Isoinertial and isokinetic sprints: muscle signalling.

To determine if the muscle signalling response to a 30 s all-out sprint exercise is modulated by the exercise mode and the endocrine response, 27 healthy volunteers were divided in 2 groups that performed isokinetic (10 men and 5 women) and isoinertial (7 men and 5 women) Wingate tests. Blood samples and vastus lateralis muscle biopsies were taken before, immediately after, 30 and 120 min after the sprints. Groups were comparable in age, height, body weight, percentage of body fat, peak power per kg of lower extremities lean mass (Pmax) and muscle fibre types. However, the isoinertial group achieved a 25% greater mean power (Pmean). Sprint exercise elicited marked increases in the musculus vastus lateralis AMPKα, ACCß, STAT3, STAT5 and ERK1/2 phosphorylation (all P<0.05). The AMPKα, STAT3, and ERK1/2 phosphorylation responses were more marked after the isoinertial than isokinetic test (interaction: P<0.01). The differences in muscle signalling could not be accounted for by differences in Pmax, although Pmean could explain part of the difference in AMPKα phosphorylation. The leptin, insulin, glucose, GH, IL-6, and lactate response were similar in both groups. In conclusion, the muscle signalling response to sprint exercise differs between isoinertial and isokinetic sprints.

Training, leptin receptors and SOCS3 in human muscle.

Endurance exercise induces SUPPRESSOR of CYTOKINE SIGNALING 3 (SOCS3) mRNA expression in rodent skeletal muscle and endurance training overimposed on strength training blunts the hypertrophic response to strength training by an unknown mechanism. The aim of this study was to determine the effects of a concurrent strength and endurance training on fat mass, serum leptin concentration, muscle morphology, and muscle vastus lateralis leptin receptors (OB-Rb) and SOCS3 protein expression. 16 healthy young men were assigned to a control (C; n=7), and to a 12-week weightlifting (3 sessions/week)+endurance training program (T; n=9) group. Training enhanced maximal dynamic strength in lower and upper body exercises (18-54%), reduced fat mass by 1.8 kg and serum leptin concentration per kg of fat mass, and elicited muscle hypertrophy of type 2 (+18.5%, P<0.05) but not of type 1 muscle fibres (+4.6%, P=NS). No significant changes were observed in either OB-Rb or SOCS3 protein expression with training. In conclusion, concurrent strength and endurance training reduces fat mass and serum leptin and the ratio leptin/fat mass without significant effects on vastus lateralis OB-Rb protein expression. Training does not increase the basal expression of SOCS3 protein in humans.

Leptin receptor 170 kDa (OB-R170) protein expression is reduced in obese human skeletal muscle: a potential mechanism of leptin resistance.

To examine whether obesity-associated leptin resistance could be due to down-regulation of leptin receptors (OB-Rs) and/or up-regulation of suppressor of cytokine signalling 3 (SOCS3) and protein tyrosine phosphatase 1B (PTP1B) in skeletal muscle, which blunt janus kinase 2-dependent leptin signalling and signal transducer and activator of transcription 3 (STAT3) phosphorylation and reduce AMP-activated protein kinase (AMPK) and acetyl-coenzyme A carboxylase (ACC) phosphorylation. Deltoid and vastus lateralis muscle biopsies were obtained from 20 men: 10 non-obese control subjects (mean +/- s.d. age, 31 +/- 5 years; height, 184 +/- 9 cm; weight, 91 +/- 13 kg; and percentage body fat, 24.8 +/- 5.8%) and 10 obese (age, 30 +/- 7 years; height, 184 +/- 8 cm; weight, 115 +/- 8 kg; and percentage body fat, 34.9 +/- 5.1%). Skeletal muscle OB-R170 (OB-R long isoform) protein expression was 28 and 25% lower (both P < 0.05) in arm and leg muscles, respectively, of obese men compared with control subjects. In normal-weight subjects, SOCS3 protein expression, and STAT3, AMPKalpha and ACCbeta phosphorylation, were similar in the deltoid and vastus lateralis muscles. In obese subjects, the deltoid muscle had a greater amount of leptin receptors than the vastus lateralis, whilst SOCS3 protein expression was increased and basal STAT3, AMPKalpha and ACCbeta phosphorylation levels were reduced in the vastus lateralis compared with the deltoid muscle (all P < 0.05). In summary, skeletal muscle leptin receptors and leptin signalling are reduced in obesity, particularly in the leg muscles.

