Correlation of immunological markers with graft vasculopathy development in heart transplantation.

This study examined the imbalance between T effector cells (Th1 defined as CD3+ interferonγ+) and T regulatory cells (Treg defined as CD4+CD25(high)FoxP3+) as a valuable albeit limited marker of cardiac allograft vasculopathy (CAV) after heart transplantation (HTx). CAV remains, with neoplasms, the most important cause of death in patients surviving the first year after HTx. It is an immune-mediated pathology, although nonimmune factors may also play a role. The process included concentric fibrous intima hyperplasia that narrows the entire length of the affected arteries. Coronary angiography is the usual method of diagnosis. Because a transplanted heart is a denervated organ, CAV is not diagnosed until the disease reaches an advanced stage, in which case transplantation is the only option for treatment. Although the host's immune response against an allogeneic graft is the major cause of endothelial dysfunction, the objective of this study was to detect anti-allogeneic responses on peripheral blood, seeking to identify signs of CAV before classical methods to predict outcomes in HTx recipients. CD3, CD4, CD8, CD19, CD56, Th1, and the Treg mononuclear cell populations were studied in 37 de novo and 20 long-term (more than 3 years) HTx patients as well as 20 healthy volunteers using flow cytometry. A progressive increase in CD8 and Th1 percentages and decrease in the CD4 population were detected during follow-up. Although Th1 changes also reflect processes not related to CAV receiver operating characteristics analysis of Th1/Treg ratio showed an area under the curve of 0.976, with an estimated sensitivity of 100% and specificity of 90%. The positive prediction value was 58.8% and the negative prediction value, 100%. These results prove that the Th1/Treg ratio was an important marker to following host immune response after HTx. The results confirm the need to test other T lymphocyte subsets.

Assessment of immunological markers as mediators of graft vasculopathy development in heart transplantation.

Heart transplantation (HT) remains the treatment of choice for patients with end-stage heart failure. Cardiac allograft vasculopathy (CAV), a diffuse form of coronary atherosclerosis, is the major cause of death after the first year of HT. CAV is thought to be multifactorial in origin. Although nonimmune factors may play a role in CAV development, it is primarily an immune-mediated disease. CAV is diagnosed by routine annual coronary angiography, and usually when diagnosed, the disease is advanced. There is a need to develop noninvasive surrogate markers for early detection. For this purpose, careful immune monitoring and graft histologic assessment are mandatory. The main objective of this study was the assessment of immunologic markers as mediators of CAV development in HT. Flow cytometry was performed to assess peripheral blood mononuclear cell populations forming CD3, CD4, CD8, CD19, CD56, Th1 (CD3+IFNγ+) or Treg (CD4+CD25(high)FoxP3+) markers among 20 de novo HT recipients. The control group included 13 patients who were more than 2 years post-HT (four with and nine without CAV) as well as 20 healthy subjects. CAV-related events over 2 years' follow-up correlated with the Th1/Treg ratio. An increased Th1 lymphocyte percentage was detected over the follow-up. Patients with medium and high Th1/Treg ratios showed higher acute rejection scores as well as greater incidences of CAV. These results indicated that the Th1/Treg ratio may represent a valuable marker to monitor allospecific T-cell responses in peripheral blood. Changes in the Th1/Treg ratio may help in the early detection of patients at risk for CAV. More studies with longer follow-up are needed to confirm these preliminary results.

Influence of spray equipment and water volume on coverage of citrus and control of citricola scale, Coccus pseudomagnoliarum (Hemiptera: Coccidae) with mineral oil.

A trial was conducted in a commercial Citrus sinensis L. variety 'Washington' navel orange orchard to compare the coverage and efficacy against citricola scale Coccus pseudomagnoliarum (Kuwana) (Hemiptera: Coccidae) of 45.5 liters/ha of an nC24 agricultural mineral oil treatment applied by two different methods: a conventional air blast sprayer and a rotary atomizer. Three water volumes (2,340, 4,680, and 7,020 liters/ha) were applied with the air blast sprayer to determine the optimal spray volume for that equipment. A single volume (2,340 liters/ha) was applied with the rotary atomizer to compare its effectiveness with that of the air blast sprayer at this same volume. Results demonstrated that all treatments reduced citricola scale densities. Moreover, all treatments conducted with the air blast sprayer provided significantly greater coverage and significantly reduced citricola scale densities compared with the treatment made with the rotary atomizer. Larger water volume applications with the air blast sprayer did not significantly reduce citricola scale densities, although significantly better coverage was attained in the interior of the tree when spraying with 4,680 and 7,020 liters/ha. As a consequence, this study demonstrated that the increased coverage obtained by applying higher water volume with the air blast sprayer was not required for an optimal treatment in August, when the citricola scale population consisted of nymphs inhabiting the outside leaves of the tree.

[Prevalence and features of headache and migraine in childhood]. / Prevalencia y características de la cefalea y la migraña en la infancia.

