Pitiriasis rosada: a propósito de un caso / Pityriasis rosea: Report of a case

Comunicamos el caso de una paciente femenina de 23 años de edad, natural y procedente de la localidad, quien consulta el 30 de Noviembre de 2016 al Centro Integral de Especialidades "Los Grillitos", CORPOSALUD, Municipio Mario Briceño Iragorry, por presentar lesiones puntiformes no pruriginosas en tronco, cuya aparición fue posterior al cuadro viral leve, motivo por el que acude al médico quien le indica antihistamínicos orales y glucocorticoides tópicos no fluorados. Con posterioridad a la primera consulta médica, se evidencian lesiones ovales rosadas con relieve no pruriginoso, diseminado en tronco. Se continúa tratamiento y se indica administrar una ampolla de betametasona intramuscular. Acude nuevamente a evaluación médica y se evidencian lesiones ovales menos eritematosas, descamativas en el límite del borde libre; en general se encuentran involucionadas, observándose actualmente mejoría clínica del cuadro.

We communicate a 23-year-old female patient, natural and from the locality, who on November 30, 2016, visits the Integral Center of Specialties "Los Grillitos", CORPOSALUD, Municipality Mario Briceño Iragorry, for presenting non-pruriginous punctate lesions on the trunk, which appeared after a mild viral picture, reason why she goes to the doctor who indicates oral antihistamines and non-fluorinated topical glucocorticoids. Subsequent medical evolution shows pink oval lesions with non-pruriginous relief, disseminated in the trunk. Treatment is continued and an intramuscular betamethasone ampoule is indicated. The patient returns to medical evaluation and there is evidence of oval lesions less erythematous, desquamative at the border of the free border; in general they are involuted, observing at the moment clinical improvement of the picture.

Protein arginine deiminase 4 inhibition is sufficient for the amelioration of collagen-induced arthritis.

Citrullination of joint proteins by the protein arginine deiminase (PAD) family of enzymes is recognized increasingly as a key process in the pathogenesis of rheumatoid arthritis. This present study was undertaken to explore the efficacy of a novel PAD4-selective inhibitor, GSK199, in the murine collagen-induced arthritis model of rheumatoid arthritis. Mice were dosed daily from the time of collagen immunization with GSK199. Efficacy was assessed against a wide range of end-points, including clinical disease scores, joint histology and immunohistochemistry, serum and joint citrulline levels and quantification of synovial autoantibodies using a proteomic array containing joint peptides. Administration of GSK199 at 30 mg/kg led to significant effects on arthritis, assessed both by global clinical disease activity and by histological analyses of synovial inflammation, pannus formation and damage to cartilage and bone. In addition, significant decreases in complement C3 deposition in both synovium and cartilage were observed robustly with GSK199 at 10 mg/kg. Neither the total levels of citrulline measurable in joint and serum, nor levels of circulating collagen antibodies, were affected significantly by treatment with GSK199 at any dose level. In contrast, a subset of serum antibodies reactive against citrullinated and non-citrullinated joint peptides were reduced with GSK199 treatment. These data extend our previous demonstration of efficacy with the pan-PAD inhibitor Cl-amidine and demonstrate robustly that PAD4 inhibition alone is sufficient to block murine arthritis clinical and histopathological end-points.

Síndrome de Nicolau: a propósito de un caso / Nicolau Syndrome: About a case

Comunicamos una paciente femenina de 24 años de edad, natural y procedente de la localidad, quien consulta en el mes de enero de 2016 al Centro Integral de Especialidades “Los Grillitos”, CORPOSALUD. Municipio Mario Briceño Iragorry por presentar lesión ulcerosa a nivel de hemicadera derecha, cuya aparición fue posterior a la administración de medicamentos vía intramuscular (ampolla de amikacina). El tratamiento aplicado fue debido a una infección vaginal que presentó en el mes de septiembre 2015, cuyo cultivo resultó sensible a este antibiótico; comenzó a presentar un área endurecida color violáceo, hasta convertirse en una úlcera en el mes de diciembre 2015. Por este motivo, acude al médico quien indica ecosonograma de partes blandas (27/1/2016), informando: úlcera de 29 mm asociado a celulitis post infecciosa a administración medicamentosa, en hemicadera derecha y hematoma, organizado en hemicadera izquierda (0,25 cc); se realiza cultivo (27/1/2016) reportando presencia de Acinetobacter baumani complex sensible a la ciprofloxacina, la que se indica, observándose actualmente mejoría clínica de la lesión.