Evaluación del estado nutricional en niños con cáncer / Performance nutrition evaluation in children with cancer

La desnutrición constituye el diagnóstico secundario más común en pacientes con cáncer; esto conlleva a que en el momento de diagnosticar la enfermedad, se realice la evaluación nutricional, que permitirá establecer el soporte nutricional adecuado y el seguimiento del paciente. El objetivo principal de este trabajo es evaluar el estado nutricional de niños que asisten a la consulta de oncología pediátrica del Instituto Oncológico “Dr. Luis Razetti”. Se realizó estudio descriptivo, transversal y prospectivo de 57 pacientes con patología oncológica que asistieron a la consulta del servicio de oncología pediátrica del Instituto Oncológico “Dr. Luis Razetti”, del Distrito Capital durante los meses enero- mayo año 2006, a los cuales se les practicó evaluación integral del crecimiento y estado nutricional. Se evidenció malnutrición por déficit en 23 (40,4 por ciento) de los niños, nutrición normal en 28 (49,1 por ciento) y malnutrición por exceso en 6 (10,5 por ciento). En cuanto a la relación entre tratamiento y malnutrición, encontramos una diferencia estadísticamente no significativa. El 100 por ciento de los pacientes con enfermedad avanzada presentaban algún grado de malnutrición por déficit, encontrando una diferencia estadísticamente significativa. Los resultados obtenidos nos permite hacer las siguientes recomendaciones: 1. Estandarizar criterios de riesgo nutricional para pacientespediátricos oncológicos, adaptados a la realidad nacional. 2. Evaluación nutricional integral a todos los pacientes pediátricos oncológicos al momento del diagnóstico. 3. Intervención nutricional individualizada. 4. Soporte nutricional y apoyo psico-social través de un equipo multidisciplinario e interdisciplinario.

Etiología del síndrome febril agudo en la provincia de Jaén, Perú 2004-2005 / Etiology of acute febrile syndrome in Jaen province, Peru 2004-2005

Conocer la etiología del síndrome febril agudo en pacientes que acudieron a tres establecimientos de saludde la provincia de Jaén entre mayo de 2004 y abril de 2005. Materiales y métodos: Estudio descriptivo prospectivo realizado en tres establecimientos de salud: Hospital General de Jaén, Hospital de Apoyo Bellavista y Centro de Salud Morro Solar. Se incluyeron pacientes entre 5 y 65 años con fiebre de menos de ocho días de evolución y sin foco infeccioso aparente. Inicialmente se les realizó gota gruesa para malaria y frotis sanguíneo para Bartonelosis; de los casos negativos se obtuvo una segunda muestra de sangre para la búsqueda de ELISA IgM y microaglutinación para el diagnóstico de leptospirosis, ELISA IgM para dengue, Mayaro, Oropuche y encefalitis equina venezolana, e inmunofluorescenciaindirecta para Rickettsiosis. Resultados: De 1039 febriles incluidos, se determinó la etiología en 680(65,4 por ciento) casos, malaria por P. falciparum 312 (30,0 por ciento), leptospirosis 115 (11,1 por ciento), dengue 105 (10,1 por ciento), malaria por P.vivax 76 (7,3 por ciento), leptospirosis más dengue 30 (2,9 por ciento), Rickettsiosis 15 (1,4 por ciento), Bartonelosis 17 (1,6 por ciento), leptospirosis másRickettsiosis 7 (0,7 por ciento), y leptospirosis, dengue más Rickettsiosis 3 (0,3 por ciento). Los serovares de Leptospira más frecuentesfueron varilla (35,7 por ciento) y bratislava (32,5 por ciento). Conclusión: La malaria es la principal causa de síndrome febril agudo en Jaén, se destaca la presencia de la leptospirosis como segunda causa, por delante del dengue; es necesario considerar dentro del diagnóstico diferencial Rickettsiosis y Bartonelosis.

