Orbital apex syndrome secondary to herpes zoster ophthalmicus.

Herpes zoster ophthalmicus usually presents with ocular manifestations, but neurological complications are much more infrequent. An 84-year-old woman with herpes zoster of the left first trigeminal branch developed herpetic keratouveitis in her left eye despite treatment with oral valaciclovir. Seven days later, a progressive and total left ophthalmoplegia appeared, requiring hospital admission and intravenous treatment with acyclovir and corticosteroids. The neuroimaging was suggestive of an orbital apex syndrome. The evolution of the ophthalmoplegia was favourable, with complete resolution at 5 months, but with decreased visual acuity due to the optic nerve involvement.

Síndrome de ápex orbitario por herpes zoster ophthalmicus / Orbital apex syndrome secondary to herpes zoster ophthalmicus

El herpes zoster ophthalmicus suele cursar con manifestaciones oculares, siendo mucho más infrecuentes las complicaciones de tipo neurológico. Una mujer de 84 años con herpes zóster en el dermatomo de la primera rama trigeminal izquierda, desarrolló una queratouveítis herpética en el ojo izquierdo a pesar del tratamiento con valaciclovir oral. A los siete días, además apareció una oftalmoplejia progresiva y total izquierda que requirió ingreso hospitalario y tratamiento intravenoso con aciclovir y corticoides. La neuroimagen fue sugestiva de un síndrome de ápex orbitario. La evolución de la oftalmoplejia fue favorable con resolución completa a los cinco meses de seguimiento, dejando una disminución de la agudeza visual por la afectación del nervio óptico. (AU)

Herpes zoster ophthalmicus usually presents with ocular manifestations, but neurological complications are much more infrequent. An 84-year-old woman with herpes zoster of the left first trigeminal branch developed herpetic keratouveitis in her left eye despite treatment with oral valaciclovir. Seven days later, a progressive and total left ophthalmoplegia appeared, requiring hospital admission and intravenous treatment with acyclovir and corticosteroids. The neuroimaging was suggestive of an orbital apex syndrome. The evolution of the ophthalmoplegia was favourable, with complete resolution at 5 months, but with decreased visual acuity due to the optic nerve involvement. (AU)

Co-composting rice hulls and/or sawdust with poultry manure in NE Argentina.

Rice hulls and sawdust are two common C-rich wastes derived from rice and timber agro-industries in subtropical NE Argentina. An alternative to the current management of these wastes (from bedding to uncontrolled burning) is composting. However, given their C-rich nature and high C/N ratio, adequate composting requires mixing with a N-rich waste, such as poultry manure. The effect of different proportions of poultry manure, rice hulls and/or sawdust on composting efficiency and final compost quality was studied. Five piles were prepared with a 2:1 and 1:1 ratio of sawdust or rice hulls to poultry manure, and 1:1:1 of all three materials (V/V). Different indicators of compost stability and quality were measured. Thermophilic phase was shorter for piles with rice hulls than for piles with sawdust (60 days vs. 105 days). Time required for stability was similar for both C-rich wastes (about 180 days). Characteristics of final composts were: pH 5.8-7.2, electrical conductivity 2.5-3.3 mS/cm, organic C 20-26%, total N 2.2-2.9%, lignin 19-22%, total Ca 18-24 g/kg, and extractable P 6-8 g/kg, the latter representing 60% of total P. Nitrogen conservation was high in all piles, especially in the one containing both C-rich wastes. Piles with sawdust were characterized by high total and available N, while piles with only rice hulls had higher Si, K and pH. Extractable P was higher in 1:1 piles, and organic C in 2:1 piles.

[Predictive biochemical indicators of a postlaryngectomy pharyngocutaneous fistula: a clinical study]. / Indicadores bioquímicos predictivos de fístula faringocutánea postlaringuectomía: un estudio clínico.

