Frontal fibrosing alopecia: clinical and prognostic classification.

BACKGROUND: Frontal fibrosing alopecia (FFA) is a chronic scarring alopecia with an unpredictable evolution. There are no current classifications of this disease that may predict its prognosis. OBJECTIVE: To analyse the differences in clinical presentation and evolution of FFA patients and to create a clinical and prognostic classification. METHODS: We conducted a retrospective analytical study of FFA patients. Clinical characteristics of frontal hairline recession were used as the sorting variable between patterns of presentation. A cohort of 106 patients homogenously treated with oral dutasteride and topical corticosteroid was followed 12 months. RESULTS: In all, 242 female patients with a mean age of 61.4 years were included. Patients were classified into three clinical patterns [118 (48.8%) patients as pattern I (linear), 109 patients (45%) as pattern II (diffuse) and 15 patients (6.2%) as pattern III (double line)]. Stabilization was achieved in 37.3% of the 106 patients treated with oral dutasteride and topical corticosteroid. Pattern III patients had less hairline recession and eyebrow involvement at the diagnosis and after treatment. LIMITATIONS: Retrospective design. CONCLUSIONS: Frontal fibrosing alopecia patients can be classified into three different clinical patterns with different prognosis. Pattern III patients have the best prognosis, while pattern II patients have the worst prognosis.

The cytohistological basis of apospory in Hypericum perforatum L.

St. John's wort (Hypericum perforatum L., 2n = 4x = 32) is a medicinal plant that produces pharmaceutically important metabolites with antidepressive, anticancer and antiviral activities. It is also regarded as a serious weed in many countries. H. perforatum is furthermore an attractive model system for the study of apomixis. Natural populations of H. perforatum are predominantly composed of tetraploid individuals, although diploids and hexaploids are known to occur. It has been demonstrated that while diploids are sexual, polyploids are facultative apomictic whereby a single individual can produce both sexual and apomictic seeds. Despite our increasing understanding of gamete formation in sexually reproducing species, relatively little is known regarding the cytological basis of reproduction in H. perforatum. Here, we have studied embryo sac formation and the genetic constitution of seeds by means of staining-clearing of ovules/ovaries, DIC microscopy and flow cytometric seed screening (FCSS) of embryo and endosperm DNA contents. Comparisons of female sporogenesis and gametogenesis between sexual and apomictic accessions have enabled the identification of major phenotypic differences in embryo sac formation, in addition to complex fertilization scenarios entailing reduced and unreduced male and female gametes. These data provide new insights into the production of aposporous seeds in H. perforatum, and complement ongoing population genetic, genomic and transcriptomic studies.

Comparative study of the craniofacial growth depending on the type of lactation received.

AIM: Several organizations consider mother's milk the optimal nutrition source for newborns [AAP, 1998; Gartner et al., 1997; Mohrbacher and Stock, 2002; WHO, 1989]. However, there is little scientific evidence supporting the idea that breastfeeding has a positive influence on the development of the orofacial structures. MATERIALS AND METHODS: The study of cases and controls (observational, analytical and retrospective) and lateral teleradiographs of the cranium of 197 patients (106 breast-fed and 91 bottle-fed) were compared. Ricketts, Steiner and McNamara values were used for the cephalometric analysis. Differences between the two groups were analysed by applying the T-test and ANOVA. Statistical significance levels were set at p<0.05. Non-nutritive infantile sucking habits have been compared; differences between the two groups were analysed by applying the Chi-square test. RESULTS: First, the upper incisors were found to be protruded in the bottle-fed group. Second, subjects belonging to the breast-fed group displayed a brachycephalic mandible arch, while those fed with bottle had a dolichocephalic Steiner mandibular plane. Third, both facial depth and distance of the pogonion to the perpendicular nasion presented a certain tendency to a retruded mandibular bone in the bottle-fed group. And fourth, the frequency of use of dummy and thumb suction were greater in the bottle feed group, without statistical significance. CONCLUSION: In addition to the multiple advantages that mother's milk offers to newborns, breastfeeding also helps correct orofacial development (not only for the incisors position, but also for the vertical and sagittal relations of the mandible with upper maxillary and cranial basis).

Fisiología bucal infantil: función y crecimiento de la cavidad oral del lactante

Todas las funciones que se realizan en la cavidad oral (respiración, succión, deglución, masticación y fonación), estimulan el crecimiento y desarrollo del tercio inferior de la cara. Por ello, el tipo de lactancia. así como los hábitos orales disfuncionales, pueden influir sobre la morfología definitiva de los maxilares y de la oclusión dentaria (AU)

La caries infantil o caries del biberón qué es y cómo podemos podemos prevenirla / Infantile or nursing bottle caries: what they and how can we prevent them?

