LOX-1 activation by oxLDL triggers an epithelial mesenchymal transition and promotes tumorigenic potential in prostate cancer cells.

Obesity is related to an increased risk of developing prostate cancer with high malignancy stages or metastasis. Recent results demonstrated that LOX-1, a receptor associated with obesity and atherosclerosis, is overexpressed in advanced and metastatic prostate cancer. Furthermore, high levels of oxLDL, the main ligand for LOX-1, have been found in patients with advanced prostate cancer. However, the role of LOX-1 in prostate cancer has not been unraveled completely yet. Here, we show that LOX-1 is overexpressed in prostate cancer cells and its activation by oxLDL promotes an epithelial to mesenchymal transition, through of lowered expression of epithelial markers (E-cadherin and plakoglobin) and an increased expression of mesenchymal markers (vimentin, N-cadherin, snail, slug, MMP-2 and MMP-9). Consequently, LOX-1 activation by oxLDL promotes actin cytoskeleton restructuration and MMP-2 and MMP-9 activity inducing prostate cancer cell invasion and migration. Additionally, LOX-1 increased the tumorigenic potential of prostate cancer cells and its expression was necessary for tumor growth in nude mice. In conclusion, our results suggest that oxLDL/LOX-1 could be ones of mechanisms that explain why obese patients with prostate cancer have an accelerated tumor progression and a greater probability of developing metastasis.

Toxicidad hepática causada por medicamentos: revisión estructurada / Structured Literature Review of Hepatic Toxicity Caused by Medicines

Resumen Objetivos: elaborar un listado actualizado de medicamentos causantes de hepatotoxicidad e identificar, de acuerdo con la evidencia científica, los medicamentos con mayor probabilidad de causar hepatotoxicidad. Método: se realizó una búsqueda en PubMed/Medline utilizando términos Mesh: "liver disease" y "drug-induced liver injury". La búsqueda se filtró por: reportes de casos, revisiones, ensayos clínicos, metaanálisis y cartas, hasta diciembre de 2015, en inglés, español y francés. Se incluyeron artículos con evidencia de hepatotoxicidad causada por medicamentos y referencias relevantes; fueron excluidos artículos sin relación con los objetivos de la búsqueda, relacionados con hepatotoxicidad por agentes diferentes, concernientes a otras causas de enfermedad hepática o relacionados con ensayos predictivos o células madre. Algunos aspectos de los medicamentos hepatotóxicos fueron: aparición de hepatotoxicidad, tipo de lesión, mecanismos de hepatotoxicidad, factores de riesgo y manifestaciones clínicas. Para valorar la probabilidad de aparición de hepatotoxicidad y del tipo de lesión se establecieron 3 categorías: definida, probable y posible. Resultados: se identificaron 610 artículos de los cuales se eligieron 402, se excluyeron 208 artículos. Se elaboró un listado con 181 medicamentos y 17 formas farmacéuticas combinadas o regímenes terapéuticos con probabilidad de causar hepatotoxicidad; de estos, 6 medicamentos tuvieron probabilidad definida (metotrexato, minociclina, vancomicina, everolimus, isoniazida y tamoxifeno). Conclusiones: se identificaron más de 180 medicamentos hepatotóxicos, 6 tienen una probabilidad definida, mientras que para la mayoría es posible. La consolidación de la información demostró que diversas categorías de medicamentos tienen mayor probabilidad de ser causantes de hepatotoxicidad.