UNLABELLED: The aim of this clinical study was to determinate biochemical predictor indicators of postlaryngectomy pharyngocutaneous fistula. PATIENTS AND METHODS: We have studied 100 patients with T2- 4 a laryngeal and piryform sinus carcinoma who underwent a laryngectomy. All patients were ASA 2-3. We studied serum albumin, protein serum level, cholesterol and lymphocites in each patient. These variables underwent statistical analysis (p < 0.05). RESULTS: 19% of the patients developed a postlaryngectomy pharyngocutaneous fistula, with a long-stay of 25 days vs. 10 days of stay in patients without postlaryngectomy pharyngocutaneous fistula. 7 postlaryngectomy pharyngocutaneous fistula needed surgical repair. Low serum albumin (< 3.5 g/dL) and a low level of serum proteins (< 6.5 g/dL) were predictive indicators of postlaryngectomy pharyngocutaneous fistula (p < 0.05). CONCLUSIONS: Our results suggest that a low-level of serum proteins and albumin are predictive clinical parameters of postlaryngeal pharyngocutaneous fistula.

Collagen I upregulates extracellular matrix gene expression and secretion of TGF-beta 1 by cultured human mesangial cells.

Progressive renal diseases are characterized by an increased synthesis of extracellular matrix (ECM) components. The mechanisms involved in the development of these alterations are not completely known, but a crucial role for TGF-beta 1 has been suggested. Moreover, the ability of the ECM to modulate the phenotypic expression of different cell types has been widely described. In experiments presented here, human mesangial cells (HMC) were grown on collagen type I (COL I) or IV (COL IV). ECM protein and TGF-beta 1 mRNA expression were evaluated by Northern blot analysis, and TGF-beta 1 secretion was evaluated by ELISA. The involvement of tyrosine kinase and serine-threonine kinase pathways was studied by Western blot analysis, immunofluorescence, and in vitro kinase assays. HMC cultured on COL I showed an increased mRNA expression of COL I and COL IV, fibronectin, and TGF-beta 1. Both tyrosine phosphorylation and integrin-linked kinase (ILK) activity increased when HMC were cultured on COL I, and blockade of these pathways inhibited the increased secretion of TGF-beta 1. In conclusion, the present results support a role for extracellular COL I in the regulation of TGF-beta 1 synthesis during progressive renal sclerosis and fibrosis and the subsequent increase in newly synthesized ECM proteins. In addition, ILK, along with the tyrosine kinases, participates in the genesis of this effect.

Prevalence of liver disease in patients with Streptococcus bovis bacteraemia.

BACKGROUND: The relationship between Streptococcus bovis bacteraemia and gastrointestinal disease (mainly colon cancer) is well known. Patients with advanced liver disease are prone to bacteraemia. Less attention has been paid to the association between liver disease and Streptococcus bovis bacteraemia in the literature. AIMS: To evaluate the prevalence of liver disease in patients with S. bovis bacteraemia. PATIENTS AND METHODS: Twenty-two episodes of S. bovis bacteraemia in 20 adults (13 males and seven females, with a median age of 61 years, range 32-94 years) were detected in a single hospital over a 7-year period. Ten of them had endocarditis. Patients' clinical records were reviewed, with special focus on underlying liver and gastrointestinal disease. RESULTS: Eleven patients (55%) had a chronic liver disease. Nine of them were cirrhotics. Ten patients had a history of chronic alcohol abuse, and four patients had hepatitis C virus antibodies (associated with alcohol abuse in three cases). Large bowel disease was present in six out of 13 evaluable patients (adenocarcinoma in three cases). Patients with liver disease were younger than patients without it. Mortality related to S. bovis bacteraemia was particularly high among patients with advanced liver disease (Child-Pugh state C). Bacteraemia recurred two times in one alcoholic cirrhotic, who was diagnosed as having a Dukes-B colon cancer 4.5 years after the first episode of S. bovis bacteraemia. CONCLUSIONS: In our area, S. bovis bacteraemia is frequently associated with chronic liver disease. Liver disease may be a predisposing factor for S. bovis bacteraemia.

[Empyema caused by Pasteurella multocida]. / Empiema por Pasteurella multocida.

A new case of pneumonia and empyema by Pasteurella multocida diagnosed by culture of pleural fluid is reported. It is also reviewed the most common ways of infection, the characteristics of the rare pulmonary diseases, the risks factors and the treatment.

Increased interleukin-12 serum levels in chronic alcoholism.

