Anal canal duplication and triplication: a rare entity with different presentations.

Anal canal duplication (ACD) is the rarest of gastrointestinal duplications. Few cases have been reported. Most cases present as an opening in the midline, posterior to the normal anus. The aim of our revision is to contribute with eight new cases, some of them with unusual presentations: five presented as the typical form, one with a perianal nodule, and two presented as two separate orifices (anal canal triplication). Complete excision was performed in all patients with no complications. ACD is the most distal and the least frequent digestive duplication. Its treatment should be surgical excision, to avoid complications such as abscess, fistulization, or malignization. Anal canal triplication has never been described before.

Feeding dynamics, consumption rates and daily ration of wahoo Acanthocybium solandri in Indo-Pacific waters.

This study reports the diet composition of 363 wahoo Acanthocybium solandri captured from the Indo-Pacific. The study also provides the first estimates of consumption and daily ration for the species worldwide, which are important parameters for ecosystem models and may improve ecosystem-based fisheries management. Thirty-four prey taxa were identified from A. solandri stomachs with Scombridae having the highest relative importance. Actinopterygii comprised 96% of the total prey wet mass, of which 29% were epipelagic fishes, with 22% alone from Scombridae. There was no significant relationship between fish size and the size of prey items consumed. Feeding intensity, as measured by stomach fullness, did not significantly differ either among seasons or reproductive activity. The mean daily consumption rate was estimated as 344 g day-1 , which corresponded to a mean daily ration of 2·44% body mass day-1 . The results from this study suggest A. solandri is an opportunistic predator similar to other pelagic piscivores, worldwide.

Estado de control de pacientes en tratamiento con anticoagulantes orales antagonistas de la vitaminaK en atención primaria. Estudio ECOPAVIK / Update on the control of patients on treatment with vitaminK antagonist oral anticoagulants in Primary Care

Introducción. En España, más del 80% de pacientes con fibrilación auricular (FA) reciben tratamiento anticoagulante oral (TAO), con un seguimiento dentro del ámbito de la atención primaria (AP) del 72% de los pacientes. Estudios recientes demuestran que existe un deficiente control de los pacientes con anticoagulantes orales (ACO). El objetivo de este estudio fue obtener un conocimiento más detallado del estado de control, así como de las patologías que lo indican y están en comorbilidad en los pacientes en tratamiento con ACO antagonistas de la vitaminaK (AVK). Metodología. Estudio observacional retrospectivo/transversal en el que participaron pacientes de una zona básica de salud incluidos dentro del programa TAO durante 2014. Se consideró que el control de INR en pacientes en tratamiento con ACO era inadecuado cuando el porcentaje de tiempo en rango terapéutico (TRT) era inferior al 65% durante un periodo de valoración de al menos 6meses. Resultados. Se incluyeron 368 pacientes, en los que la patología con indicación de anticoagulación oral más prevalente fue la FA no valvular. Se realizaron 5.128 controles, de los cuales 2.359 (46%) estaban fuera de rango terapéutico y 2.769 (54%) estaban en rango terapéutico. El 91% de los pacientes en tratamiento con ACO AVK presentaban un riesgo muy elevado de tromboembolismo. Conclusiones. La indicación de anticoagulación en nuestra población es correcta, asumiendo un riesgo hemorrágico bajo/intermedio en la mayoría de los pacientes. La medición del TRT mediante el método de Rosendaal indica que existe un deficiente control de los pacientes en tratamiento con ACO AVK (AU)

Background. In Spain, more than 80% of patients with atrial fibrillation (AF) receive oral anticoagulant therapy (OAT), and 72% of these patients are followed up in the Primary Care (PC) setting. Recent studies have shown that there is insufficient control of patients on OAT. The objective of the present study was to obtain more detailed information on the state of control of patients on treatment with vitaminK antagonist (VKA) oral anticoagulants (OAC), on the diseases for which the therapy was indicated and on concomitant diseases. Methods. This was a retrospective, cross-sectional, observational study with the participation of patients from a single health area included in an OAT programme throughout 2014. In patients on treatment with OAC, International Normalised Ratio (INR) control was considered insufficient when the percentage time in therapeutic range (TTR) was below 65% during an evaluation period of at least 6months. Results. A total of 368 patients were included in the study, where the most frequent indication for oral anticoagulation was non-valvular AF. A total of 5,128 INR controls were performed, of which 2,359 (46%) were outside the therapeutic range, and 2,769 (54%) were within range. The risk of thromboembolism was very high in 91% of patients on treatment with VKA OAC. Conclusions. The indication for anticoagulation is correct in our population, assuming a low-intermediate risk of haemorrhage in the majority of patients. Measurement of the TTR using the Rosendaal method shows that the control of patients on treatment with VKA OAC is insufficient (AU)

