Cisternografía radioisotópica con 99Tc-DTPA en el diagnóstico etiológico del síndrome de hipotensión intracraneal: reporte de caso / Cisternography radioisotope with 99Tc-DTPA in the etiological diagnosis of intracranial hypotension syndrome: a case report

Introducción: Las fístulas de líquido cefalorraquídeo (LCR) constituyen una complicación frecuente de la cirugía espinal. La cisternografíaradioisotópica es una herramienta diagnóstica que permite la confirmación y localización de las mismas.Caso clínico: Paciente masculino de 30 años, con antecedentes de hidrocefalia congénita y a quien se le retiró hace ocho años un sistema derivativo lumboperitoneal colocado por esa causa. Consultó por episodios de cefalea ortostática de aproximadamente seismeses de evolución y que se aliviaban con el decúbito. Al realizarle la punción lumbar, para el estudio del LCR, se comprobó una presión de apertura de 5 cm H2O y los estudios citoquímicos, bacteriológicos, micológicos y virológicos fueron negativos. Se le realizó una cisternografía radioisotópica con 99Tc-DTPA que mostró una fístula de LCR en el sitio donde fue retirado el catéter de derivación lumboperitoneal.Conclusión: La cisternografía radioisotópica es una opción práctica y eficaz para corroborar el diagnóstico de fístula de LCR como complicación de la cirugía espinal en pacientes con hipotensión intracraneal(AU)

Introduction: Cerebrospinal fluid (CSF) fistulas are a common complication of spinal surgery. The radioisotope cisternography is a diagnostic tool that allows confirmation and localization.Case report: Male patient of 30 years, with a history of congenital hydrocephalus and eight years ago was removed a derivative lumboperitoneal shunt system placed by that cause. Consulted by episodes of approximately six months of orthostatic headache with relief in decubitus. A lumbar puncture was done for the study of CSF, an opening pressure of 5 cm H2O, and cytochemical, bacteriological,mycological and virological studies were negative. A cisternography radioisotope 99Tc-DTPA was done and showed a CSF fistula on the site where the lumboperitoneal shunt catheter was removed.Conclusion: The radioisotope cisternography is a practical and effective option to confirm the diagnosis CSF fistula as a complication ofspinal surgery in patients with intracranial hypotension(AU)

The effect of artificial saliva on the rheological properties of tooth whitening systems.

This work was undertaken to explore the effect of saliva addition on the rheological properties of two contrasting tooth bleaching systems, one of which was a paste (Colgate Platinum) and the other a gel (Zaris, 3M ESPE). Using a dynamic stress rheometer with cone and plate geometry, it was shown that addition of artificial saliva reduced the apparent viscosity of each material. However, in some cases this was accompanied by an increase in elasticity. It is suggested that saliva may not have a deleterious effect on the ability of the materials to remain in the bleaching tray.

Overexpression of matrix metalloproteinase-10 and matrix metalloproteinase-3 in human diabetic corneas: a possible mechanism of basement membrane and integrin alterations.

We have previously described decreased immunostaining of nidogen-1/entactin; laminin chains alpha1, alpha5, beta1,gamma1; and epithelial integrin alpha3beta1 in human diabetic retinopathy (DR) corneas. Here, using 142 human corneas, we tested whether these alterations might be caused by decreased gene expression levels or increased degradation. By semiquantitative reverse transcription-polymerase chain reaction, gene expression levels of the alpha1, alpha5, and beta1 laminin chains; nidogen-1/entactin; integrin alpha3 and beta1 chains in diabetic and DR corneal epithelium were similar to normal. Thus, the observed basement membrane and integrin changes were unlikely to occur because of a decreased synthesis. mRNA levels of matrix metalloproteinase-10 (MMP-10/stromelysin-2) were significantly elevated in DR corneal epithelium and stroma, and of MMP-3/stromelysin-1, in DR corneal stroma. No such elevation was seen in keratoconus corneas. These data were confirmed by immunostaining, zymography, and Western blotting. mRNA levels of five other proteinases and of three tissue inhibitors of MMPs were similar to normal in diabetic and DR corneal epithelium and stroma. The data suggest that alterations of laminins, nidogen-1/entactin, and epithelial integrin in DR corneas may occur because of an increased proteolytic degradation. MMP-10 overexpressed in the diabetic corneal epithelium seems to be the major contributor to the observed changes in DR corneas. Such alterations may bring about epithelial adhesive abnormalities clinically seen in diabetic corneas.

Retroviral transfer of the beta-nerve growth factor gene into murine neuroectodermal tumor cells modulates cell proliferation rate, neurite formation, and NGF binding site expression.