BACKGROUND/AIMS: In the present study the serum levels of interleukin-12 were analyzed in alcoholic patients in order to explore the possible relationship between them and both the ethanol intake status and the existence of alcoholic liver disease. METHODS: For that purpose interleukin-12 levels were analyzed in a total of 26 alcoholic patients. Additionally, both interferon-gamma and interleukin-4 serum levels were measured in the same patients as a means of exploring the balance between the T-helper-1 and T-helper-2 immune responses. All patients had consumed at least 90 g of ethanol per day for more than 5 years. Fourteen were alcoholics without liver disease (AWLD group) and the other 12 patients were diagnosed as having alcoholic liver cirrhosis. In parallel to the patients, 10 age- and sex-matched healthy volunteers were included in the study. RESULTS: Our results show that interleukin-12 serum levels are significantly increased in AWLD patients as compared to normal controls (p<0.05). In patients with cirrhosis, interleukin-12 serum levels varied, depending on the ethanol intake status at the time of evaluation. Accordingly, as compared to normal controls, significantly increased concentrations of serum interleukin-12 were found in the alcoholic liver cirrhosis patients with active ethanol intake (ALCET group) (p<0.01), while in the cirrhotic individuals with at least 1 year of alcohol withdrawal interleukin-12 serum levels remained within the normal range. Only the cirrhotic patients had increased interferon-gamma serum levels. Among them, the highest levels were found for individuals from the ALCET group, the differences with respect to the healthy subjects being close to statistical significance (p=0.05). No significant differences were detected regarding interleukin-4 serum levels for any of the groups of patients analyzed compared to the control individuals. CONCLUSIONS: Our results show the existence of a relationship between ethanol intake and increased interleukin-12 serum levels, suggesting that this cytokine may play an important role in the induction of the immunological abnormalities found in chronic alcoholism, independently of whether or not alcoholic liver disease is present.

Age-related increase in expression of TGF-beta1 in the rat kidney: relationship to morphologic changes.

In the kidney, aging is characterized by the development of structural changes, including glomerulosclerosis and interstitial fibrosis. Transforming growth factor-beta1 (TGF-beta1) is known to play a critical role in the genesis of these alterations in pathologic conditions. The present experiments were designed to test the hypothesis that TGF-beta1 may be involved in the development of age-related histopathologic changes in rat kidney, and that captopril, an angiotensin-converting enzyme inhibitor, may influence the progression of glomerular and interstitial lesions. In this study, 3-, 18-, 24-, and 30-mo-old rats were examined, and an age-related increase in urinary protein excretion was found; plasma creatinine and systolic BP did not change. Significant structural changes, including glomerular sclerosis and interstitial fibrosis, were found in the group of aged rats (24- and 30-mo-old). Immunostaining for TGF-beta in the renal cortex interstitium was increased in the group of 24-mo-old rats, with a parallel increase in TGF-beta1 mRNA expression, measured with reverse-transcription PCR. Captopril-treated animals showed a statistically significant decrease in urinary protein excretion but no significant changes in BP. Moreover, captopril reduced the extent of interstitial fibrosis, but did not affect the degree of glomerulosclerosis. A significant inhibition of TGF-beta1 mRNA expression was observed in the captopril-treated animals. These findings suggest that TGF-beta1 may act as a fibrogenic growth factor that could be responsible, at least partially, for the renal interstitial fibrosis associated with aging. Treatment with captopril might delay the progression of these lesions.

Alterations in tumor necrosis factor-alpha, interferon-gamma, and interleukin-6 production by natural killer cell-enriched peripheral blood mononuclear cells in chronic alcoholism: relationship with liver disease and ethanol intake.