¿Es necesario realizar una cistouretrografía miccional seriada (CUMS) tardía tras el tratamiento endoscópico exitoso inicial con copolímero de dextranómreo/ácido hialurónico (Dx/HA) para el reflujo vesicoureteral (RVU)? / Routine delayed voiding cystourethography after initial successful endoscopic treatment with Dextranomer/Hialuronic Acid Copolimer (Dx/HA) of vesicoureteral reflux (VUR). Is it necessary?

Introducción: La mayoría de las guías recomiendan realizar una cistografía miccional (CUMS) temprana tras el tratamiento endoscópico del reflujo vesicoureteral (RVU), pero no hay consenso sobre cómo hacer el seguimiento a largo plazo en este grupo de pacientes. El objetivo de este estudio es analizar si es necesaria la realización de una CUMS tardía en aquellos pacientes tratados con éxito. Material y método: Hemos revisado las historias clínicas de aquellos pacientes tratados de RVU con el copolímero de dextranómero/ácido hialurónico (Dx/AH) desde 2006 a 2010. Se han seleccionado aquellos pacientes que estaban curados tras el tratamiento con más de 3 años de seguimiento y control cistográfico tardío. Hemos analizado los hallazgos clínicos y radiológicos a largo plazo. Resultados: Ciento sesenta niños con 228 uréteres refluyentes recibieron tratamiento con Dx/AH con un seguimiento medio de 52,13 meses. A 215 se les realizó CUMS de forma temprana, siendo la tasa de éxito del 84,1%. El grupo de estudio fueron 94/215 uréteres refluyentes que tuvieron un seguimiento clínico y cistográfico tardío mayor de 3 años. En el 79,8% la CUMS mostró ausencia de RVU, siendo la tasa de éxito tardío clínico del 91,7%. La incidencia de infección del tracto urinario febril entre aquellos que estaban curados desde el punto de vista radiológico frente a aquellos en los que recidivó el RVU fue del 8 y 15%, respectivamente. Solo existieron diferencias significativas en la recidiva del RVU entre aquellos uréteres que se habían tratado de forma inicial con una punción o con 2 punciones de Dx/AH. Conclusión: Si el objetivo del tratamiento del RVU es disminuir las infecciones del tracto urinario febril, no es necesario realizar una CUMS tardía tras un tratamiento exitoso inicial con Dx/AH, a pesar de que la tasa de éxito radiológico es menor que la del clínico

Introduction: Some guidelines recommend an early voiding cystourethrography (VCUG) after endoscopic treatment of vesicoureteral reflux (VUR), but there's no consensus if it's necessary a long-term follow-up in these patients. The aim of our study is analyze if it's necessary a delayed VCUG after initial successful treatment with Dx/HA. Material and method: We have reviewed all medical charts of patients that underwent Dx/HA treatment from 2006 to 2010. We have selected patients with initial successful treatment and more than 3 years of radiological and clinical follow-up. We have analyzed late clinical and radiological outcomes. Results: One hundred and sixty children with 228 refluxing ureters underwent Dx/HA endoscopic treatment with a mean follow-up of 52.13 months. Early VCUG was performed in 215 ureters with an initial successful rate of 84.1%. The group of study was 94/215 ureters with more than 3 years of follow-up with a delayed VCUG. VUR was still resolved in 79,8% of the ureters. Clinical success rate was 91.7%. The incidence of febrile urinary tract infection in those patients with cured VUR and those with a relapsed VUR was 8 and 15%, respectively; but there were no significant differences. We have not found any variable related with relapsed VUR except those ureters that initially received 2 injections (P < .05). Conclusion: If our objective in the treatment of VUR is to reduce the incidence of febrile urinary tract infection it is not necessary to perform a delayed VCUG even though the long-term radiological outcomes is worse than clinical outcome