It is 24 years female patient age and naturally from the locality, who consults in January 2016 to Integral Center Specialty "The Grillitos" Corposalud. Municipio Mario Briceño Iragorry to present Injury ulcer type level right hemi hip whose appearance was after drug administration (vial amikacin) treatment applied due to a vaginal infection present in the month of September 2015 whose culture was sensitive to this antibiotic, he began to present purple colored hardened to become ulcerated area in December 2015. Which is why go to the doctor who said soft tissue sonography (01/27/2016) ulcer reporting 29 mm associated with post-infectious cellulitis to drug administration right hemi hip and a left organized hematoma (0.25 cc); culture (01.27.2016) is perform reporting presence of Acinetobacter baumani sensitive Ciprofloxacin treatment indicated Complex currently observed clinical improvement of the injury.

Effect of Zinc Intake on Growth in Infants: A Meta-analysis.

A systematic review and meta-analysis of available randomized controlled trials (RCTs) was conducted to evaluate the effect of zinc (Zn) intake on growth in infants. Out of 5500 studies identified through electronic searches and reference lists, 19 RCTs were selected after applying the exclusion/inclusion criteria. The influence of Zn intake on growth was considered in the overall meta-analysis. Other variables were also taken into account as possible effect modifiers: doses of Zn intake, intervention duration, nutritional status, and risk of bias. From each select growth study, final measures of weight, length, mid upper arm circumference (MUAC), head circumference, weight for age z-score (WAZ), length for age z-score (LAZ), and weight for length z-score (WLZ) were assessed. Pooled ß and 95% confidence interval (CI) were calculated. Additionally, we carried out a sensitivity analysis. Zn intake was not associated with weight, length, MUAC, head circumference, and LAZ in the pooled analyses. However, Zn intake had a positive and statistically effect on WAZ (ß = 0.06; 95%CI 0.02 to 0.10) and WLZ (ß = 0.05; 95%CI 0.01 to 0.08). The dose-response relationship between Zn intake and these parameters indicated that a doubling of Zn intake increased WAZ and WLZ by approximately 4%. Substantial heterogeneity was present only in length analyses (I(2) = 45%; p = 0.03). Zn intake was positively associated with length values at short time (four to 20 weeks) (ß = 0.01; CI 95% 0 to 0.02) and at medium doses of Zn (4.1 to 8 mg/day) (ß = 0.003; CI 95% 0 to 0.01). Nevertheless, the effect magnitude was small. Our results indicate that Zn intake increases growth parameters of infants. Nonetheless, interpretation of these results should be carefully considered.

Anthocyanins and Phenolic Acids of Hybrid and Native Blue Maize (Zea mays L.) Extracts and Their Antiproliferative Activity in Mammary (MCF7), Liver (HepG2), Colon (Caco2 and HT29) and Prostate (PC3) Cancer Cells.

Blue maize is an excellent source of bioactive components such as phenolic acids and anthocyanins but when it is processed for human consumption, these compounds decrease considerably. Therefore, blue maize could be directed to produce nutraceutical extracts. The aim of this study was to evaluate the relation between anthocyanins composition of acidified and non-acidified extracts from native and hybrid blue maize genotypes and their antiproliferative effect in mammary (MCF7), liver (HepG2), colon (Caco2 and HT29) and prostate (PC3) cancer cells. The most abundant phenolic acid was ferulic acid. Nine anthocyanins were quantified in the extracts, being Cy3-Glu the most abundant. Acylated forms were also obtained in high abundance depending of the extraction method. An extract concentration range of 4.31 to 7.23 mg/mL inhibited by 50% the growth of untransformed cells NIH3T3. Antiproliferative effect on PC3, Caco2, HepG2 and MCF7 cancer cells of acidified extracts from hybrid blue maize was larger than the observed using non-acidified extracts. Among the nine compounds that were quantified in the extracts tested, CyMalGlu I showed the strongest correlation with the reduction of cell viability in Caco2 (-0.876), HepG2 (-0.813), MCF7 (-0.765) and PC3 (-0.894). No significant correlation or differences in antiproliferative effect on HT29 was found among the extracts. The method of extraction of maize anthocyanins must be selected to obtain a high yield of CyMalGlu I more than only Cy3-Glu since acylation affects the inhibition of cancer cell growth.