The response of wild-type and genetically engineered neuroectodermal tumor (NET) cells to exogenous and endogenously synthesized nerve growth factor (NGF) was investigated. Differences in cell proliferation rate, neurite formation, and expression of NGF binding sites were quantitatively determined. Ecotropic retroviral vectors were used to transfer the genes for beta-galactosidase (beta-GAL) and NGF into wild-type C-1300 and Neuro-2A murine neuroblastoma (MNB) and rat pheochromocytoma (PC-12) cells. Conditioned media obtained from NET cells infected with the NGF gene contained biologically active NGF, whereas media from beta-GAL infected cells did not. Infection with the NGF vector induced a short-term decrease in cell proliferation rate and increased neurite formation in wild-type, substrate-adherent PC-12 and Neuro-2A MNB cells (P > 0.05). Incubation of wild-type C-1300, Neuro-2A MNB, and PC-12 cells with NGF (0-200 ng/ml) for 5 days significantly reduced proliferation rates in a concentration-dependent manner and increased neurite extrusion. All NGF-NET cells had a significantly diminished response to the antiproliferative action of exogenous NGF. Ligand binding assays with 125I-NGF demonstrated a marked reduction in the number of NGF binding sites on NGF-NET cells compared to wild type. The attenuated response of NGF-NET cells to exogenous NGF correlated positively with the down-regulation of NGF binding sites. In conclusion, beta-NGF gene transfer into wild-type NET cells induces the synthesis and secretion of NGF, temporarily decreases cell proliferation rate, increases neurite extrusion, down-regulates NGF binding sites, and reduces NET cell responsiveness to NGF. A putative role for NGF may be the modulation of NET cell proliferation and differentiation.

Analysis of gene expression in human bullous keratopathy corneas containing limiting amounts of RNA.

PURPOSE: To validate the use of polymerase chain reaction (PCR)-amplified full-length cDNA as a substitute for mRNA in nucleic acid array and gene expression analysis. METHODS: Total RNA was isolated from age-matched normal autopsy corneas and pseudophakic bullous keratopathy (PBK) corneas. Full-length cDNA was generated and PCR amplified using the Smart cDNA synthesis technology. Southern blot analysis of this cDNA was compared with Northern blot analysis of the RNA. Amplified cDNA was used to probe a commercial gene array. By immunohistochemistry, the expression pattern of several adhesion molecules represented on the array was assessed. RESULTS: The cDNA produced by the Smart cDNA system gave results very similar to those of northern blot analysis when examined for beta2-microglobulin, Rab geranylgeranyl transferase, and tenascin-C. This cDNA obtained from normal or PBK corneas was labeled and used to probe a 588 gene array (Clontech). Among other differences, beta6 integrin was detected only with the PBK probe, beta-catenin was markedly elevated in PBK, and beta4 integrin appeared to be reduced in PBK. Immunohistochemical patterns of these proteins were consistent with the hybridization signals on the gene array. CONCLUSIONS: Smart cDNA synthesis and nucleic acid arrays were combined and validated for the first time to identify differential gene expression in normal and diseased corneas. These techniques require very little RNA such as that equivalent to a half of a single cornea, which is useful when the amount of tissue is limiting. Altered expression of adhesive proteins beta6 integrin and beta-catenin may be related to the formation of epithelial bullae and microcystic changes in PBK patients.

Thromboxane A2 acts at a site perfused by the carotid vasculature to mediate cardiovascular and adrenocortical responses.

Increases in thromboxane A2 (TxA2) synthesis are associated with hemodynamic responses and activation of the hypothalamus-pituitary-adrenal axis. This study tested the hypothesis that TxA2 acts on a site perfused by the carotid vasculature to mediate these responses. The TxA2 mimetic U46619 was infused for 30 min into the carotid artery or the vena cava of chronically instrumented adult sheep at doses of 0, 0.25, 0.5, and 1.0 microgram.kg-1.min-1. Mean arterial pressure increased in response to carotid or vena cava U46619 infusions of 0.5 and 1.0 microgram.kg-1.min-1. Heart rate was elevated in response to carotid (0.5 and 1.0 microgram.kg-1.min-1) or vena cava (1.0 microgram.kg-1.min-1) infusions of U46619. Paco2 declined and pH2 increased significantly in response to carotid infusions of 0.5 and 1.0 microgram.kg-1.min-1 but did not change in response to vena cava infusions. Adrenocorticotropic hormone (ACTH) increased in response to carotid infusions of 0.5 microgram.kg-1.min-1, while cortisol increased in response to infusions of 0.25, 0.5, and 1.0 microgram.kg-1.min-1. ACTH and cortisol did not change in response to vena cava infusions. Pao2, hematocrit, and arginine vasopressin did not change significantly. Pulmonary artery pressure and total peripheral resistance increased while cardiac output decreased in response to carotid or vena cava U46619 infusions of 1 microgram.kg-1.min-1; carotid and vena cava responses were not different from one another. We conclude that increases in blood pressure are mediated by peripheral PGH2/TxA2 receptor activation and that pituitary adrenal, blood gas, and heart rate responses are mediated by PGH2/TxA2 receptor activation at a site perfused by the carotid vasculature.