Routine delayed voiding cystourethography after initial successful endoscopic treatment with Dextranomer/Hialuronic Acid Copolimer (Dx/HA) of vesicoureteral reflux (VUR). Is it necessary? / ¿Es necesario realizar una cistouretrografía miccional seriada (CUMS) tardía tras el tratamiento endoscópico exitoso inicial con copolímero de dextranómreo/ácido hialurónico (Dx/HA) para el reflujo vesicoureteral (RVU)?

INTRODUCTION: Some guidelines recommend an early voiding cystourethrography (VCUG) after endoscopic treatment of vesicoureteral reflux (VUR), but there's no consensus if it's necessary a long-term follow-up in these patients. The aim of our study is analyze if it's necessary a delayed VCUG after initial successful treatment with Dx/HA. MATERIAL AND METHOD: We have reviewed all medical charts of patients that underwent Dx/HA treatment from 2006 to 2010. We have selected patients with initial successful treatment and more than 3 years of radiological and clinical follow-up. We have analyzed late clinical and radiological outcomes. RESULTS: One hundred and sixty children with 228 refluxing ureters underwent Dx/HA endoscopic treatment with a mean follow-up of 52.13 months. Early VCUG was performed in 215 ureters with an initial successful rate of 84.1%. The group of study was 94/215 ureters with more than 3 years of follow-up with a delayed VCUG. VUR was still resolved in 79,8% of the ureters. Clinical success rate was 91.7%. The incidence of febrile urinary tract infection in those patients with cured VUR and those with a relapsed VUR was 8 and 15%, respectively; but there were no significant differences. We have not found any variable related with relapsed VUR except those ureters that initially received 2 injections (P<.05). CONCLUSION: If our objective in the treatment of VUR is to reduce the incidence of febrile urinary tract infection it is not necessary to perform a delayed VCUG even though the long-term radiological outcomes is worse than clinical outcome.

Definition of an 18-mer Synthetic Peptide Derived from the GB virus C E1 Protein as a New HIV-1 Entry Inhibitor.

BACKGROUND: A slower progression of AIDS and increased survival in GBV-C positive individuals, compared with GBV-C negative individuals has been demonstrated; while the loss of GBV-C viremia was closely associated with a rise in mortality and increased progression of AIDS. Following on from the previous reported studies that support the thesis that GBV-C E2 interferes with HIV-1 entry, in this work we try to determine the role of the GBV-C E1 protein in HIV-1 inhibition. METHODS: The present work involves the construction of several overlapping peptide libraries scanning the GBV-C E1 protein and the evaluation of their anti-HIV activity. RESULTS: Specifically, an 18-mer synthetic peptide from the GBV-C E1 protein, E1(139-156), showed similar antiviral activity against HIVs from viruses from clades A, B, C, D and AE. Competitive ELISA using specific gp41-targeting mAbs, fluorescence resonance energy transfer as well as haemolysis assays demonstrated that this E1 peptide sequence interacts with the highly conserved N-terminal region of the HIV-1 gp41 (the fusion peptide) which is essential for viral entry. CONCLUSIONS: We have defined a novel peptide lead compound and described the inhibitory role of a highly conserved fragment of the E1 protein. GENERAL SIGNIFICANCE: The results together allow us to consider the non-pathogenic E1 GBV-C protein as an attractive source of peptides for the development of novel anti-HIV therapies.

[Update on the control of patients on treatment with vitaminK antagonist oral anticoagulants in Primary Care]. / Estado de control de pacientes en tratamiento con anticoagulantes orales antagonistas de la vitaminaK en atención primaria. Estudio ECOPAVIK.