Abstract Objectives: The aim of this study was to prepare an updated list of drugs that cause hepatotoxicity and identify drugs most likely to cause hepatotoxicity according to scientific evidence. Method: A search of PubMed/Medline was conducted using the MeSH terms: "Liver disease" and "Drug-induced Liver Injury". The search was filtered by case reports, reviews, clinical trials, metaanalyses and letters until December 2015. The search was limited to articles in English, Spanish and French. Articles with evidence of hepatotoxicity caused by medications and relevant references were included. Articles not related to the objectives of the search were excluded. These include articles related to hepatotoxicity due to other agents, articles about other causes of liver disease and/or articles related to predictive tests or stem cells. Some aspects of hepatotoxic drugs were appearance of hepatotoxicity, type of injury, mechanisms of hepatotoxicity, risk factors and clinical manifestations. Three categories, definite, probable and possible, were established to assess probability of hepatotoxicity and type of lesion. Results: Six hundred ten articles were identified, 402 articles were chosen, and 208 articles were excluded. A list was prepared with 181 drugs and 17 combined pharmaceutical forms or therapeutic regimens likely to cause hepatotoxicity. Of these, methotrexate, minocycline, vancomycin, everolimus, isoniazid, and tamoxifen were categorized as definite probabilities. Conclusions: More than 180 hepatotoxic drugs were identified, six were categorized as definite probabilities, and most were categorized as possibilities. The consolidation of information shows that diverse categories of drugs are likely to cause liver toxicity.

Cáncer y paro / Cancer and unemployment

La falta de trabajo es una realidad dramática cada vez más frecuente en la época que estamos viviendo. La experiencia diaria de los clínicos nos aporta importantes indicios que nos hacen pensar en la existencia de una relación directa entre situaciones prolongadas de paro y la predisposición a padecer graves problemas de salud, y en concreto a padecer determinados tipos de cáncer. El presente trabajo pretende hacer una revisión de los principales estudios epidemiológicos que han abordado la relación entre cáncer y paro laboral, especialmente aquellos que analizan la relación entre situaciones de paro y aumento de la mortalidad por cáncer. Los resultados de esta revisión permiten formular diversas hipótesis derivadas de le intensa relación existente entre el paro y el cáncer. En nuestro país son necesarios estudios de incidencia poblacionales con suficiente tamaño muestral que analicen esta relación ajustando por otros factores de riesgo que actúan como confusores (AU)

The lack of work is a increasingly dramatic situation in the times we are living. Daily experience of clinicians provides us with important clues that remind us of the existence of a direct relationship between prolonged unemployment and predisposition to serious health problems, in particular to suffering certain types of cancer. This paper aims to review the major epidemiological studies that have dealt the relationship between cancer and unemployment. Several hypotheses may be formulated with the results of this review arising from the possible etiological relationship between unemployment and development (or poor prognosis) of neoplastic processes (AU)

[Cancer and unemployment]. / Cáncer y paro.

The lack of work is a increasingly dramatic situation in the times we are living. Daily experience of clinicians provides us with important clues that remind us of the existence of a direct relationship between prolonged unemployment and predisposition to serious health problems, in particular to suffering certain types of cancer. This paper aims to review the major epidemiological studies that have dealt the relationship between cancer and unemployment. Several hypotheses may be formulated with the results of this review arising from the possible etiological relationship between unemployment and development (or poor prognosis) of neoplastic processes.

[Hysteroscopic polypectomy, treatment of abnormal uterine bleeding]. / Polipectomía histeroscópica para el tratamiento del sangrado uterino anormal.

OBJECTIVES: To evaluate the effectiveness of the hysteroscopic polypectomy in terms of the decrease of the abnormal uterine bleeding. METHODS: A cross-sectional and analytical study was done with patients to whom a hysteroscopic polypectomy was done for treating the abnormal uterine bleeding, between January 2009 and December 2013. The response to the treatment was evaluated via a survey given to the patients about the behavior of the abnormal uterine bleeding after the procedure and about overall satisfaction. RESULTS: The results were obtained after a hysteroscopic polypectomy done to 128 patients and were as follows. The average time from the polypectomy applied until the survey was 30.5 months, with a standard deviation of 18 months. 67.2% of the patients reported decreased abnormal uterine bleeding and the 32.8% reported a persistence of symptoms. On average 82.8% of the. patients were satisfied with the treatment. Bivariate and multivariate analysis showed no association between the variables studied and no improvement of abnormal uterine bleeding after surgery (polypectomy). There were no complications. CONCLUSION: Hysteroscopic polypectomy is a safe surgical treatment, which decreases on two of three patients the abnormal uterine bleeding in the presence of endometrial polyps, with an acceptable level of satisfaction.