Identification of a peroxisome proliferator-responsive element upstream of the human peroxisomal fatty acyl coenzyme A oxidase gene.

Peroxisome proliferators cause a rapid and coordinated transcriptional activation of genes encoding the enzymes of the peroxisomal beta-oxidation pathway in rats and mice. Cis-acting peroxisome proliferator responsive elements (PPREs) have been identified in the 5'-flanking region of H202-producing rat acyl-CoA oxidase (ACOX) gene and in other genes inducible by peroxisome proliferators. To gain more insight into the purported nonresponsiveness of human liver cells to peroxisome volume density and in the activity of the beta-oxidation enzyme system, we have previously cloned the human ACOX gene, the first and rate-limiting enzyme of the peroxisomal beta-oxidation system. We now present information on a regulatory element for the peroxidase proliferator-activated receptor (PPAR)/retinoid X receptor (RXR) heterodimers. The PPRE, consists of AGGTCA C TGGTCA, which is a direct repeat of hexamer half-sites interspaced by a single nucleotide (DR1 motif). It is located at -1918 to -1906 base pairs upstream of the transcription initiation site of this human ACOX gene. This PPRE specifically binds to baculovirus-expressed recombinant rat PPAR alpha/RXR alpha heterodimers. In transient transfection experiments, the maximum induction of luciferase expression by ciprofibrate and/or 9-cis-retinoic acid is dependent upon cotransfection of expression plasmids for PPAR alpha and RXR alpha. The functionally of this human ACOX promoter was further demonstrated by linking it to a beta-galactosidase reporter gene or to a rat urate oxidase cDNA and establishing stably transfected African green monkey kidney (CV1) cell lines expressing reporter protein. The human ACOX promoter has been found to be responsive to peroxisome proliferators in CV1 cells stably expressing PPAR alpha, whereas only a basal level of promoter activity is detected in stably transfected cells lacking PPAR alpha. The presence of a PPRE in the promoter of this human peroxisomal ACOX gene and its responsiveness to peroxisome proliferators suggests that factors other than the PPRE in the 5'-flanking sequence of the human ACOX gene may account for differences, if any, in the pleiotropic responses of humans to peroxisome proliferators.

[Cuba: fertility trends in recent decades]. / Cuba: la evolucion de la fecundidad en las ultimas decadas.

PIP: Trends in fertility in Cuba during the past 30 years are reviewed. The emphasis is on the impact of the 1959 political revolution on fertility and the effects on such determinants as marriage and divorce, education, and female labor force participation. (SUMMARY IN ENG AND FRE)^ieng

[Considerations concerning the theory of the demographic revolution. Its development in Cuba]. / Consideraciones acerca de la teoria de la revolucion demografica. Su evolucion en Cuba

PIP: A review of the world's literature on the demographic transition is presented. The author, in his analysis of the non-Marxist literature, suggests that considerable efforts have been made to update demographic transition theory in order to take into account recent demographic trends in developing countries. On the other hand, the Marxist literature is divided into studies in which attempts are made to develop general demographic theories and those in which the value of such theories is questioned. The paper concludes with a description of the demographic transition process as it has been experienced in Cuba, and it is noted that a major feature of this process has been a general trend toward a reduction in demographic differentials.^ieng

Consideraciones acerca de la teoria de la revolucion demografica. Su evolucion en Cuba. / The theory of demographic revolution: its evolution in Cuba

Al revisar la bibliografia actual sobre la evolucion demografica mundial, realizada por Investigadores no marxistas, se constato que se han realizado numerosos trabajos que apuntan, en su mayoria, a revitalizar y ampliar la teoria de la revolucion demografica, con el objetivo de una aplicacion mas consecuente de la misma a los procesos demograficos que experimentan actualmente los paises subdesarrollados.En los trabajos de los demograficos marxistas han surgido diversos enfoques, en la mayoria de los cuales se ubica la teoria necesaria para el analisis de los procesos de reproduccion de la poblacion; en otros se critica dicha teoria como superflua y carente de sentido, y se indica que mas bien tiende a confundir que a brindar claridad en la explicacion del desarrollo de la reproduccion humana. Ademas de los aspectos planteados, en el presente trabajo se realiza un breve analisis del proceso de la revolucion demografica en Cuba.Una de las principales caracteristicas de dicho proceso es la gran homogeneizacion del nivel de la fecundidad y la mortalidad entre las diversas provincias, asi como otros diferenciales comunmente utilizados, como fecundidad segun nivel educacional, etc