BACKGROUND: In Spain, more than 80% of patients with atrial fibrillation (AF) receive oral anticoagulant therapy (OAT), and 72% of these patients are followed up in the Primary Care (PC) setting. Recent studies have shown that there is insufficient control of patients on OAT. The objective of the present study was to obtain more detailed information on the state of control of patients on treatment with vitaminK antagonist (VKA) oral anticoagulants (OAC), on the diseases for which the therapy was indicated and on concomitant diseases. METHODS: This was a retrospective, cross-sectional, observational study with the participation of patients from a single health area included in an OAT programme throughout 2014. In patients on treatment with OAC, International Normalised Ratio (INR) control was considered insufficient when the percentage time in therapeutic range (TTR) was below 65% during an evaluation period of at least 6months. RESULTS: A total of 368 patients were included in the study, where the most frequent indication for oral anticoagulation was non-valvular AF. A total of 5,128 INR controls were performed, of which 2,359 (46%) were outside the therapeutic range, and 2,769 (54%) were within range. The risk of thromboembolism was very high in 91% of patients on treatment with VKA OAC. CONCLUSIONS: The indication for anticoagulation is correct in our population, assuming a low-intermediate risk of haemorrhage in the majority of patients. Measurement of the TTR using the Rosendaal method shows that the control of patients on treatment with VKA OAC is insufficient.

Miscibility and Langmuir Studies of the Interaction of E2 (279-298) Peptide Sequence of Hepatitis G Virus/GB Virus-C with Dipalmitoylphosphatidyl Choline and Dimiristoylphosphatidyl Choline Phospholipids.

Mixed monolayers of E2(279-298), a synthetic peptide belonging to the structural protein E2 of the GB virus C (GBV-C), formerly know as hepatitis G virus (HGV), and the phospholipids dipalmitoylphosphatidyl choline (DPPC) and dimiristoylphosphatidyl choline (DMPC),which differ in acyl chains length, were obtained at the A/W interface (monolayers of extension) in order to provide new insights on E2/phospholipids interaction. Analysis of the surface pressure-area isotherms, Brewster angle microscopy images, relative thickness, and mean areas per molecule has allowed us to establish the conditions under which the mixed components of the monolayer are miscible or immiscible and know how the level of the E2/phospholipid interaction varies with the composition of the mixed films, the surface pressure, and the hydrocarbon chains length of the phospholipids. The steric hindrance caused by the penetration of the polymer strands into the more or less ordered hydrocarbon chains of the phospholipids was suggested to explain the differences in the peptide interaction with the phospholipids studied. Therefore, the novelty of results obtained with the Langmuir film balance technique, supplemented with BAM images allow us to achieve a deeper understanding of the interaction.

Características bacterianas y significado clínico de catéteres ureterales doble J en niños / Bacterial characteristics and clinical significance of ureteral double-J stents in children

Objetivo: Determinar la incidencia de infección del tracto urinario en los pacientes en los que hemos utilizado un catéter ureteral doble J como desvío interno después de procedimientos urológicos. Material y métodos: Se revisaron todas las historias clínicas de los pacientes que tenían un catéter ureteral doble J después de un procedimiento urológico desde agosto de 2007 hasta mayo de 2013. Hemos analizado los siguientes datos: edad, sexo, tipo de profilaxis, incidencia de la infección del tracto urinario (ITU), días de desviación interna con catéter doble J, procedimiento quirúrgico, características bacterianas, sensibilidad de las bacterias a los antibióticos y tratamiento de ITU. Resultados: Hemos utilizado 73 catéteres doble J como desvío interno ureteral en 67 pacientes con una edad media de 44,73 ± 57,23. Los procedimientos quirúrgicos fueron 50 pieloplastias laparoscópicas Anderson-Hynes en 49 pacientes y 20 dilataciones con balón de alta presión de la unión ureterovesical para tratar megauréter obstructivo primario en 15 pacientes, y 3 pacientes con obstrucción ureterovesical después del tratamiento endoscópico del reflujo vesicoureteral. Cuarenta y tres catéteres mostraron una colonización bacteriana en los cultivos. Pseudomona aeruginosa estaba presente en 9 (20,9%) catéteres. Solo en 12 catéteres la colonización bacteriana era sensible a la profilaxis antibiótica. La colonización del catéter era mayor en los niños y los pacientes más jóvenes. Cuatro pacientes tuvieron una ITU febril. La incidencia de ITU en los pacientes más jóvenes que se sometieron a DBAP de UUV es mayor. Conclusión: La colonización bacteriana es frecuente en los catéteres doble J, pero la incidencia de ITU es baja. La colonización doble J es mayor en los pacientes más jóvenes. Los pacientes que se sometieron a DBAP tienen un mayor riesgo de ITU relacionada con el catéter ureteral doble J