Objective: To know the etiology of acute febrile syndrome in patients presenting to three healthcare facilities in Jaen province,between May 2004 and April 2005. Materials and methods: A prospective and descriptive study was performed in three healthcare facilities:Jaen General Hospital,Bellavista Support Hospital and Morro Solar Health Center.Patients between 5 and 65 years were included.They had fever for less than eight days and with no apparent infectious etiology. Initially patients were screened with a thick smear blood test for malaria and a thin smear for Bartonellosis.Patients reported as negative for these test underwent a second blood test which included the following assays:IgM ELISA and microagglutination for leptospirosis,IgM ELISA for dengue fever,Mayaro,Oropuche and Venezuelan equine encephalitis, and indirect immunofluorescence for Rickettsiosis. Results: Of 1039 febrile patients included,a diagnosis was made in 80 65,4%)ases:P.alciparum malaria n 12 30,0%),eptospirosis in 15 11,1%),engue ever in 05 10,1%), P.vivax malaria in 76 (7,3%),leptospirosis and dengue fever in 30 (2,9%),rickettsiosis in 15 (1,4%),and leptospirosis plus dengue plus Rickettsiosis in 3 (0,3%).Most frequent Leptospira serovars were varilla (35,7%)and bratislava (32,5%). Conclusion: Malaria is the main cause of acute febrile syndrome in Jaen.It is also noteworthy the presence of leptospirosis in second place,above dengue fever;it is necessary to include this condition,as well as Bartonellosis and Rickettsiosis in the differential diagnosis.

Epoxide adducts at the guanine residue within single-stranded DNA chains: reactivity and stability studies.

Emphasis was placed in this work on the assessment of structural and biological features of nucleobase adducts that result from the reaction of DNA with epoxide derivatives. Thus we have prepared and characterized a set of site-specifically modified oligonucleotides at N7-position of a guanine residue, upon reaction with diepoxibutane, with the purpose of further investigating some of their biochemical features. The stability of the lesion-containing DNA fragments has also been investigated and clearly shows that the latter modified oligomers may be used as substrates for in vitro enzymatic assays, aimed at determining the biological effects within cell of these chemically induced DNA damage.

Expression of calcium-binding proteins in the proliferative zones around the corticostriatal junction of rabbits during pre- and postnatal development.

Herein we asked whether cells expressing calcium-binding proteins around the corticostriatal junction are of pallial or subpallial origin. Brains of rabbit embryos between embryonic day E18 and E28 and postnatal day 0-P22 were immunoreacted with monoclonal antibodies raised against calretinin, calbindin and parvalbumin. At E18-E21, calbindin- and calretinin-immunoreactive cells were seen in distinct proliferative zones in the vicinity of the corticostriatal junction. Whereas calbindin-immunoreactive neurons were in the ventricular zone of the ventral pallium (the medial wall of the lateral ventricular angle), calretinin-immunoreactive cells were, nearby, in the subventricular zone of the subpallium at the lateral edge of the lateral ganglionic eminence. From E25 to P22, both calbindin- and calretinin-immunoreactive cells appeared in the pallial ventricular and subventricular zones around the lateral ventricular angle. Some of these cells resembled migratory neuroblasts. Parvalbumin-immunoreactive cells appeared at P5-P10, albeit they were almost negligible in the proliferative zones around the corticostriatal junction and the lateral ventricular angle. The results suggest that a number of the calbindin-expressing neurons that are generated in mid-gestation and postnatally are of pallial origin. They also indicate that only a few of the late-generated calretinin-immunoreactive cells may have a pallial source. The origin of the parvalbumin-immunoreactive cells was not ascertained in the present study.

Adhesive small bowel obstruction: predictive value of oral contrast administration on the need for surgery.