Sacrocolpopexia laparoscópica para el tratamiento del prolapso apical: resultados y seguimiento a largo plazo / Laparoscopic sacrocolpopexy for apical prolapse

Objetivos: Evaluar los resultados subjetivos, anatómicos y funcionales a largo plazo de las pacientes sometidas a sacrocolpopexia laparoscópica para manejo de prolapso apical. Métodos: Estudio observacional con pacientes a quienes se les hizo sacrocolpopexia laparoscópica entre febrero de 2006 y diciembre de 2012, en tres centros. El nivel de soporte del piso pélvico se midió mediante la escala de cuantificación del prolapso de órganos pélvicos (POP-Q). Los resultados funcionales se evaluaron mediante un cuestionario de síntomas intestinales, urinarios, sexuales y de molestias físicas. También se estimó la satisfacción global de las pacientes con una escala de uno a diez. Resultados: Se realizó sacrocolpopexia laparoscópica a 68 pacientes, pero el seguimiento fue posible sólo en 24. Ninguna paciente tuvo prolapso apical postoperatorio. El punto C medio del POP-Q fue -6,8 cm. Se observó mejoría importante con respecto a los síntomas subjetivos de prolapso con reducciones significativas en las puntuaciones del cuestionario en el seguimiento postoperatorio. La satisfacción fue en promedio de 9,1. La incontinencia urinaria preoperatoria se resolvió en el 35 por ciento de las que la reportaron, sin necesidad de cirugía de continencia concomitante. No hubo complicaciones a corto plazo. A largo plazo hubo una hernia incisional en el sitio del trocar y una obstrucción intestinal por la malla. Conclusión: La sacrocolpopexia laparoscópica es un tratamiento quirúrgico seguro y eficaz para el prolapso apical post-histerectomía. Proporciona un excelente soporte apical y buen nivel de satisfacción, con una mejoría general de los síntomas de prolapso.

Objective: To evaluate the long-term subjective, anatomical and functional outcomes after laparoscopic sacrocolpopexy for apical prolapse. Methods: An observational study of women undergoing laparoscopic sacrocolpopexy between February 2006 and December 2012 was undertaken, at three centers. Pelvic organ support was assessed objectively using the pelvic organ prolapse quantification scale (POP-Q). Functional outcomes were assessed using a questionnaire of bowel, urinary, sexual and physical discomfort symptoms postoperatively. Also was assessed the overall satisfaction of surgery with a scale of one to ten. Results: During the period of the study, sacrocolpopexy was done in 68 patients, but follow-up was possible only in 24. At a mean follow up of 34 months, all 24 women had stage 0 vault support with point C of the POP-Q score averaging -6.8 cm. Subjective improvements in prolapse symptoms were observed with significant reductions in the questionnaire scores. The satisfaction measured with visual scale averaged 9.1. Fifteen women reported stress urinary incontinence before sacrocolpopexy, and it was resolved in 35 percent without concomitant continence surgery. New onset incontinence was reported in two women. There were no intraoperative and perioperative complications. The long term complications were an incisional hernia on the trocar port site and bowel obstruction caused by the mesh that needed intestinal resection. Conclusions: Laparoscopic sacrocolpopexy is a safe and effective surgical treatment for post-hysterectomy apical prolapse. It provides excellent apical support and good level of satisfaction, with overall improvement in prolapse symptoms.

Segregation of chromosomes in sperm of reciprocal translocation carriers: a review.