Recurrent mutations, including NPM1c, activate a BRD4-dependent core transcriptional program in acute myeloid leukemia.

Recent evidence suggests that inhibition of bromodomain and extra-terminal (BET) epigenetic readers may have clinical utility against acute myeloid leukemia (AML). Here we validate this hypothesis, demonstrating the efficacy of the BET inhibitor I-BET151 across a variety of AML subtypes driven by disparate mutations. We demonstrate that a common 'core' transcriptional program, which is HOX gene independent, is downregulated in AML and underlies sensitivity to I-BET treatment. This program is enriched for genes that contain 'super-enhancers', recently described regulatory elements postulated to control key oncogenic driver genes. Moreover, our program can independently classify AML patients into distinct cytogenetic and molecular subgroups, suggesting that it contains biomarkers of sensitivity and response. We focus AML with mutations of the Nucleophosmin gene (NPM1) and show evidence to suggest that wild-type NPM1 has an inhibitory influence on BRD4 that is relieved upon NPM1c mutation and cytosplasmic dislocation. This leads to the upregulation of the core transcriptional program facilitating leukemia development. This program is abrogated by I-BET therapy and by nuclear restoration of NPM1. Finally, we demonstrate the efficacy of I-BET151 in a unique murine model and in primary patient samples of NPM1c AML. Taken together, our data support the use of BET inhibitors in clinical trials in AML.

Síndrome de Felty: Presentación de un caso y revisión bibliográfica / Felty's syndrome: A case report and literature review

El síndrome de Felty se caracteriza por reunir la tríada compuesta por: artritis reumatoide, neutropenia y esplenomegalia. Es una enfermedad autoinmune poco frecuente, con compromiso sistémico, articular y extra articular. Se desarrolla en personas de mediana edad, con historia de artritis reumatoide crónica deformante. El diagnóstico es eminentemente clínico y el tratamiento está enfocado a disminuir el dolor articular, las altas tasas de infecciones y evitar las deformidades óseas. Presentamos una paciente de 69 años de edad, diagnosticada en nuestro hospital, motivo por el que realizamos revisión bibliográfica de la entidad.

Felty's syndrome has such as main feature the triad composed by: rheumatoid arthritis, neutropenia and splenomegaly. It is unusual autoimmune disease that compromises the nervous system as well as joint affectation and extra joint. This illness develops in middle aged subjects with arthritis rheumatoid chronic deform history. The diagnosis is clinical and the focus treatment is to diminish the articular pain, to reduce the infections high rates and to avoid the bony deformities. We report a clinical case of a patient who is 69 years-old, she was diagnosed in our hospital and we reviewed the bibliographic entity.

Síndrome de Felty: Presentación de un caso y revisión bibliográfica / Feltys syndrome: A case report and literature review

El síndrome de Felty se caracteriza por reunir la tríada compuesta por: artritis reumatoide, neutropenia y esplenomegalia. Es una enfermedad autoinmune poco frecuente, con compromiso sistémico, articular y extra articular. Se desarrolla en personas de mediana edad, con historia de artritis reumatoide crónica deformante. El diagnóstico es eminentemente clínico y el tratamiento está enfocado a disminuir el dolor articular, las altas tasas de infecciones y evitar las deformidades óseas. Presentamos una paciente de 69 años de edad, diagnosticada en nuestro hospital, motivo por el que realizamos revisión bibliográfica de la entidad.(AU)

Feltys syndrome has such as main feature the triad composed by: rheumatoid arthritis, neutropenia and splenomegaly. It is unusual autoimmune disease that compromises the nervous system as well as joint affectation and extra joint. This illness develops in middle aged subjects with arthritis rheumatoid chronic deform history. The diagnosis is clinical and the focus treatment is to diminish the articular pain, to reduce the infections high rates and to avoid the bony deformities. We report a clinical case of a patient who is 69 years-old, she was diagnosed in our hospital and we reviewed the bibliographic entity.(AU)