Consideraciones acerca de la teoria de la revolucion demografica. Su evolucion en Cuba. / The theory of demographic revolution: its evolution in Cuba

Al revisar la bibliografia actual sobre la evolucion demografica mundial, realizada por Investigadores no marxistas, se constato que se han realizado numerosos trabajos que apuntan, en su mayoria, a revitalizar y ampliar la teoria de la revolucion demografica, con el objetivo de una aplicacion mas consecuente de la misma a los procesos demograficos que experimentan actualmente los paises subdesarrollados.En los trabajos de los demograficos marxistas han surgido diversos enfoques, en la mayoria de los cuales se ubica la teoria necesaria para el analisis de los procesos de reproduccion de la poblacion; en otros se critica dicha teoria como superflua y carente de sentido, y se indica que mas bien tiende a confundir que a brindar claridad en la explicacion del desarrollo de la reproduccion humana. Ademas de los aspectos planteados, en el presente trabajo se realiza un breve analisis del proceso de la revolucion demografica en Cuba.Una de las principales caracteristicas de dicho proceso es la gran homogeneizacion del nivel de la fecundidad y la mortalidad entre las diversas provincias, asi como otros diferenciales comunmente utilizados, como fecundidad segun nivel educacional, etc

[The beginning of the Cuban demographic revolution]. / El comienzo do la revolucion demografica en Cuba

PIP: The characteristics of the Cuban demographic revolution associated with the main economic, political, and social changes in the country are analyzed. The authors begin with a brief historical outline of the political-economic situation in the country in the middle of the 19th century. There is emphasis on the dependency of the Cuban economy and its monoproducer nature (with sugar being the major export). This was due to the Spanish colonization and to the subsequent American neocolonization. The discovery of the cause for yellow fever by a Cuban physician and the sanitation campaign conducted by the Americans contributed to a diminishing of mortality. A great migratory flow occurred due to the price of sugar in the world market. This must have influenced Cuban demographic patterns which are a major factor linked to the demographic revolution. The influence on proliferation of urbanization and educational trends is emphasized. The low participation in economic activities of women during the early part of the century did affect fertility levels. The trends in mortality throughout the period 1907-43 are pointed out. It was found that 1 major aspect which had a bearing on Cuban demographic patterns was the 2 large migratory flows. An analysis of growth rates in the population--which also confirms the demographic changes in Cuba--is presented. It is concluded that the 4th decade of this century witnessed Cuba's entry in a new stage of the demographic revolution, a stage in which decreased fertility and mortality go together to create a new period. (author's)^ieng

Notas sobre la población y los servicios sociales en Cuba / Notes on Cuban population and social services

El trabajo analiza la más reciente evolución del crecimiento de la población cubana, especialmente de las variables demográficas que componen este crecimiento: fecundidad, mortalidad y migraciones interiores e internacionales. Se señalan las características diferenciales de las citadas variables por provincias y zonas urbanas y rurales, en la medida de las posibilidades que brinda la información disponible. los períodos 1970-1975-1980 y 1995-2000 son los que se utilizan indistintamente; se presentan cuadros con indicadores que señalan la futuras perspectivas de la evolución de la fecundidad, la mortalidad y las migraciones interiores e internacionales. En el trabajo se plantea que la tendencia decreciente de la fecundidad determinará que la tasa de crecimiento de la población cubana en el futuro experimente a su vez una tendencia decreciente, y se acerque a los niveles de fecundidad de los países desarrollados (AU)

[Early diagnosis of hip dysplasia]. / Diagnóstico precoz de la displasia de la cadera.

Stress is placed on early diagnosis and treatment of dysplasia of the hip, which should ideally be made at birth. The frequency of this condition with dislocation in babies born at Hospital Infantil de Bogotá was 2.7 per 1,000. The frequency of breech presentation in babies with dysplasia of the hip was 20.2%. The average age at the first consultation for this condition was 24 months. The most important clinical signs for the diagnosis are Barlow's and Ortolani's signs and limitation in abduction of the hip. X-ray studies bear an unquestionable importance in the diagnosis; however, a normal film in the newborn does not discard a clinical diagnosis of dysplasia. Examination of the hips should be a routine in all newborn services in the country. A special regulation in this sense should be set. In this campaign, there should be a joint participation of pediatricians, obstetricians and orthopedists. The pediatrician must control the hips of the child, even if they apparently normal, until walking is initiated. The principles of treatment of dysplasia of the hip in all its varieties are described. The main objective of this work is to invite the medical body to participate in a preventive campaign directed to detect dysplasia of the hip in the newborn and to obtain, with an early treatment, the solution to this severe nosological and social problem.