La caries del biberón es la aparición brusca de caries en los incisivos y molares temporales, relacionadas con el hábito de succionar el chupete o el biberón, impregnados de sustancias cariogénicas. Afecta a los niños en las primeras etapas de la vida. Los dientes de leche son fundamentales para diferentes funciones como la masticación y el habla. Este trabajo revisa cuáles son sus causas más comunes y las medidas preventivas más indicadas. (AU)

Isolation and characterization of four isomers of a C(60) bisadduct with a TTF derivative. Study of their radical ions.

A family of triads composed of C(60) attached by a rigid spacer to two identical TTF moieties has been synthesized, and some of the isomers have been isolated and characterized by UV-vis spectroscopy, LDI-TOF-MS, and HMBC NMR spectroscopy. AM1 semiempirical calculations of the dipolar moments and the heats of formation of the different isomers have been carried out in order to verify their assignments. Oxidation and reduction of the triads affords the derived radical ion systems, TTF(+*)-C(60)-TTF(+*) and TTF-C(60)(-*)-TTF, which were studied by EPR spectroscopy. Spin density distributions of these radical cations and radical anions show that the unpaired electron is located mainly on the TTF and fullerene moieties, respectively. However, while the EPR signals obtained from the radical cations are very similar for all the isomers, the structured signals observed for the radical anions arising from the coupling of the unpaired electron with the hydrogen atoms of the methylene bridges in the spacer show that there is a strong influence of the isomerism on the spin distribution. Importantly, the theoretical calculations of the spin density distributions of the radical anions fit well with the experimental EPR results.

Stereoisomerism of molecular multipropellers. 1. Static stereochemistry of bis- and tris-triaryl systems.

The static stereoisomerism of bis- and tris-triaryl systems has been analyzed by a systematic stereochemical analysis, and the resulting theoretical predictions have been experimentally confirmed by using reversed-phase HPLC and ESR and (1)H NMR spectroscopies with a family of seven distinct polychlorinated aromatic multipropellers. To analyze the static stereochemistry of these molecules, we have developed a specific procedure that uses a symmetry-adapted symbolic notation, allowing the theoretical prediction of both the number and symmetry of the isomers of the investigated molecules. Due to the steric hindrance introduced by the presence of bulky chlorine substituents, (all) conformational isomers can be characterized experimentally by several independent techniques confirming the theoretical stereochemical predictions. The different propeller moieties that constitute the molecule appear to be nearly independent of each other. Consequently, most of the observed isomers show comparable populations in solution at room temperature.

Stereoisomerism of molecular multipropellers. 2. Dynamic stereochemistry of bis- and tris-triaryl systems.

The dynamic stereochemistry of bis- and tris-triaryl systems, the most simple "molecular multipropellers", is discussed on the basis of an extension of a systematic stereochemical analysis based on a symmetry-adapted symbolic notation developed specifically for these molecules. A suitable theoretical basis for our study is provided by the classical hypotheses concerning the dynamics of simple triaryl systems as formulated by Mislow and co-workers (J. Am. Chem. Soc. 1973, 95, 1535-1547), which, once applied to molecular multipropellers, show the existence of two modes of rearrangement for each propeller. Interconversion graphs for all molecules under study, covering a wide span of structural complexity, are presented. A complete NMR study of a two- and a three-propeller molecule indicates that all experimentally observable exchange pathways are indeed predicted by theoretical analysis. Moreover, quantitative analysis of 2D-EXSY experiments affords the activation energy of the subset of pathways that give rise to observable interconversions on the NMR time scale. Assuming that two-ring flips are the threshold mechanism for individual propeller interconversion, the experimental evidence indicates a preference for the flip of the central ring and one of the outer rings over the flip of two outer rings.

[Progressive multifocal leukoencephalopathy in elderly immunocompetent patients. Report of 2 cases]. / Leucoencefalopatía multifocal progresiva en pacientes ancianos inmunocompetentes. A propósito de dos casos.