Hipertensión arterial en niños de 10 a 14 años / Hypertension in children from 10 to 14 years of age

La hipertensión arterial es una de las principales causas de morbimortalidad en muchos países, por lo que constituye un problema de salud mundialmente. Realizamos un estudio sobre esta enfermedad y los factores relacionados con ella en la población pediátrica entre los 10 y 14 años del municipio de Ranchuelo, en el período comprendido desde enero del 2001 a diciembre del 2002. Se estudiaron 1250 infantes con el objetivo de detectar niños hipertensos y con riesgo de padecer esta enfermedad, así como comparar el comportamiento de los factores relacionados con esta patología, tanto en los menores clasificados como sanos, riesgos e hipertensos, después de medirles la tensión arterial a cada uno y auxiliarnos de las tablas existentes de presión arterial para la edad, talla y peso. A todos se les realizó una amnesis detallada y se investigaron las manifestaciones clínicas y de laboratorio e los niños riesgos e hipertensos. La enfermedad fue poco sintomática, sin repercusión sistémica de forma general. Recomendamos informar a estadística los resultados del trabajo, que los médicos hagan un estudio similar a éste en su área y que desarrollen acciones de salud para prevenir y controlar la hipertensión arterial en la infancia(AU)

Hipertensión arterial en niños de 10 a 14 años / Arterial hypertension in children from 10 to 14 years

La hipertensión arterial es una de las principales causas de morbimortalidad en muchos países, por lo que constituye un problema de salud mundialmente. Realizamos un estudio sobre esta enfermedad y los factores relacionados con ella en la población pediátrica entre los 10 y 14 años del municipio de Ranchuelo, en el período comprendido desde enero del 2001 a diciembre del 2002. Se estudiaron 1250 infantes con el objetivo de detectar niños hipertensos y con riesgo de padecer esta enfermedad, así como comparar el comportamiento de los factores relacionados con esta patología, tanto en los menores clasificados como sanos, riesgos e hipertensos, después de medirles la tensión arterial a cada uno y auxiliarnos de las tablas existentes de presión arterial para la edad, talla y peso. A todos se les realizó una anamnesis detallada y se investigaron las manifestaciones clínicas y de laboratorio en los niños riesgos e hipertensos: Encontramos 78 niños con riesgo de padecer de hipertensión, para un 6,2 por ciento y 24 hipertensos (1,9 por ciento) del total estudiado. Las edades más afectadas fueron los 10 y 13 años, con mayor representación en el sexo femenino. Los antecedentes patológicos positivos en los familiares de los menores confirman el valor de la herencia en esta patología. La enfermedad fue poco sintomática, sin repercusión sistémica de forma general. Recomendamos informar a estadística los resultados del trabajo, que los médicos hagan un estudio similar a éste en su área y que desarrollen acciones de salud para prevenir y controlar la hipertensión arterial en la infancia (AU)

Metastasis of hepatocellular carcinoma to the right colon manifested by gastrointestinal bleeding.

An 82-year-old black woman with a history of hepatocellular carcinoma presented with gastrointestinal bleeding. Barium enema and fibrocolonoscopy revealed a 4-cm polypoid mass at the level of the ascending colon with evidence of active bleeding. Biopsies of the lesion proved it to be metastatic hepatocellular carcinoma. Exploratory laparotomy revealed no further dissemination of the tumor, and the patient underwent an ileocolectomy. The serosal side of the colonic lesion was free from tumor, and there was no peritoneal implantation, direct extension, or lymph node involvement. This case represents an extremely rare presentation of metastatic hepatocellular carcinoma.

Effect of antiviral drugs used to treat cytomegalovirus end-organ disease on subsequent course of previously diagnosed Kaposi's sarcoma in patients with AIDS.