Reciprocal translocations, the most frequent structural aberration in humans, are mainly transmitted by one of the parents. In order to analyze the chromosomal content of the spermatozoa from carriers of chromosomal reorganizations, two methods have been used, karyotyping of sperm chromosomes by the human-hamster system and fluorescence in situ hybridization (FISH) in decondensed sperm nuclei. In this work, we review 92 sperm chromosome segregation studies from 85 different reciprocal translocation carriers, including a triple translocation carrier. Using the human-hamster method, a total of 5,818 spermatozoa from 44 reciprocal translocation carriers have been analyzed, 43 of them carrying a single reciprocal translocation and one was a carrier of a double reciprocal translocation. A segregation analysis in a carrier of a t(2;22;11) has been also reported. Carrying out FISH in sperm nuclei, a total of 237,042 spermatozoa from 46 reciprocal translocation carriers have been analyzed. Six of these were also analyzed by the human-hamster system. Taking into account both methods, a total of 76 different reciprocal translocations have been studied. In 74 of these 76 translocations, the reorganization occurs between autosomes, and in the other two, the Y chromosome is involved. Although along general lines, there are similarities between the results obtained by the two methods of analysis, variations are observed when the distribution of the different types of segregations that produce imbalances is compared. As a general rule reciprocal translocation carriers produce more unbalanced sperm than normal or balanced sperm. The results reported also corroborate that the proportion of unbalanced forms depends on the characteristics of the reorganization and that it varies widely. Thus the importance of performing a detailed meiotic behavior analysis for each particular translocation in order to obtain enough information to give adequate genetic counseling is stressed. Aspects as to the possible overestimation of 3:1 segregations or the presence of interchromosomal effects still need to be elucidated.

[Validation of a rapid urease test for the diagnosis of Helicobacter pylori infection]. / Validación de un test de ureasa rápido para el diagnóstico de la infección por H. pylori.

OBJECTIVE: Several non-commercial rapid urease tests have been designed with the objective of reducing the cost of Helicobacter Pylori infection diagnosis. The objective of the present prospective trial is to assess one of these tests, using the histologic evaluation for the presence of Helicobacter Pylori, as the standard reference of diagnosing this infection. METHODS: Patients undergoing upper endoscopy for various reasons were prospectively enrolled. Three endoscopic biopsies of the antrum and three from the corpus of the stomach were taken in every patient enrolled. The specimens were evaluated by the rapid urease test on an individual basis, comparing the results with the histology assessment of the Helicobacter Pylori status, which was considered as the standard reference for the diagnosis of the infection. RESULTS: One hundred and four patients were enrolled, of which 94 were eligible. Fifty-five patients (60.43%) were infected with Helicobacter Pylori. The sensibility and specificity of the urease test evaluated at 4 hours was 65.45% and 100% respectively. The evaluation at 24 hours of the sensibility and specificity was 83% and 94% respectively. CONCLUSIONS: The non-commercial rapid urease test is a practical, fast, and cost effective method for the detection of Helicobacter Pylori infection, and its diagnostic utility is similar to the commercial test available.

Validación de un test de ureasa rápido para el diagnóstico de la infección por H. Pylori / Validation of a rapid urease test for the diagnosis of helicobacter pylori infection

OBJECTIVE: Several non-commercial rapid urease tests have been designed with the objective of reducing the cost of Helicobacter Pylori infection diagnosis. The objective of the present prospective trial is to assess one of these tests, using the histologic evaluation for the presence of Helicobacter Pylori, as the standard reference of diagnosing this infection. METHODS: Patients undergoing upper endoscopy for various reasons were prospectively enrolled. Three endoscopic biopsies of the antrum and three from the corpus of the stomach were taken in every patient enrolled. The specimens were evaluated by the rapid urease test on an individual basis, comparing the results with the histology assessment of the Helicobacter Pylori status, which was considered as the standard reference for the diagnosis of the infection. RESULTS: One hundred and four patients were enrolled, of which 94 were eligible. Fifty-five patients (60.43%) were infected with Helicobacter Pylori. The sensibility and specificity of the urease test evaluated at 4 hours was 65.45% and 100% respectively. The evaluation at 24 hours of the sensibility and specificity was 83% and 94% respectively. CONCLUSIONS: The non-commercial rapid urease test is a practical, fast, and cost effective method for the detection of Helicobacter Pylori infection, and its diagnostic utility is similar to the commercial test available