INTRODUCTION: Progressive multifocal leukoencephalopathy is a disorder which is rare in immunocompetent patients. OBJECTIVES: We report the cases of two elderly patients with serology, in one case positive for hepatitis C, and in the other with anti-DNA antibodies, and discuss the part these might play in causing progressive multifocal leukoencephalopathy. CLINICAL CASES: Case 1. An 86 year old man had been found on serology investigations to be positive for hepatitis C virus. In November 1996 he complained of dysarthria and left hemi-negligence following an accidental fall. Since his clinical condition became worse he was admitted to hospital for further investigation. On neuroimaging studies the intracerebral lesions were increased. The only other finding confirmed was that of positive serology for hepatitis C virus. The patient deteriorated progressively and died 50 days after admission. Case 2. A 70 year old woman began to show progressive cognitive impairment and left hemiparesia in June 1996. Se was investigated in another centre and provisionally diagnosed as having vasculitis of the CNS, in view of her positive anti-DNA antibody and right frontoparietal hypodense lesion. Treatment had been started with corticosteroids. She was admitted to our hospital when her neurological deficits worsened. The immunological alterations were confirmed. On MRI the lesions in the white matter were seen to have progressed. The patient slowly improved. She was discharged from hospital in February 1997 in a semiconscious state, able to follow persons and things with her eyes, with global aphasia and with spastic tetraparesia which was mainly left-sided. She remains stable. CONCLUSION: Progressive multifocal leukoencephalopathy is a condition which should be remembered when dealing with immunocompetent patients.

[Intraventricular hemorrhage due to the rupture of atherosclerotic dissecting aneurysm of the middle cerebral artery]. / Hemorragia intraventricular por rotura de aneurisma disecante ateroscleroso de la arteria cerebral media.

INTRODUCTION: We present a case of fusiform intracranial aneurysm where, apart from the unusual site, we draw attention to the form of clinical presentation, namely intraventricular haemorrhage. Clinical case. A 68 year-old-man with a history of smoking, hyperuricemia with seizures of gout treated with colchicine and allopurinol, and hypertension treated with captopril. Nine years previously he had a right capsulothalamic haematoma and presented (as a sequela of this) a left sensomotor deficit, with a good functional level. In December 1998 he was admitted for sudden onset of headache and deterioration of consciousness. He had right limb movements which were typical of decerebration and made intubation and mechanical ventilation necessary. Cerebral CT, with angiographic sequences, showed blood in the lateral ventricles and III ventricle, with ventricular dilation and a fusiform aneurysm of the left middle cerebral artery. In view of the neurological state of the patient, treatment of the aneurysm was postponed. After initial improvement, which permitted extubation, tetraparesia (predominantly right) and a pseudobulbar syndrome were seen. The patient had repeated respiratory infections and died from sepsis caused by Pseudomona aeruginosa (of respiratory origin) three months after admission. CONCLUSIONS: Fusiform intracranial aneurysms form 9% of all aneurysms. Localization to the middle cerebral artery is infrequent, the basilar trunk and internal carotid artery are commoner sites. In our case angio-CT was a useful non-invasive neuro-radiological technique.

Solution conformation of an immunogenic peptide from HRV2: comparison with the conformation found in a complex with a Fab fragment of an anti-HRV2 neutralizing antibody.

The conformation of a [15]-peptide (H-VKAETRLNPDLQPTE-NH2) from VP2 of rhinovirus HRV2 complexed with a Fab fragment was previously shown by X-ray crystallographic studies to be similar to the one found in the corresponding region of HRV1A. Antibodies raised against this peptide bind to and neutralize HRV2. In order to identify structural features preserved in solution that may explain the ability of this short peptide to mimic the structure of the protein surface, the peptide has been studied by NMR in aqueous solution as well as under denaturing conditions. The peptide is shown to be a random coil in solution. However, the sequence forming a 3(10)helix in the complex is biased into a helical conformation according to NOE intensity data as well as from urea and pH titrations. This sequence adopts the same conformation in an unrelated protein. NOE data suggest that a beta-turn found in the complex may be sampled in solution. Also, Glu4, interacting with Arg6 in the crystal, has a reduced pKa value in solution. It is concluded that the local structure present in the random coil state of VP2(156-170) contains enough information to direct the production of antibodies that bind to and neutralize HRV2.

Cyclization of disulfide-containing peptides in solid-phase synthesis.

Disulfide-containing peptides may be obtained in good yields and purities when oxidations are carried out on peptide chains anchored to polymeric supports used for solid-phase synthesis. Such approaches take advantage of the pseudo-dilution phenomenon which favors intramolecular processes. A variety of procedures have been demonstrated using the related model peptides Ac-Cys-Pro-D Val-Cys-NH2 and Ac-Pen-Pro-D Val-Cys-NH2 (which both readily assume a type II beta-turn conformation that becomes stabilized by a 14-membered disulfide-containing intramolecular ring), and oxytocin (conformationally mobile 20-membered disulfide ring). Both Boc and Fmoc were used for N alpha-amino protection, the beta-thiols of cysteine or penicillamine were blocked by S-acetamidomethyl (Acm), S-9-fluorenylmethyl (Fm), or S-trityl (Trt), and compatible anchoring linkages included HF-labile 4-methylbenzhydrylamide (MBHA), TFA-labile tris (alkoxy)benzylamide (PAL), and photolabile o-nitrobenzylamide (Nonb). Assemblies of linear sequences proceeded smoothly, and polymer-supported oxidations were carried out in a variety of ways either directly or after deblocking to the resin-bound dithiol. Chains were released from the support without substantial damage to the disulfide bridges, and overall yields were as high as 60-90%.