OBJECTIVE: To evaluate the association of ganciclovir (GCV) and foscarnet (PFA) therapy with the outcome of previously diagnosed Kaposi's sarcoma (KS) after initiating antiviral therapy for cytomegalovirus (CMV) end-organ disease. DESIGN: Retrospective study. METHODS: KS progression was defined as a clinically obvious increase in size of baseline cutaneous or mucosal lesions, a new diagnosis of visceral KS, or initiation of a new systemic antineoplastic regimen or radiation therapy to treat KS. Multivariate analyses of risk of KS progression were calculated for prior duration of KS before initiating CMV treatment, treatment with PFA or GCV, number of weeks treated with PFA or GCV, absolute CD4 lymphocyte count at time of CMV-related disease diagnosis, diagnosis of KS prior to 1991, visceral KS, prior systemic chemotherapy, and prior radiation therapy. RESULTS: Among 66 patients who received > or = 14 days PFA (N=20) or only GCV (N=46), median time to progression of KS was 211 days (95% confidence interval [CI], 46-578) for patients who received PFA versus 22 days (95% CI, 15-41) for those who received only GCV (p < .001). In the stepwise multivariate analysis, only prior visceral KS (rate ratio [RR]=2.80; 95% CI, 1.07-7.35) and foscarnet therapy (RR = 0.24; 95% CI, 0.11-0.53) were significantly associated with risk of KS progression. CONCLUSION: PFA may be an effective therapy for AIDS-related KS; prospective trials are indicated.

Transarterial chemoembolization is a safe treatment for unresectable hepatic malignancies.

Acute liver failure has been reported as a frequent complication of transarterial chemoembolization (TACE). We prospectively evaluated the adverse effects and biochemical changes of TACE. From 10/95 to 9/96, 35 patients with hepatic malignancies were evaluated for TACE. Fifteen patients (9 male and 6 female) received 23 treatments. Ten of 15 patients had hepatocellular carcinoma, and 5 had metastatic tumors. Treatment exclusion criteria included advanced liver disease, hepatic vascular thrombosis, and severe comorbidity. TACE consisted of intra-arterial infusion of a mixture of doxorubicin, cisplatin, and mitomycin followed by embolization. Clinical symptoms and laboratory studies were monitored following treatment. Technical success was achieved in all patients. Adverse symptoms were transient, and most resolved within 1 week. Changes in hepatic, renal, and hematologic function were temporary and returned to pre-TACE levels by 1 month. None developed acute liver failure. The mean hospital stay was 3 days. Ten of 13 patients had a significant decrease in baseline tumor markers. The actual survival was 93 per cent with a median follow-up of 10 months. TACE can be performed safely in patients with hepatic tumors. The adverse effects can be anticipated and easily managed.

Ontogeny of basal and regulated proopiomelanocortin-derived peptide secretion from fetal and neonatal pituitary intermediate lobe cells: melanotrophs exhibit transient glucocorticoid responses during development.

Proopiomelanocortin (POMC)-producing cells comprise nearly 100% of the adult rat intermediate lobe (IL) hormone-producing cells. Secretion by these cells in the adult is primarily under negative regulation by dopamine. Although the POMC-derived peptide alpha-MSH has been detected in plasma of fetal rats, the secretory capability of fetal melanotrophs has not yet been examined directly. Here we have used the reverse hemolytic plaque assay to assess, at the single-cell level, basal and regulated release by melanotrophs from fetal and early postnatal ages. Basal secretion was detected at the earliest age examined [Embryonic Day 17.5 (e17.5)], but CRH (10(-8) M) stimulated secretion was not observed until e19.5. As development proceeded, CRH increased both individual plaque sizes and the percentage of melanotrophs stimulated to secrete. An unexpected, transient inhibition of CRH stimulated release from melanotrophs by dexamethasone (DEX, 10(-6) M) was observed from e19.5-p2 (postnatal Day 2). By p3, however, DEX no longer inhibited melanotroph secretion while inhibition of CRH-stimulated release from p3 corticotrophs was readily detected. The dopamine agonist ergocryptine (ERG, 10(-6) M) inhibited basal secretion from melanotrophs, but not corticotrophs, at all ages examined. Taken together, these results indicate that melanotrophs undergo a maturation process in which they are initially nonresponsive to CRH, next possess functional CRH and steroid receptors, and finally, undergo functional uncoupling of steroid receptors which characterizes the adult IL. The loss of steroid-mediated inhibition of stimulated secretion parallels the arrival of catecholaminergic input into the IL. In contrast, the early response of melanotrophs to dopaminergic agonists, which can be detected 1 week prior to arrival of catecholaminergic fibers into the neurointermediate lobe, appears to be an intrinsic feature of these cells that is never present in corticotrophs.