Validación de un test de ureasa rápido para el diagnóstico de la infección por H. Pylori / Validation of a rapid urease test for the diagnosis of helicobacter pylori infection

OBJECTIVE: Several non-commercial rapid urease tests have been designed with the objective of reducing the cost of Helicobacter Pylori infection diagnosis. The objective of the present prospective trial is to assess one of these tests, using the histologic evaluation for the presence of Helicobacter Pylori, as the standard reference of diagnosing this infection. METHODS: Patients undergoing upper endoscopy for various reasons were prospectively enrolled. Three endoscopic biopsies of the antrum and three from the corpus of the stomach were taken in every patient enrolled. The specimens were evaluated by the rapid urease test on an individual basis, comparing the results with the histology assessment of the Helicobacter Pylori status, which was considered as the standard reference for the diagnosis of the infection. RESULTS: One hundred and four patients were enrolled, of which 94 were eligible. Fifty-five patients (60.43%) were infected with Helicobacter Pylori. The sensibility and specificity of the urease test evaluated at 4 hours was 65.45% and 100% respectively. The evaluation at 24 hours of the sensibility and specificity was 83% and 94% respectively. CONCLUSIONS: The non-commercial rapid urease test is a practical, fast, and cost effective method for the detection of Helicobacter Pylori infection, and its diagnostic utility is similar to the commercial test available (AU)

Validación de un test de ureasa rápido para el diagnóstico de la infección por H. pylori. / [Validation of a rapid urease test for the diagnosis of Helicobacter pylori infection]

OBJECTIVE: Several non-commercial rapid urease tests have been designed with the objective of reducing the cost of Helicobacter Pylori infection diagnosis. The objective of the present prospective trial is to assess one of these tests, using the histologic evaluation for the presence of Helicobacter Pylori, as the standard reference of diagnosing this infection. METHODS: Patients undergoing upper endoscopy for various reasons were prospectively enrolled. Three endoscopic biopsies of the antrum and three from the corpus of the stomach were taken in every patient enrolled. The specimens were evaluated by the rapid urease test on an individual basis, comparing the results with the histology assessment of the Helicobacter Pylori status, which was considered as the standard reference for the diagnosis of the infection. RESULTS: One hundred and four patients were enrolled, of which 94 were eligible. Fifty-five patients (60.43

) were infected with Helicobacter Pylori. The sensibility and specificity of the urease test evaluated at 4 hours was 65.45

and 100

respectively. The evaluation at 24 hours of the sensibility and specificity was 83

and 94

respectively. CONCLUSIONS: The non-commercial rapid urease test is a practical, fast, and cost effective method for the detection of Helicobacter Pylori infection, and its diagnostic utility is similar to the commercial test available.

Cytogenetic characterization of two colon cell lines by using conventional G-banding, comparative genomic hybridization, and whole chromosome painting.

The heterogeneous nature of genetic alterations in cancer cells handicaps the full characterization of its occurrence and the analysis of their molecular bases and relation to biological processes. Although many cancer cells are highly aneuploid, in other cases, as in a subset of colorectal carcinomas displaying microsatellite instability, chromosomal aberrations are scarce. The aim of this study was to fully characterize both qualitatively and quantitatively, the karyotypes of two established colon carcinoma cell lines (LoVo and HCT 116) previously reported as being near diploid. An array of complementary cytogenetic techniques were used: G-banding, comparative genome hybridization (CGH), and whole-chromosome painting (WCP). Combinations of these techniques provided an accurate karyotype for the two cell lines: LoVo cells showed 49,XY,t(2;12)(q13;p11.2),+5,+7,+12,i(15)(q10) and HCT 116 cells showed 45,X,-Y,dup(10)(q24q26),der(16)t(8;16)(q13;p13), der(18)t(17;18)(q21;p11.3). Heterogeneity was also observed in both cell lines as shown by G-banding. Chromosomal unbalances determined by CGH (many of them related to structural reorganizations) were characterized by WCP, allowing the reliable identification of those chromosome markers that could not be completely identified by G-banding. We show that combined analysis with classical and molecular cytogenetic techniques provides an accurate map of chromosomal aberrations in these two cell lines not identified in previous investigations.