INTRODUCTION: adhesive small bowel obstruction (SBO) is a common cause of hospital admission. Nonoperative management is initially recommended unless there is suspicion of strangulation, but its optimal duration is controversial. The aims of our study was to evaluate the usefulness of radiographic small bowel examination with contrast medium to predict the need for surgery in SBO. MATERIAL AND METHODS: this prospective study carried out from January 1999 to December 2001, included 100 patients with clinical and radiological criteria of adhesive SBO. We described the past medical history, as well as clinical picture, blood tests and radiological findings in these patients. Fifty cubic centimeters of 5% barium suspension were given orally, and plain abdominal radiographs were taken at 4, 8, 16, and 24 hours afterwards. A liquid diet was given as soon as the contrast medium appeared in the right colon. Otherwise, surgical intervention was considered based on the outcome of the patient and the criteria of the emergency surgical team. RESULTS: in 70 patients, barium contrast appeared in the right colon, and a liquid diet was tolerated by 69 of them (98.6%). Mean hospitalization time for this group was 43 +/- 17 hours. In the remaining 30 patients, no evidence of barium contrast in the right colon was seen, and 25 of them underwent surgery (75%), while the other 5 tolerated a liquid diet. Mean hospitalization time for this second group of patients was 13.8 +/- 11 days. Sensitivity, specificity, positive predictive value, and negative predictive value for the absence of contrast medium in the right colon within 24 hours as a predictor of surgery were 93, 96, 98 and 83%, respectively. There was a statistical significant relationship (p < 0.01) between the "Presence of contrast medium in the right colon" and "Oral diet tolerance". Only the variable "Number of previous surgical interventions" tended to reach statistical significance (p = 0.07). Tolerance of liquid diet was more likely when patients had more than one previous abdominal surgery. CONCLUSIONS: early oral administration of a radiological contrast medium in patients with adhesive SBO can effectively predict the need for a surgical procedure. It can shorten not only hospital stay, but also the potential morbidity of late surgery, secondary to a prolonged and unsuccessful nonoperative treatment.

Synergistic interaction of diazepam with 3',5'-cyclic adenosine monophosphate-elevating agents on rat aortic rings.

We investigated the effect of the phosphodiesterase type 4 (PDE4) inhibitory activity of diazepam on the arterial wall. To this purpose, we examined the interaction of diazepam with 3',5'-cyclic adenosine monophosphate (cyclic AMP)-elevating agents on vasodilatation and cyclic AMP levels in rat aortic rings precontracted with phenylephrine. The involvement of benzodiazepine receptors was also studied. Diazepam (5-100 microM) produced a relaxation of this preparation which was neither mimicked by gamma-aminobutyric acid (GABA), nor antagonized by flumazenil and 1-(2-chlorophenyl)-N-methyl-N-(1-methylpropyl)-3-isoquinolinecarboxamide (PK 11195), inhibitors of central or peripheral type benzodiazepine receptors, respectively. The diazepam-induced relaxation was potentiated by the presence of isoprenaline (10 nM), forskolin (50 nM) or milrinone (0.1 microM). Furthermore, diazepam increased the enhancement of cyclic AMP levels induced by these three agents in this tissue. Our results demonstrate a functional and biochemical synergistic interaction of diazepam with cyclic AMP-elevating agents on rat aortic rings.

[Usefulness of quantification and visual analysis of the uptake of (99m)Tc-MIBI in the diagnosis of mammary lesions]. / Utilidad de la cuantificación y análisis visual de la captación de (99m)Tc-MIBI en el diagnóstico de lesiones mamarias.

OBJECTIVE: Scintigraphy studies with (99m)Tc-MIBI are widely used in the diagnosis of non-invasive breast cancer and their results have been verified by many studies. However, the scintigraphic technique produces erroneous false negative and positive results. This study aims to verify how the different characteristics of the uptake of (99m)Tc-MIBI (intensity, size, morphology, etc.) can help to increase sensitivity and specificity of breast scintigraphy. MATERIALS AND METHODS: We have studied 201 patients (84 breast cancer and 117 benign lesions). All of them underwent a breast scintigraphy with (99m)Tc-MIBI and anatomopathological study. A semiquantitative analysis (by T/F indexes) and visual study were performed in the lesions that presented radiodrug uptake. RESULTS: Eleven false positive results and 8 false negative results were obtained in the study of the 201 patients. The analysis of the T/F indexes did not demonstrate any significant differences between the benign and malignant lesions (p>0,05). There is a statistically significant correlation (p<0.05) between the tracer uptake morphology and the AP diagnosis and between the localization of the lesion in a breast quadrant and the uptake intensity. CONCLUSIONS: Quantification of (99m)Tc-MIBI uptake by T/F indexes does not provide any conclusive data on the lesion's malignancy, however, a more detailed analysis of the characteristics of the tracer uptake would permit us to make the correct diagnosis and would reduce the false positive and negative results of this technique.

[99m Tc-MIBI scintigraphy compared to mammography in the diagnosis of breast cancer in dense, operated and young women breasts]. / Gammagrafía con 99mTc-MIBI frente a la mamografía en el diagnóstico de cáncer de mama en mamas densas, mamas intervenidas y mujeres jóvenes.