Ontogeny of basal and regulated secretion from POMC cells of the developing anterior lobe of the rat pituitary gland.

Proopiomelanocortin (POMC)-producing cells are present in both the anterior (AL) and intermediate (IL) lobes of the adult rat pituitary. Both cell types are derived from a single embryonic rudiment, Rathke's pouch, and synthesize the same hormone precursor, POMC, but differ in the pattern of precursor processing and regulation of peptide secretion. Here we have used the reverse hemolytic plaque assay to determine the ontogeny of basal and regulated secretion by AL POMC cells. Basal secretion of beta-endorphin was first observed at Embryonic Day 13.5 (e13.5), the age when POMC-derived peptides were first detected immunocytochemically. Peptide secretion stimulated by corticotropin releasing hormone (CRH; 10(-8) M) was first detected at e15.5. The CRH-stimulated secretion involved two different components: (1) an increase in the amount of hormone secreted per cell (increase in plaque size) as well as (2) an increase in the number of plaque-producing cells. The greatest stimulation by CRH was observed at e16.5, a time when AL POMC mRNA levels increase significantly and when CRH neurons are first detected immunocytochemically in the hypothalamus. CRH-stimulated secretion, but not basal release, was inhibited by preincubation with dexamethasone (DEX; 10(-6) M) as early as e15.5, while the dopamine agonist ergocryptine (ERG; 10(-6) M) did not alter basal or CRH-stimulated release at any age studied. These results demonstrate that AL POMC cells are capable of hormone secretion as early as POMC peptides are first detected immunocytochemically and that these cells respond in an adult-like manner to physiological regulators soon after their initial appearance. Moreover, these responses remain unaltered during the early postnatal stress-nonresponsive period, suggesting that deficits at this time must lie at a level other than the corticotroph. Taken together, these results show that AL POMC cells possess functional regulatory receptor systems prior to maturation of the hypothalamic-hypophyseal portal system.

Hepatic resection for malignancy in the elderly.

Although elderly patients are accounted for in all large series of major hepatic resections, the role of age as a determinant of outcome remains unclear. At Cedars-Sinai Medical Center, we review a series of 20 major hepatectomies for neoplasia performed in patients older than 66 years of age (4 of them > or = 80 years old) over a 5-year period. A retrospective comparison was conducted with a group of 22 hepatectomies for malignancy performed in 20 patients younger than 59 years of age during the same time period. The younger group had a significantly greater degree of liver resected (12 trisegmentectomies vs 3). Although one operative death (5% mortality) was observed in the elderly group, no statistically significant difference was noted, when compared to the younger group (Chi-square, P = 0.48). Likewise, no significant difference in the complication rate (20% vs 33%) was noticed (Chi-square, P = 0.8). Severe postoperative liver dysfunction was present in 2 cases (10%) in the elderly group and one (4%) in the younger group. These patients underwent a right trisegmentectomy (TS). Nine patients from each group were resected without red blood cell transfusion. We conclude that major hepatic resection in elderly patients without severe comorbid disease is a safe procedure that is not associated with an increased perioperative morbidity or mortality rate.

Late surgical complications of choledochal cystoenterostomy.

Choledochal cyst is a rare congenital abnormality of the biliary tract characterized by dilatation and stasis. Cyst excision is now preferred to internal drainage because of the predilection for development of cancer in the unresected cyst wall. We report on four patients who required reoperations for complications of prior cystoenteric drainage from 14 to 21 years after the original operations. Gastrointestinal bleeding from cyst ulceration as occurred in one patient is heretofore unreported. This reoperative experience emphasizes the importance of cyst excision as primary therapy and underscores these principles: 1) The spectrum of complications, including infection, pancreatitis, cancer, and bleeding may occur with or without intracyst and ductal stones; 2) Radical operative procedures may be required for treatment of the complications; 3) Despite these, cholangiocarcinoma has a dismal prognosis; 4) Patients whose cysts remain unexcised require meticulous lifelong scrutiny and strong consideration for planned reoperation at the time of the first complication.