Objective: To determine the incidence of urinary tract infection in those patients that we have used an ureteral double-J stent as internal diversion after urological procedures. Material and methods: We reviewed all the medical records of patients who had a ureteral double-J stent after a urological procedure from August 2007 to May 2013. We have analyzed the following data: age, gender, type of prophylaxis, incidence of urinary tract infection (UTI), days of internal diversion with double-J stent, surgical procedure, bacterial characteristics, bacterial sensibility to antibiotics and UTI treatment. Results: We have used 73 double-J stents as ureteral internal diversion in 67 patients with a mean age of 44.73 ± 57.23. Surgical procedures were 50 laparoscopic Anderson-Hynes pyeloplasties in 49 patients, and 20 high-pressure balloon dilatation of the ureterovesical junction to treat primary obstructive megaureter in 15 patients; and 3 patients with ureterovesical obstruction after endoscopic treatment of vesicoureteral reflux. Forty three stents showed a bacterial colonization in cultures. Pseudomona aeruginosa was present in 9 (20.9%) stents. Only in 12 stents, bacterial colonization was sensible to antibiotic prophylaxis. Stent colonization was higher in boys and younger patients. Four patients had a febrile UTI. Incidence of UTI in younger patients that underwent HBPD of UVJ is higher. Conclusion: Bacterial colonization is frequent in double-J stents but the incidence of UTI is low. Double-J colonization is higher in younger patients. Patients that underwent HPBD have a higher risk of UTI related with ureteral double J stent

Surface behavior of peptides from E1 GBV-C protein: Interaction with anionic model membranes and importance in HIV-1 FP inhibition.

The interaction between a peptide sequence from GB virus C E1 protein (E1P8) and its structural analogs (E1P8-12), (E1P8-13), and (E1P8-21) with anionic lipid membranes (POPG vesicles and POPG, DPPG or DPPC/DPPG (2:1) monolayers) and their association with HIV-1 fusion peptide (HIV-1 FP) inhibition at the membrane level were studied using biophysical methods. All peptides showed surface activity but leakage experiments in vesicles as well as insertion kinetics in monolayers and lipid/peptide miscibility indicated a low level of interaction: neither E1P8 nor its analogs induced the release of vesicular content and the exclusion pressure values (πe) were clearly lower than the biological membrane pressure (24-30 mN m(-1)) and the HIV-1 FP (35 mN m(-1)). Miscibility was elucidated in terms of the additivity rule and excess free energy of mixing (GE). E1P8, E1P8-12 and E1P8-21 (but not E1P8-13) induced expansion of the POPG monolayer. The mixing process is not thermodynamically favored as the positive GE values indicate. To determine how E1 peptides interfere in the action of HIV-1 FP at the membrane level, mixed monolayers of HIV-1 FP/E1 peptides (2:1) and POPG were obtained. E1P8 and its derivative E1P8-21 showed the greatest HIV-1 FP inhibition. The LC-LE phase lipid behavior was morphologically examined via fluorescence microscopy (FM) and atomic force microscopy (AFM). Images revealed that the E1 peptides modify HIV-1 FP-lipid interaction. This fact may be attributed to a peptide/peptide interaction as indicated by AFM results. Finally, hemolysis assay demonstrated that E1 peptides inhibit HIV-1 FP activity.

Bacterial characteristics and clinical significance of ureteral double-J stents in children.