UNLABELLED: Breast scintimammography with 99mTc-MIBI has proven to be a useful complement to mammography in the diagnosis of breast cancer in the female population. Although the mammography, along with a physical examination, is the backbone of breast cancer diagnosis, there are groups of patients in whom the mammography has an even lower specificity. OBJECTIVE: Our study has aimed to assess the usefulness of breast 99mTc-MIBI scintimammography in those situations in which the mammography was indeterminate, such as, in dense breasts, young females or breasts with architectural distortion after surgery or radiation therapy. MATERIALS AND METHODS: We studied 109 females with mammographically dense breasts, 8 young females under 30 and 24 patients who had undergone previous surgery or radiation therapy. All cases were studied to rule out breast cancer. Final diagnosis was established with excisional biopsy. RESULTS: In dense breasts MIBI scintimammography sensitivity was 88% and the mammography one 81%. MIBI scintimammography specificity was 90% and the mammography 28%. In young females MIBI scintimammography sensitivity was 100% and the mammography 50%, MIBI scintimammography specificity 100% and the mammography 20%. In previous surgery, MIBI scintimammography sensitivity was 80% and the mammography 80%, MIBI scintimammography specificity 100% and the mammography 42%. CONCLUSION: Breast scintimammography with 99mTc-MIBI is an excellent diagnostic technique with high specificity. Undoubtedly it is complementary to mammography in those cases where mammography has major limitations such as dense breasts, young females and breasts with severe scarring after surgery or radiation therapy.

Gammagrafía con 99m Tc-MIBI frente a la mamografía en el diagnóstico de cáncer de mama en mamas densas, mamas intervenidas y mujeres jóvenes / 99m Tc-MIBI scintingraphy compared to the mammography in the diagnosis of breast cancer in dense, operated and young women's breasts

La gammagrafía mamaria con 99mTc-MIBI ha demostrado ser de utilidad como complemento a la mamografía en el diagnóstico del cáncer de mama. Existen grupos concretos de pacientes en las que la mamografía encuentra aún más disminuida su especificidad.Objetivo: En este estudio nos planteamos valorar la utilidad de la gammagrafía mamaria con 99mTc-MIBI, en aquellas situaciones que mamográficamente plantean problemas diagnósticos, como ocurre en las pacientes con: mamas densas, mujeres jóvenes y mamas intervenidas y radiadas.Material y Método: Estudiamos un total de 201 pacientes; 109 pacientes con patrón mamográfico de mamas densas, 8 pacientes menores de 30 años y 24 pacientes con mamas intervenidas y radiadas. Los resultados fueron en el diagnóstico de mamas densas una sensibilidad del 88 por ciento para el MIBI frente al 81 por ciento para la mamografía y especificidad del 90 por ciento frente al 28 por ciento. En las mujeres menores de 30 años la sensibilidad para el MIBI fue del 100 por ciento frente a la mamografía con sensibilidad del 50 por ciento, la especificidad fue del 100 por ciento frente al 20 por ciento. En las mujeres con mamas intervenidas, MIBI sensibilidad 80 por ciento frente a mamografía 80 por ciento, especificidad MIBI 100 por ciento y mamografía 42 por ciento.Conclusiones: La gammagrafía mamaria con 99mTc-MIBI es una excelente técnica de diagnóstico, por su elevada especificidad, complementando a la mamografía en el diagnóstico de cáncer de mama en pacientes con mamas densas, mujeres jóvenes y mamas intervenidas y radiadas (AU)

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Utilidad de la cuantificación y análisis visual de la captación de 99mTc-MIBI en el diagnóstico de lesiones mamarias / Usefulness of quantification and visual analysis of the uptake of 99m Tc-MIBI in the diagnosis of mammary lesions