Developmental regulation of beta-thymosins in the rat central nervous system.

HPLC analysis of guanidinium hydrochloride extracts of neonatal and adult rat brain revealed a polypeptide that is present in high concentration in the immature nervous system, but whose levels decline dramatically in the adult. This polypeptide has been isolated and its complete amino acid sequence determined by gas-phase Edman degradation following specific chemical and enzymatic cleavages. The molecule is identified as thymosin beta 10, a member of a multigene family that encodes a structurally conserved series of small acidic polypeptides of uncertain function. Thymosin beta 10 is present in the developing nervous system as early as embryonic day 9. Levels subsequently increase to peak values between embryonic day 15 and postpartum day 3, before falling to adult values (about a 20-fold reduction) by postpartum day 14. The elevated levels of thymosin beta 10 in fetal and neonatal brain correlate with high levels of thymosin beta 10 mRNA, whereas the low values of the polypeptide in the adult and juvenile are mirrored by an approximate 15-fold reduction in specific mRNA. In comparison, the levels of thymosin beta 4 polypeptide, a homologue of thymosin beta 10, only decline by about 20% during the same developmental period. However, the mRNA encoding thymosin beta 4 is elevated in fetal brain, and its levels decrease approximately four-fold to a stable value around the time of birth. The reason for this discrepancy between thymosin beta 4 protein and mRNA levels is unknown. Thymosin beta 10 can also be detected by HPLC in fetal liver, where levels are approximately 5% of those in brain. In liver, thymosin beta 10 also declines following birth. It is concluded that beta-thymosin expression (as measured by steady-state mRNA and polypeptide levels) is both up- and down-regulated during different phases of maturation of the mammalian nervous system.

The intracolonic bypass tube for left colon and rectal trauma. The avoidance of a colostomy.

Traumatic perforations of the left colon and rectum are most frequently managed by procedures that include the formation of a colostomy. Primary repair without colostomy is much less commonly employed. We report nine patients with traumatic perforations of the left colon and rectum treated with the intracolonic bypass tube (ICBT) without concomitant colostomy. In all these patients we believe the standard treatment would have included fecal diversion. Four patients sustained blunt trauma and five sustained penetrating trauma. Healing of the colonic anastomosis occurred in all cases, and the ICBTs were passed per rectum between the tenth and nineteenth days postoperatively. On the basis of this study, we conclude that the ICBT has a role in the treatment of selected injuries of the left colon and rectum as a safe means of avoiding a colostomy.

Developmental changes in levels of proopiomelanocortin intron A-containing heterogeneous nuclear RNA and mature messenger RNA in the anterior and neurointermediate lobes of the rat pituitary.

The POMC cells of the rat pituitary undergo dynamic phenotypic changes during differentiation. Here we have determined that alterations in the relative levels of a POMC precursor RNA species and POMC mRNA occur during development and may represent another level at which the POMC phenotype is developmentally regulated. We performed solution hybridization/nuclease protection assays using a POMC exon 1/intron A splice junction probe to quantitate levels of both intron A-containing POMC heterogeneous nuclear (hnRNA) and fully processed POMC mRNA in separated anterior and neurointermediate lobes of the fetal, neonatal, and adult pituitary. The levels of POMC hnRNA per anterior lobe increased 7-fold from embryonic day 15 to adulthood (0.022 to 0.159 fmol/lobe), while POMC mRNA levels increased 121-fold (0.15 to 18.2 fmol/lobe). POMC hnRNA levels per neurointermediate lobe increased 23-fold from embryonic day 18 to adulthood (0.024 to 0.54 fmol/lobe), while POMC mRNA levels increased 69-fold (0.65 to 44.6 fmol/lobe). Thus, both anterior and neurointermediate lobes contain higher relative abundances of POMC hnRNA compared to mRNA during early development. These subsequently decrease (from 1:7 to 1: approximately 110 in the anterior lobe and from 1:27 to 1:83 in the intermediate lobe over the ages examined) as the levels of POMC mRNA in both anterior and neurointermediate lobe increase at a greater rate than POMC hnRNA as development progresses. These results provide the first measurements of POMC mRNA and hnRNA levels during ontogeny and suggest that there may be a developmental change in the regulation of POMC primary transcript processing.