Cytogenetic analysis of sperm chromosomes and sperm nuclei in a male heterozygous for a reciprocal translocation t(5;7)(q21;q32) by in situ hybridisation.

We have studied the meiotic segregation of a reciprocal translocation t(5;7)(q21;q32) in a male carrier, using the human sperm-hamster oocyte fusion technique and the whole chromosome painting. A total of 296 sperm complements were analysed by dual chromosome painting. The frequencies of alternate, adjacent-1, adjacent-2 and 3:1 segregation were 49.7%, 32.4%, 16.2% and 1.7% respectively. Aneuploidy frequencies for chromosomes not involved in the translocation were determined by FISH on decondensed sperm heads using probes from chromosomes X, Y, 6, 18 and 21. A total of 20,118 spermatozoa was analysed, 10,201 by two-colour FISH (probes for chromosomes 6 and 21) and 9917 by three-colour FISH (probes for chromosomes X, Y, and 18). There was no evidence of an interchromosomal effect, since disomy frequencies were within the range of normal controls.

Two sinusoidal heart rate patterns in fetal lambs undergoing extracorporeal membrane oxygenation.

OBJECTIVES: The study analyzed the phase relationship between fetal heart rate and arterial blood pressure fluctuation during sinusoidal heart rate patterns in fetal lambs. STUDY DESIGN: Thirty-two fetal lambs were placed on extracorporeal membrane oxygenation after cesarean delivery at ages ranging between 113 and 133 days' gestation. Sinusoidal heart rate patterns persisting for >10 minutes were analyzed. The relationships between the sinusoidal heart rate cycles and the arterial blood pressure cycles were quantitatively expressed in degrees by timing the zenith and the nadir of each and assigning a phase-angle index (with 0 [360] and 180 degrees being synchronized and reciprocal, respectively). Simultaneous blood samples were taken from the 4 different sites of the fetal circulation for blood gas and acid-base analysis when the sinusoidal heart rate pattern appeared. Regional cerebral blood flow was determined by means of the colored microsphere technique in 8 fetuses with sinusoidal patterns and 7 control fetuses. RESULTS: Sinusoidal heart rate patterns were observed in 13 (40.6%) of the 32 fetal lambs. Two types of fetal heart rate and arterial blood pressure relationship could be recognized during sinusoidal pattern, the reciprocal type (n = 7) and the synchronized type (n = 9). A reciprocal type of sinusoidal pattern preceded a synchronized type pattern in 3 lambs that showed sinusoidal patterns at different stages of the experiment. The reciprocal type was associated with a higher baseline heart rate and amplitude of the sinusoidal heart rate pattern than was the synchronized type. The synchronized type was associated with a lower pH and base excess than was the reciprocal type. The cerebral blood flow in the medulla oblongata was significantly lower during the synchronized type pattern than during the reciprocal type pattern. CONCLUSION: There are 2 types of sinusoidal heart rate pattern. A synchronized type sinusoidal heart rate pattern may indicate more advanced fetal compromise than is associated with a reciprocal type pattern.

Sperm segregation analysis of a complex chromosome rearrangement, 2;22;11, by whole chromosome painting.

Using the human sperm-hamster oocyte fusion technique and whole chromosome painting, we studied sperm chromosome segregation in a male heterozygous for a complex chromosome rearrangement, 46,XY,-2, +der(2)t(2;11)(q13; q23),-11,+der(11)t(11;22)(q23;q11.2),-22, +der(22)t(2;22)(q13; q11.2). A total of 208 sperm complements were analyzed. The frequency of sperm carrying a normal or a balanced complement was 13.5% (9.62% and 3.85%, respectively). The frequency of unbalanced sperm was 86.5% (64.9% from 3:3 segregation, including 30 different types; 20.7% from 4:2 segregation, including 21 different types; and 0.96% from 5:1 segregation, including 2 different types). The sex ratio, determined in 134 sperm complements, did not differ from the expected 1:1 ratio. The results obtained in this study are compatible with the formation, during the synaptic process, of a complex hexavalent figure involving chromosomes 2, 11, and 22. The behavior and segregation of this complex figure would explain the high frequency (86.5%) of unbalanced complements observed in this carrier.