INTRODUCTION: A study of the prevalence of childhood cephalea has been carried on. MATERIAL AND METHODS: We studied a sample of children aged from 3 to 14 years old that consulted to different public health services clinics for control routine. We used an interview based in a questionnaire planned to be answered by parents and the child himself. RESULTS AND CONCLUSIONS: The more relevant results were: 1. Prevalence of cephalea 42%; 2. Prevalence of migraine according to Vahlquist and Kurtz criteria: 8.7% and 6.5% respectively (confidence intervals between 4.4% and 11.1%); 3. Higher proportion of girls for both cephalea and migraine; 4. Higher frequency of cephalea and the migraine type headache are facts related to the decision of seeking medical assistance; 5. 87% of children with migraine from the sample have relatives with intermittent cephalea; 6. Patients selected as having migraine, according to Vahlquist criteria, have the following predominant symptoms: Unilateral condition, vomiting/ nausea, improving with sleep, photophobia, phonophobia, changes in physical facial appearance, need to interrupt activities, pulsation quality, and visual aura.

[Identification of marker chromosomes and complex chromosomal translocations, using non radioactive in situ hybridization, in malignant hemopathies]. / Identificación de cromosomas marcadores y translocaciones cromosómicas complejas, mediante hibridación in situ no radioactiva, en hemopatías malignas.

We describe five patients with hematological malignancies in which fluorescence in situ hybridization technique (FISH) has been combined with classical cytogenetic study for characterizing chromosomal abnormalities. Three of them were chromosome Philadelphia positive; using a 22 chromosome painting probe it was confirmed the presence or absence of a variant complex translocation. In patients 4 and 5, the karyotype showed a marker chromosome which was definitively identified by FISH as a deletion of X chromosome and a 18 ring chromosome, respectively. The value of this methodology in the cytogenetic diagnosis of hematological malignancies is commented.

[Correlation between cellular and cytogenetic morphology using fluorescence in situ hybridization in the study of malignant hemopathies]. / Correlación entre morfología celular y citogenética mediante hibridación in situ fluorescente en el estudio de hemopatías malignas.

The in situ hybridization technique (ISH), using specific chromosome DNA probes on stained bone marrow or peripheral blood smears, allow us to correlate morphological findings with the cytogenetic abnormalities detected by conventional cytogenetic analysis. We have applied this methodology to study three patients, two of them diagnosed of acute lymphoblastic leukaemia (ALL) and one with a myeloid blast crisis of chronic myeloid leukaemia (BC-CML). Conventional cytogenetic analysis showed, among other chromosomal abnormalities, a trisomy 8 in two cases and a trisomy 7 in one case. ISH demonstrated that cytogenetic clonality was restricted to the lymphoblasts in both cases with ALL. In the BC-CML patient, myeloid blasts as well as mature and semimature granulocytic elements showed three hybridization signals. ISH correlating morphological and cytogenetic findings may be a useful technique for lineage as well as for the follow-up of the haematological patients.

Fluorochrome labelling in Roman period skeletons from Dakhleh Oasis, Egypt.

A histological aging study of femoral midshafts in a late Roman period sample from the Dakhleh Oasis, Egypt, showed discrete fluorochrome labelling. The fluorochrome is yellow-green in colour and fluoresces at a wavelength of 525 nm. The labelling occurs at the mineralization fronts and is so distinct that several histomorphometric measurements were made. The percent labelled surface values ranged from 6.03% to 59.34%, and the mean distance between labels ranged from 13.57 to 20.63 microns. Teeth from several individuals were also labelled within the enamel matrix. Comparisons were made between the patterns of fluorescent labelling from this population and from patients treated with interval and continuous dosages of tetracycline. The results collectively indicate that the fluorochrome is most likely tetracycline that made its way into the bone (in vivo) via stored grain contaminated by Streptomycetes. The labelling was differential, much like that of the patient on interval doses of tetracycline, so it is argued that the tetracycline was ingested occasionally, probably on a seasonal basis. The lack of bone infection in the adults (n = 29) suggests that the tetracycline may have provided some antibiotic protection in this population.

Possible case of hyperparathyroidism in a Roman period skeleton from the Dakhleh Oasis, Egypt, diagnosed using bone histomorphometry.

A histomorphometric study of thin femoral head sections of a skeletal sample from the Dakhleh Oasis, Egypt, dated from circa 36 B.C. to 400 A.D., identified an adult female (Dk31-A1) in her mid-50s with a high percentage resorption surface with tunneling resorption as is typically found in hyperparathyroidism. Five static histomorphometric bone parameters were measured with the following results for this individual: 1) mean wall thickness, 41.94 micron, 2) trabecular bone volume, 18.54%, 3) surface volume, 4,070 mm2/cm3, 4) mean trabecular diameter, 132 microns, and 5) total resorption surface, 12.31%. The overall histomorphometric features and differential diagnosis support the diagnosis of hyperparathyroidism. We conclude that histomorphometry of dried bone, particularly in this case where preservation is ideal, is a valuable investigative technique for paleopathology.