OBJECTIVE: To determine the incidence of urinary tract infection in those patients that we have used an ureteral double-J stent as internal diversion after urological procedures. MATERIAL AND METHODS: We reviewed all the medical records of patients who had a ureteral double-J stent after a urological procedure from August 2007 to May 2013. We have analyzed the following data: age, gender, type of prophylaxis, incidence of urinary tract infection (UTI), days of internal diversion with double-J stent, surgical procedure, bacterial characteristics, bacterial sensibility to antibiotics and UTI treatment. RESULTS: We have used 73 double-J stents as ureteral internal diversion in 67 patients with a mean age of 44.73±57.23. Surgical procedures were 50 laparoscopic Anderson-Hynes pyeloplasties in 49 patients, and 20 high-pressure balloon dilatation of the ureterovesical junction to treat primary obstructive megaureter in 15 patients; and 3 patients with ureterovesical obstruction after endoscopic treatment of vesicoureteral reflux. Forty three stents showed a bacterial colonization in cultures. Pseudomona aeruginosa was present in 9 (20.9%) stents. Only in 12 stents, bacterial colonization was sensible to antibiotic prophylaxis. Stent colonization was higher in boys and younger patients. Four patients had a febrile UTI. Incidence of UTI in younger patients that underwent HBPD of UVJ is higher. CONCLUSION: Bacterial colonization is frequent in double-J stents but the incidence of UTI is low. Double-J colonization is higher in younger patients. Patients that underwent HPBD have a higher risk of UTI related with ureteral double J stent.

Modification of FP-HIV activity by peptide sequences of GB virus C: a biophysical approach.

Three synthetic peptide sequences of 18 amino acid each, corresponding to different fragments of the E2 capsid protein of GB virus C (GBV-C): SDRDTVVELSEWGVPCAT (P45), GSVRFPFHRCGAGPKLTK (P58) and RFPFHRCGAGPKLTKDLE (P59) have been characterized in order to find a relationship between their physicochemical properties and the results obtained in cellular models. Experiments were performed in presence and absence of the HIV fusion peptide (FP-HIV) due to the evidences that GBV-C inhibits AIDS progression. P45 peptide showed lower surface activity and less extent of penetration into 1,2-dimyristoyl-sn-glycero-3-phosphocholine (DMPC) and 1,2-dimyristoyl-sn-glycero-3-phospho-L-serine (DMPS) (3:2, mol/mol) lipid monolayers than P58 and P59. However, P45 peptide presented higher capacity to inhibit FP-HIV induced cell-cell fusion than the other two sequences. These results were supported by fluorescence anisotropy measurements which indicated that P45 had a significant effect on the inhibition of FP-HIV perturbation of liposomes of the same lipid composition. Finally, atomic force microscopy (AFM) studies have evidenced the modification of the changes induced by the FP-HIV in the morphology of lipid bilayers when P45 was present in the medium.

Use of high-pressure balloon dilatation of the ureterovesical junction instead of ureteral reimplantation to treat primary obstructive megaureter: is it justified?

OBJECTIVE: To compare outcomes between high-pressure balloon dilatation of the ureterovesical junction (UVJ) and ureteral reimplantation with ureteral tapering to treat primary obstructive megaureter (POM). PATIENTS AND METHODS: Retrospective review of clinical data from patients who underwent surgical treatment of POM from 2005 to 2010. Patients were divided into two groups: endoscopic treatment (ET) with UVJ dilatation and ureteral reimplantation (UR) with Cohen's or Leadbetter-Politano neoureterocystostomy and Hendren's tapering. Preoperative studies included ultrasound scan (US), voiding cystourethrography, and diuretic isotopic renogram. Outcome parameters were US, differential renal function (DRF), presence of postoperative vesicoureteral reflux, need for secondary reimplantation and complications. RESULTS ET: 13 patients with a median age of 7 (4-24) months; UR: 12 patients with a median age of 14 (7-84) months, with no statistical differences in age and gender between groups. Preoperative US parameters were similar. ET: mean diameter of renal pelvis, calices and ureter was 23.5 mm, 13.46 mm and 15.77 mm respectively. UR: mean diameter of renal pelvis, calices and ureter was 22.25 mm, 11.75 mm, and 19.08 mm, respectively. Preoperative DRF was 45.62% and 39.33% for ET and UR, respectively (p > 0.05). Significant improvement of hydroureteronephrosis was observed in 11/13 patients of ET and 11/12 patients of UR (p > 0.05). Postoperative DRF was 42% and 48% for ET and UR, respectively (p > 0.05). Postoperative vesicoureteral reflux was observed in 2 patients of ET and 1 of UR (p > 0.05). Secondary ureteral reimplantation was needed in 3 patients of ET and 2 of UR (p > 0.05). CONCLUSION: Endoscopic treatment of POM is as effective as ureteral reimplantation but further randomized clinical trials are needed to support these results.