Conformational analysis of bacitracin A, a naturally occurring lariat.

The proton nmr spectra of bacitracin A in H2O and DMSO-d6 have been assigned and the conformational behavior of the peptide in the two solvents has been compared. Although bacitracin A shows a conformational equilibrium between at least two conformations differing in the relative position of the cyclic and linear domains of the molecule, the spectra in water can be interpreted in terms of a preferred conformation in which the linear part is folded over the cyclic moiety and a turn is present around Ile(8)-DPhe(9).

Application of acetamidomethyl and 9-fluorenylmethyl groups for efficient side protection of penicillamine in solid-phase peptide synthesis.

Synthesis of S-acetamidomethyl and S-fluorenylmethyl derivatives of penicillamine is described. Both groups are completely stable to all the usual reagents in solid-phase peptide synthesis, including the HF cleavage step, and show an excellent degree of orthogonality to each other. Treatment of the protected peptides Ac-L-Pen(X)-L-Pro-D-Val-L-Cys(X)-NH2 with thallium (III) trifluoroacetate or iodine for X = Acm or piperidine/DMF (1:1) for X = Fm induced with good yield the formation of the intramolecular disulfide bridge. This cyclic peptide appears to assume a type II beta-turn conformation in d6-DMSO as evidenced by 1H-NMR spectra.

[Nuclear resonance in intracranial venous thrombosis]. / Resonancia nuclear en la trombosis venosa intracraneal.

We have reviewed the nuclear resonance NR images in three patients with intracranial venous thrombosis. Tomodensitometric findings are not reliable in intracranial venous thrombosis and cerebral angiography is required for the diagnosis. The usefulness of NR for the investigation of venous disease has been recently demonstrated. Ten patients in whom a diagnosis of intracranial venous thrombosis was made with NR have been reported. Initially, the vacuum signal in the T1 enhanced sequences disappears and the thrombus becomes hypointense in the T2 enhanced sequences. In the following phase, proton relaxation is impaired by methemoglobin production and thrombosis appears as hyperintense in both the T1 and T2 enhanced sequences. During the resolution phase, the vacuum signal in the vascular lumen reappears and the hyperintensity of the thrombus signal becomes attenuated. In our study we have shown the different stages of intracranial venous thrombosis with NR. In addition, we have demonstrated the close relation between these images and the clinical evolution. NR is a useful noninvasive investigation in patients with suspected intracranial venous thrombosis.

Ischemic stroke in young adults. I. Analysis of the etiological subgroups.

An ischemic stroke (IS) group including 386 patients under 50 years old is analysed taking into account different etiological subgroups and comparing risk factors against a control group of 100 people. The series points out the presence of 66.1% patients included in the inconclusive-atherothrombosis group, of which 22.7% had defined criteria of atheromatosis, while 11.6% were diagnosed of lacunar infarct. 13.5% of cases were considered as cardiac origin embolisms, and 14.1% were affected of mitral valve prolapse. The migraine group includes 4.9% of the patients while 17.6% belong to the miscellaneous group. The comparison of each of these groups with the control group showed significant differences for family history of stroke, personal history of peripheral arteriopathy, tobacco, arterial hypertension and previous IS.

[Carotid artery disease induced by irradiation]. / Enfermedad de la arteria carótida inducida por irradiación.

We have evaluated 39 patients with ischemic strokes secondary to atherosclerotic disease of the extracranial carotid artery. Seven of them had been treated in the past with cervical radiotherapy for neoplastic diseases (radiotherapy group); the remaining 32 patients had not received radiation therapy (non-radiotherapy group). When the prevalence of risk factors was compared between the two groups, there was a significantly higher prevalence of peripheral arterial disease (p less than 0.05), hypertension (p less than 0.05) and atherogenicity index lower than 21.5% (p less than 0.05) in the non-radiotherapy group. Regarding angiographic data, the radiotherapy group showed a significantly higher occurrence of localized findings than the non-radiotherapy group (p less than 0.005). It is concluded that radiation-induced carotid disease is a clinical condition which may be individualized from the remaining patients with atherosclerotic carotid artery disease.