Objetivo: Los estudios gammagráficos con 99mTc-MIBI en el diagnóstico no invasivo del cáncer de mama se encuentran ampliamente difundidos, y sus resultados corroborados por multitud de estudios. Sin embargo, la técnica gammagráfica tiene resultados erróneos, falsos positivos y negativos. El objetivo de este estudio es comprobar en que medida las diferentes características de la captación de 99mTc-MIBI, intensidad, tamaño, morfología etc., pueden ayudar a aumentar la sensibilidad y especificidad de la gammagrafía mamaria.Material y métodos: Estudiamos 201 pacientes (84 carcinomas mamarios y 117 lesiones benignas). A todas ellas se les realizó gammagrafía mamaria con 99mTc-MIBI y estudio anatomopatológico. A las lesiones que presentaron captación del radiofármaco se les realizó un estudio semicuantitativo (mediante índices T/F) y visual de dicha captación. Resultados: Del estudio de las 201 pacientes se obtuvieron 11 resultados falsos positivos, y 8 resultados falsos negativos. El análisis de los índices T/F mostró que no había diferencias estadísticamente significativas entre lesiones benignas y malignas (p>0,05). Existe una correlación estadísticamente significativa (p<0,05)entre la morfología de la captación del trazador y un determinado diagnóstico A.P. y entre la localización de la lesión en un cuadrante mamario y la intensidad de la captación.Conclusiones: La cuantificación mediante índices T/F de la captación de 99mTc-MIBI no aporta datos concluyentes acerca de la malignidad de las lesiones, sin embargo, un análisis más detallado de las características de la captación de trazador, nos permitirá aproximarnos más al diagnóstico correcto, disminuyendo el número de falsos positivos y negativos de la técnica. (AU)

Asociación de atrofia medial del lóbulo temporal en TC e hipocaptación temporoparietal mediante SPECT / Association between medial temporal lobe atrophy on ct and parietotemporal uptake decrease on SPECT to the study of cognitive impairment and depressive symptoms

La tomografía computarizada (TC) y la resonancia magnética (RM) cerebrales aportan a la evaluación diagnóstica del paciente con depresión y deterioro cognoscitiva significativo una excelente información anatómica, mientras la tomografía computarizada de emisión de fotón único (SPECT cerebral), permite obtener una información funcional a través de la medición del flujo sanguíneo cerebral regional (FSCr). Objetivo: Evaluar la validez de la combinación de atrofia del lóbulo medial temporal e hipocaptación temporoparietal al diagnóstico de demencia degenerativa primaria, así como su capacidad para discriminar entre demencia degenerativa primaria y depresión. Material: 23 pacientes, 9 hombres (39,1 por ciento) y 14 mujeres (60,9 por ciento), edad media de 61 años, con el diagnóstico de depresión y deterioro cognoscitivo significativo sin cumplir criterios de demencia, según códigos diagnósticos GMS-HAS y DSM-IV. 10 individuos sanos, de similares características sociodemograficas y sin historia anterior de trastorno psiquiátrico, neurológico ni abuso de drogas. Métodos: se ha realizado sistemáticamente tomografía axial computarizada (TC) y por emisión de fotón único (SPECT) cerebrales en sujetos mayores de 65 años con un MEC <24 y menores de 65 años con un MEC > 27. Resultados: se han establecido 6 patrones de perfusión cerebral para el grupo de pacientes El más frecuentemente observado fue el patrón C (39,13 por ciento), hipoperfusión temporal y/o parietal bilateral. Conclusiones:

Presacral extramedullary haematopoiesis with involvement of the sciatic nerve.

We present the case of a 60-year-old woman with no known blood disease who developed an extramedullary haematopoiesis of presacral localization that affected the right sciatic nerve. The diagnosis was made with imaging studies and CT-guided fine-needle aspiration.

[Molecular forms of PSA and differentiating between benign hypertrophy,carcinoma, and disseminated prostatic carcinoma. Correlation between two determination technics]. / Formas moleculares de PSA en la discriminación entre hipertrofia benigna, carcinoma y carcinoma diseminado de próstata. Correlación entre dos diferentes técnicas de determinación.

OBJECTIVE: To determine the correlation between two methods of measurement of total PSA (PSA-T) and free PSA (PSA-F) and the utility of the PSA-F/PSA-T ratio in patients with PSA-T between 4 and 10 ng/ml suspected as having prostate cancer. METHODS: Determinations of both PSA-T and PSA-F were performed using two different techniques in 91 patients suspected as having prostate cancer. Diagnosis was made on the findings of biopsy and the complementary tests. RESULTS: The following correlation was found for the two techniques: R = 0.99 and p < 0.05 for PSA-T, and R = 0.85 and p < 0.05 for PSA-F. For PSA-T values of 4-10 ng/ml and PSA-F greater than 25%, we found two patients with prostate cancer. For a PSA-F/PSA-T ratio less than 9%, all cases had prostate cancer. Three cases with bone metastasis had PSA-T values less than 10 ng/ml. CONCLUSIONS: A PSA-F/PSA-T ratio greater than 25% does not exclude malignancy in patients with a total PSA of 4-10 ng/ml; values less than 9% correspond to prostate cancer. Bone metastasis was found with both methods in patients with total PSA values less than 10 ng/ml.

