxicity assay and clinical assessment were used to evaluate the performance of the latex agglutination and EIA tests. Clostridium difficile associated diarrhea was documented in 30/149 samples (20.1%) from 130 patients. All test results matched in 113 instances. Latex agglutination, EIA-C, and EIA-V yielded false positive results in 10, 4, and 7 samples and false negative results in 8, 9, and 14 samples, respectively. Latex agglutination demonstrated 87.8% efficiency compared with 91.3% for EIA-C and 85.7% for EIA-V and 3 min hands-on time compared with 4.5 min for EIA-V and 10 min for EIA-C. On the basis of these findings and given the fact that all rapid tests have their shortcomings, we believe that latex agglutination is the most practical method.

Fine mapping of probes in the adenomatous polyposis coli region of chromosome 5 by in situ hybridization.

The gene for adenomatous polyposis coli has been localized to 5q21-22. We have mapped six probes from this region using isotopic or nonisotopic in situ hybridization. Using tritium-labeled probes we localized II227 (D5S37) to 5q14-15 and ECB27 (D5S98) to 5q21. Following hybridization with biotin-labeled probes, the positions of signals along the chromosomes were measured as fractional length relative to the length of the chromosome arm from centromere to qter (FLcen-qter). Ninety-five percent confidence limits, compared with standard karyotypes, provided the corresponding band localization. By this method we localized Cllpll (D5S71) to FLcen-qter 0.407-0.452 (5q21.1-21.3), ECB27 to FLcen-qter 0.426-0.473 (5q21.3), YN5.48 (D5S81) to FLcen-qter 0.459-0.496 (5q21.3-22.2), and ECB134 (D5S97) to FLcen-qter 0.509-0.533 (5q22.3-23.1). ECB220 had three sites of hybridization, a major site at FLcen-qter 0.460-0.492 (5q21.3-22.1) and minor sites at FLcen-qter 0.299-0.339 (5q14.3-15) and FLcen-qter 0.629-0.691 (5q23.3-31.2). We have shown that the chromosome 5 breakpoint in a t(5;15) translocation from a patient with Gardner's syndrome (GM03314) is between Cllpll and ECB27. Linkage data are presented suggesting that ECB27 is located on the same side of the APC locus as II227. These and published results including data on several constitutional deletions (M, SD, and brothers PW and ND) give a probable order of [cen] - [II227, proximal SD breakpoint] - [Cllpll] - [proximal PW/ND, M breakpoint(s), GM03314 breakpoint] - [ECB27] - [APC] - [YN5.48] - [distal PW/ND breakpoint] - [ECB134] - [distal M breakpoint] - [qter]. The major site of ECB220 appears to be between ECB27 and the distal PW/ND breakpoint; the distal SD breakpoint is distal to YN5.48.

Origins of the Urological Society of Australasia.

The origins of urology as a specialty and the organization of urologists is outlined. This coincides with the 50th anniversary of the Urological Society of Australasia (USA). Biographies of the first five presidents of the USA illustrate some characteristics of the foundation members.

Preventing iron deficiency in preschool children by implementing an educational and screening programme in an inner city practice.

OBJECTIVE: To assess the feasibility and acceptability of screening young children for iron deficiency in a deprived inner city practice and to assess the effects of a programme of dietary education. DESIGN: Prospective study of children in general practice, comparison with historical controls. SETTING: A deprived inner city practice. PATIENTS: 127 Children aged 13-24 months. Findings were compared with those in 110 children of the same age studied previously. INTERVENTIONS: All mothers received dietary education antenatally and in the first year after giving birth. Screening for iron deficiency (defined as mean cell volume less than 75 fl and haemoglobin concentration less than 105 g/l) and haemoglobinopathy (when appropriate) was offered for all children attending for immunisation against measles, mumps, and rubella over 12 months; capillary blood samples were taken after immunisation. MAIN OUTCOME MEASURES: Uptake of the screening programme expressed as the percentage of all children eligible for immunisation who were screened, and the effectiveness of the dietary education as shown by the prevalence of iron deficiency in the two groups. RESULTS: Altogether, 122 of the 127 (96%) children who attended for immunisation had their haemoglobin concentration and mean cell volume measured; 90% of all children aged 13-24 months in the practice were screened. Dietary education, clinical procedures, and counselling were incorporated successfully into the clinic's work. Ten children (8%) were iron deficient, all of whom responded to iron supplements, and eight had a haemoglobinopathy trait. In the previous study 110 children (70%) had been screened and 28 children (25%) had been iron deficient. The two groups were similar in terms of sex, social class, and ethnic group. CONCLUSIONS: Screening young children for iron deficiency, sickle cell disease, and thalassaemia when they attended for immunisation was acceptable and successful in a socially deprived inner city practice. Dietary education may have accounted for some of the reduction in the prevalence of iron deficiency that occurred over the two years.

Inhibition of protein synthesis reduces the cytotoxicity of 4'-(9-acridinylamino)methanesulfon-m-anisidide without affecting DNA breakage and DNA topoisomerase II in a murine mastocytoma cell line.

Stimulation of cleavable complex formation by 4'-(9-acridinylamino)methanesulfon-m-anisidide (mAMSA) and related anticancer drugs is an important initial event in drug action which correlates with cytotoxicity. However, it was recently suggested that factors in addition to cleavable complex formation are needed to express lethality. Therefore we investigated the effects of inhibitors of DNA replication and RNA and protein synthesis on mAMSA-induced cell killing in the K21 subline of the P815 murine mastocytoma cell line. This showed that RNA and protein synthesis, but not DNA replication, was necessary for maximal mAMSA cytotoxicity. Moreover, inhibition of RNA synthesis with cordycepin or protein synthesis with cycloheximide protected cells from the cytotoxic action of mAMSA without reducing DNA breakage or cleavable complex formation and there was no decrease in DNA topoisomerase II activity in nuclear extracts from cells treated with cordycepin or cycloheximide. We conclude that cleavable complex formation is independent of RNA and/or protein synthesis and we propose that the subsequent conversion into a lethal event requires an additional labile protein factor.

Glycosylation reduces the bioactivity of calcitonin.

The biological significance of peptide hormone glycosylation is uncertain. To examine the effect of Asn-linked glycosylation on calcitonin's bioactivity we purified glycosylated calcitonin from a transplantable rat medullary thyroid carcinoma. Glycosylated calcitonin constituted 2.3% of the total extracted immunoreactive calcitonin. The structure of this peptide differed from nonglycosylated calcitonin only by the oligosaccharide modification of asparagine 3. Affinity of glycosylated calcitonin for lentil lectin indicated that the oligosaccharide was a complex processed form. In a standard in vivo bioassay glycosylated calcitonin had a markedly reduced hypocalcemic activity compared to nonglycosylated calcitonin, an effect most likely due to the presence of the oligosaccharide.