Acute and delayed vesicoureteral obstruction after endoscopic treatment of primary vesicoureteral reflux with dextranomer/hyaluronic acid copolymer: why and how to manage.

OBJECTIVE: To present our cases of ureteral obstruction after endoscopic treatment of vesicoureteral reflux (VUR) with dextranomer/hyaluronic acid (Dx/HA). PATIENTS AND METHODS: We collected data from patients who had suffered ureteral obstruction after endoscopic treatment of VUR with Dx/HA in our institution. RESULTS: From April 2002 to April 2011 we treated endoscopically 475 ureters with VUR, and detected 5 ureteral obstructions. Median age at reflux treatment was 39 months. Reflux grade before treatment was III in one patient and IV in four. Three ureterovesical junctions (UVJ) were blocked after a second endoscopic treatment. The median of Dx/HA injected was 1 ml (0.6-1.1). In two patients ureteral obstruction presented acutely and was treated with a ureteral stent. In the other three, the ureteral obstruction appeared gradually and was detected by ultrasound scans and MAG3 diuretic renogram; one underwent nephrectomy because of poor renal function, and the other two were treated with endoscopic dilatation of the UVJ. In all these patients both reflux and obstructions have resolved. CONCLUSIONS: On preoperative cystography, three of the patients had a narrowed distal ureter, and probably had a refluxing and obstructive megaureter. Other causes are not clear, except for those patients with acute presentation in whom edema of the UVJ was found. Ureteral obstruction after endoscopic treatment of VUR is rare. Endoscopic intervention such as ureteral stent placement or high-pressure balloon dilatation of the UVJ has good results as a treatment of acute and delayed obstruction.

Interaction of two overlapped synthetic peptides from GB virus C with charged mono and bilayers.

The physical chemistry properties and interactions of E2 (125-139) and E2 (120-139) peptide sequences from GB virus C with model cell membranes were investigated by means of several biophysical techniques in order to gain better understanding of the effect of peptide length and lipid charge on membrane binding. The peptides, having one net negative charge at the pH of the assays, interacted with monolayers of all the phospholipids regardless of the charge but with more extent with the cationic DPTAP thus indicating that the interaction had both a hydrophobic and an electrostatic component as has been observed for other peptides of the same family. The peptides were able to leakage contents of liposomes and showed fluorescence energy transfer in vesicles depending on the vesicles lipid composition. On another hand, circular dichroism has shown that the peptides exist mainly as a mixture of disordered structure and ß-type conformations in aqueous solution but diminished its unstructured content, folding preferentially into α-helical conformation upon interaction with hydrophobic solvents or positively charged lipid surfaces. Altogether, results of this work indicate that the peptides interact at a surface level, penetrate into bilayers composed of fluid lipids and that conformational changes could be responsible for this effect.

Study of the inhibition capacity of an 18-mer peptide domain of GBV-C virus on gp41-FP HIV-1 activity.

The peptide sequence (175-192) RFPFHRCGAGPKLTKDLE (P59) of the E2 envelope protein of GB virus C (GBV-C) has been proved to decrease cellular membrane fusion and interfere with the HIV-1 infectivity in a dose-dependent manner. Based on these previous results, the main objective of this study was to deepen in the physicochemical aspects involved in this interaction. First, we analyzed the surface activity of P59 at the air-water interface as well as its interaction with zwitterionic or negatively charged lipid monolayers. Then we performed the same experiments with mixtures of P59/gp41-FP. Studies on lipid monolayers helped us to understand the lipid-peptide interaction and the influence of phospholipids on peptide penetration into lipid media. On another hand, studies with lipid bilayers showed that P59 decreased gp41-FP binding to anionic Large Unilamellar Vesicles. Results can be attributed to the differences in morphology of the peptides, as observed by Atomic Force Microscopy. When P59 and gp41-FP were incubated together, annular structures of about 200 nm in diameter appeared on the mica surface, thus indicating a peptide-peptide interaction. All these results confirm the gp41-FP-P59 interaction and thus support the hypothesis that gp41-FP is inhibited by P59.