[Reliability of the evaluation of regional cerebral blood flow using SPECT in chronic schizophrenia and bipolar disorder]. / Fiabilidad de la evaluación del flujo sanguíneo cerebral regional FSCR mediante SPECT en esquizofrenia crónica y trastorno bipolar.

OBJECTS: Demonstrate the reliability of cerebral SPECT using 99 mTc-HMPAO. METHODS & MATERIALS: Evaluation of cerebral blood flow using SPECT in 24 patients with schizophrenia, 24 patients with bipolar disorder and 20 controls. In the study we have reliability between observers and intraobserver. In both cases kappa statistic has been applied for measuring reliability. RESULTS: reliability between observers represents a kappa coefficient of 0.71. Intraobserver reliability, with a medium grade concordance slightly superior, shows a medium kappa coefficient of 0.74. CONCLUSIONS: Visual evaluation of SPECT images using 99mTc--HMPAO is a trustworthy technique to document the different patterns of regional cerebral blood flow. Reliability is determinate by the improvement, during visual analysis of reliability between observers (kappa: 0.71) and intraobservers (kappa: 0.74).

Discrepancy between inotropic response and cyclic AMP production induced by isoprenaline and forskolin in rat ventricle strips.

The effects of isoprenaline and forskolin were studied on contractile response and cyclic AMP levels in the right ventricle strips of the rat heart. Isoprenaline, in concentrations ranging from 10 nM to 1 microM, significantly increased, in a concentration-dependent manner, the contractile force in this preparation. Forskolin (1-10 microM), which directly stimulates adenylate cyclase, also produced a concentration-dependent increase in cardiac contractility. The mean EC50 (microM) for the contractile action of isoprenaline was 0.08 +/- 0.014 and that of forskolin 7.3 +/- 1.1 being about 70 times less potent than isoprenaline. However, isoprenaline (0.1 microM) and forskolin (8 microM), which produced about the same inotropic response, increased tissue cyclic AMP levels by about two and five fold respectively, when compared to the basal value. These figures further indicate that while the intracellular levels of cyclic AMP in rat ventricular myocardium may be an important determinant of positive inotropism, the connection between the two parameters is more complex than the simple ratio between the tension generated and the amount of cyclic AMP found inside the cells.

Endogenous endotoxemia of intestinal origin during cardiopulmonary bypass. Role of type of flow and protective effect of selective digestive decontamination.

OBJECTIVE: To evaluate the possible related factors to endotoxemia and cytokine activation during the ischemic phase of extracorporeal surgery, and the effect of selective digestive decontamination (SDD) as a preventive measure. DESIGN: Prospective, open, randomized trial. SETTING: Two multidisciplinary ICUs (tertiary care hospitals). PATIENTS: One hundred consecutive patients undergoing cardiopulmonary bypass (CPB), randomly allocated to two groups; gut decontamination (group I = 50 cases) and controls (group II = 50 cases). INTERVENTIONS: Preoperative administration of oral non-absorbable antibiotics (polymyxin E, tobramycin and amphotericin B) versus no administration. MEASUREMENTS AND RESULTS: The assessment of decontamination by means of the bacteriologic control of rectal swabs. Determinations of gastric intramucosal pH (gastric pHi) and plasma endotoxin, tumor necrosis factor (TNF) aNd interleukin-6 (IL-6) before surgery and during the ischemic and reperfusion phases of bypass. Rectal aerobic Gram-negative bacilli (AGNB) were significantly reduced in the treated patients and in 56% total eradication was achieved. Endotoxin, TNF and IL-6 plasma levels were significantly lower in this group. By contrast, both endotoxin and TNF/IL-6 levels and gastric pHi correlated with the type of surgical flow (pulsatile versus non-pulsatile). CONCLUSIONS: SDD reduces the gut content of enterobacteria. This may explain the lower endotoxin and cytokine levels detected in decontaminated patients. In addition to SDD, the type of flow employed during bypass seems to influence endotoxemia and cytokine levels.