Fetal heart rate patterns in postasphyxiated fetal lambs with brain damage.

OBJECTIVE: We previously showed that in asphyxiated fetal lambs the duration of hypotension correlated well with the severity of histologic damage to the brain, whereas the duration of bradycardia did not. This study compares fetal heart rate patterns with the degree of histologic damage to the brain. STUDY DESIGN: Twelve chronically instrumented near-term fetal lambs were subjected to asphyxia by umbilical cord occlusion until fetal arterial pH was <6. 9 and base excess was <-20 mEq/L. An additional 4 fetuses served as sham-asphyxia controls. Fetal heart rate (from electrocardiogram), arterial blood pressure, fetal breathing movements, and electrocorticogram were continuously monitored before, during, and for 72 hours after asphyxia. Fetal brain histologic features were categorized as mild (group 1, n = 5), moderate (group 2, n = 4), and severe (group 3, n = 3). Long-term fetal heart rate variability expressed as amplitude range was assessed visually every 5 minutes from 30 minutes before asphyxia until 2 hours of recovery and at 6, 12, 24, 48, and 72 hours of recovery. RESULTS: Long-term fetal heart rate variability amplitude decreased from 32 +/- 17 beats/min (mean +/- SEM) preocclusion to 4 +/- 13 beats/min at the end of occlusion (P <.001) without significant differences among the 3 groups. During 10 to 45 minutes of recovery, the long-term variability of group 1 was significantly greater than that of groups 2 and 3. At 24 to 72 hours of recovery, the long-term variability of groups 1 and 2 was significantly higher than that of group 3, which was almost 0. The "checkmark" and sinusoidal fetal heart rate patterns were observed during the recovery period in groups 2 and 3. CONCLUSIONS: Decreased long-term fetal heart rate variability and the "checkmark" and sinusoidal fetal heart rate patterns were indicators of the severity of asphyxial histologic damage in the fetal brain.

Grouping of Aspergillus species with exoantigens.

Ninety-two slant extracts prepared from 2-week-old cultures of seven Aspergillus groups, nonsporulating "albino-type" A.fumigatus, Blastomyces dermatitidis, Histoplasma capsulatum, 3 Penicillium spp., 2 Pseudallescheria spp., 3 Paecilomyces spp., and Acremonium sp., were analyzed concurrently against antisera to A. fumigatus, A. flavus, A. nidulans, A. niger, and A. terreus. The extract of each of the aforementioned five pathogenic Aspergillus spp. produced 2-11 specific antigen-antibody complexes after reacting with its homologous antiserum. Antisera prepared against extracts to these pathogenic aspergilli demonstrated variable intra-generic crossreactivity, which were eliminated by adsorption with heterologous Aspergillus spp. antigens. Fewer nonspecific reactions were noted with the reference antigen-antibody precipitates of A. nidulans and A. Terreus than with reference precipitates of the other Aspergillus spp. Exoantigen extracts of "albino-type" isolates of A. fumigatus produced two to five specific precipitins against anti-A. fumigatus serum only. Based on the specific reactions produced by the eight albino-type isolates and 1 Aspergillus sp. isolate, all these fungi were identified correctly and placed in the A. fumigatus group. Analyses of conventionally identified A. fumigatus, A. flavus, A. nidulans, A. niger, and A. terreus including an isolate of A. parasiticus, enabled us correctly to classify them (51/51, or 100%) into their respective groups. Specific Aspergillus spp. antigen-antibody precipitates were characterized and used as references in exoantigen tests. None of the fungi in the genera other than Aspergillus produced antigens identical to the selected reference antigens.