[Features of antigen-antibody interaction during use of linear synthetic peptides and multipeptide antigen modeling antigenic determinants of hepatitis A virus].

AIM: To study features of antigen-antibody interaction during use of linear synthetic peptides and multipeptide antigen modelling antigenic determinants of hepatitis A virus (HAV) and to evaluate perspectives for use of heterogeneous tetrameric multipeptide antigens for detection of HAV serological markers. MATERIALS AND METHODS: Linear peptides VP1 and VP3 were synthesized by fluorenylmethyloxycarbonyl (Fmoc)-polyamide solid phase method. MAP4 (VP1+VP3) was synthesized according to 9-Fmoc strategy. Interaction of these peptides with anti-HAV IgM positive sera from patients with HA was studied by noncompetitive and competitive methods of immunoenzyme assay. RESULTS. Using immunoenzyme assay, high heterogeneity of immune response in patients with HA (62 and 67% in two groups) was shown. MAP4 (VP1+VP3), unlike the combination of linear peptides VP1 and VP3, interacted with anti-HAV IgM in 41 - 45% of sera and, at the same time, did not lead to false positive results. CONCLUSION: Population of HAV is not so uniform which is usually assumed. It could be reasonable to use heterogenous multipeptide antigens, including those containing VP1 (11 - 25 a.r.) and VP3 (110 - 121 a.r.), for the development of new assays for HA diagnostics.

Application of a chimeric synthetic peptide in the development of a serologic method for the diagnosis of hepatitis G virus infection.

New putative antigenic peptides corresponding to the N- and C-terminal of the E2 envelope protein of GBV-C/HGV were synthesized using solid-phase chemistry. The antigens were obtained in linear and chimeric forms with the main aim of improving the sensitivity of the enzyme immunoassays. Furthermore, CD and FTIR have been used in conjunction to characterize their conformational changes showing that the chimeric peptide presents a more ordered secondary structure than its parent peptides.

3D-Structure of the interior fusion peptide of HGV/GBV-C by 1H NMR, CD and molecular dynamics studies.

In this work, we present a structural characterization of the putative fusion peptide E2(279-298) corresponding to the E2 envelope protein of the HGV/GBV-C virus by (1)H NMR, CD and MD studies performed in H(2)O/TFE and in lipid model membranes. The peptide is largely unstructured in water, whereas in H(2)O/TFE and in model membranes it adopts an helical structure (approximately 65-70%). The partitioning free energy DeltaG ranges from -6 to -7.5 kcal mol(-1). OCD measurements on peptide-containing hydrated and oriented lipid multilayers showed that the peptide adopts a predominantly surface orientation. The (1)H NMR data (observed NOEs, deuterium exchange rates, Halpha chemical shift index and vicinal coupling constants) and the molecular dynamics calculations support the conclusions that the peptide adopts a stable helix in the C-terminal 9-18 residues slightly inserted into the lipid bilayer and a major mobility in the amino terminus of the sequence (1-8 residues).

Synthetic peptides for the immunodiagnosis of human diseases.

Synthetic peptides have been shown to be valuable tools for viral laboratory diagnosis and can provide uniform, chemically well-defined antigens for antibody analysis, reducing inter- and intra-assay variation. The main aim in the development of peptide-based diagnostic tests is to recognise specific antibodies induced by the whole viral proteins but using selected short fragments containing the most potent antigenic determinants. The success of this approach depends on the extent to which synthetic peptides are able to mimic the immunodominant epitopes of antigens. In recent years, synthetic peptides that mimic specific epitopes of infectious agents' proteins have been used in diagnostic systems for various human diseases. The present review summarizes some of the drawbacks of the use of relatively short linear peptides as antigenic substrates and the subsequent chemical strategies developed in order to overcome the low peptide reactivity against specific antibodies. Moreover, it outlines the most significant bibliography published in the last five years which provides validated peptide based tests potentially useful for diagnosis of viral, bacterial, parasitic and autoimmune diseases.