No previous studies have been reported on human alcoholism in which the pattern of cytokine secretion by natural killer (NK) cells is explored. The goal of the present study was to evaluate the role of NK cells in the production of cytokines in patients with chronic alcoholism, analyzing at the same time the possible relationship between cytokine production and both alcoholic liver disease and ethanol (EtOH) intake. A total of 30 chronic alcoholic patients-11 without liver disease [alcoholics without liver disease (AWLD) group] and 19 diagnosed of alcoholic liver cirrhosis-were included in this study. Twenty-five age- and sex-matched healthy volunteers were analyzed as controls. Production of interferon (IFN)-gamma, tumor necrosis factor-alpha (TNF-alpha), and interleukin (IL)-6 was performed on NK-enriched peripheral blood mononuclear cells (PBMC) after stimulation with IL-2 and IFN-alpha. In AWLD patients, the production of TNF-alpha was significantly reduced, compared with normal controls, under both IFN-alpha (p < 0.01) and IL-2 (p < 0.05) stimulation. In patients with cirrhosis, TNF-alpha production by PBMC enriched in NK cells varied depending on the EtOH intake status at the moment of evaluation. Accordingly, an increased concentration of this cytokine was detected in the supernatants of cirrhotic patients and active EtOH intake, particularly after IFN-alpha stimulation (p < 0.05); whereas, in patients with at least 1 year of alcohol withdrawal, TNF-alpha levels remained within normal range. The results on the production of IL-6 and IFN-gamma in AWLD and cirrhotic patients showed that only cirrhotic patients with a prolonged EtOH withdrawal period display abnormal production. Accordingly, in this group of patients, a significantly increased release of IL-6 was observed after both IFN-alpha and IL-2 stimulation (p < 0.01 and p < 0.05, respectively). By contrast, a lower IFN-gamma production (p < 0.005) was detected with respect to the control group. Our results point to the existence of an abnormal cytokine secretion by NK cells from chronic alcoholism patients, which depend on both the existence of liver disease and the status of EtOH intake.

Pharmacological studies of 1-(p-chlorophenyl)propanol and 2-(1-hydroxy-3-butenyl)phenol: two new non-narcotic analgesics designed by molecular connectivity.

Molecular topology has been applied to the design of new analgesic drugs. Linear discriminant analysis and connectivity functions were used to design two potentially suitable drugs which were synthesized and tested for analgesic properties by the acetic acid-induced abdominal constriction test in mice and the tail-flick test in rats. In mice, the compound 1-(p-chlorophenyl)propanol showed higher analgesic activity, both intraperitoneally and orally, than acetylsalicylic acid. 2-(1-Hydroxy-3-butenyl)phenol exhibited a lesser protective effect (70% of that shown by acetylsalicylic acid). In rats, acetylsalicylic acid gave the greatest protection against pain when administered intraperitoneally, while 1-(p-chlorophenyl)propanol was the most active orally. The 2-(1-hydroxy-3-butenyl)phenol, both intraperitoneally and orally, showed the least protective effect. These results demonstrated the peripheral analgesic properties of the selected compounds, thus confirming the validity of the molecular design method.

Comparative in-vitro activity of sparfloxacin against genital pathogens.

The in-vitro activity of sparfloxacin against four pathogens commonly implicated in genital infections was compared with that of a number of other commonly administered antimicrobials. Sparfloxacin demonstrated excellent activity against Neisseria gonorrhoeae (MIC range of < or = 0.0002-5 mg/L for beta-lactamase producing strains, and < or = 0.0002-0.03 mg/L for non-beta-lactamase producing strains). This activity was similar to that of lomefloxacin and ciprofloxacin and was greater than that of ofloxacin. Sparfloxacin was more active against Ureaplasma urealyticum (MIC90 1 mg/L) than the other three quinolones (MIC90 4 mg/L). Sparfloxacin was much more active against Mycoplasma hominis (MIC90 0.06 mg/L) than the other quinolones (MIC90 1 mg/L). Sparfloxacin showed the most potent inhibitory and bactericidal activity of the quinolones against Chlamydia trachomatis with MIC and MBC of 0.06 mg/L (ofloxacin MIC and MBC 1 mg/L; ciprofloxacin and lomefloxacin MIC and MBC 2 mg/L). The results of this study and others performed by workers using different methods are consistently similar. Since sparfloxacin has broad activity against pathogens implicated in genital infections it may be a good therapeutic alternative for these syndromes.

Liver, spleen and kidney cultures in different conditions of splenic preservation.

The appearance of the postsplenectomy syndrome has made investigators focus all attention on the immunitary aspects that could change following a splenic extirpation. Besides this, bacterial clearance has been considered fundamental in this pathology. We present an experimental study comparing liver, spleen and kidney cultures in different conditions of splenic preservation, including autotransplantation, and with sepsis induced by the inoculation of capsulated Escherichia coli. The majority of tissue cultures were positive, showing, in must cases, a statistical correlation between the number of microorganisms in each organ for every animal. This confirms that all three organs act alike, as bacterial filters.