Source investigation of two outbreaks of skin and soft tissue infection by Mycobacterium abscessus subsp. abscessus in Venezuela.

Outbreaks of soft tissue or skin infection due to non-tuberculous mycobacteria are reported frequently in scientific journals but in general the infection source in these outbreaks remains unknown. In Venezuela, in two distinct outbreaks, one after breast augmentation surgery and another after hydrolipoclasy therapy, 16 patients contracted a soft tissue infection due to Mycobacterium abscessus subsp. abscessus. Searching for the possible environmental infection sources in these outbreaks, initially the tap water (in the hydrolipoclasy therapy outbreak) and a surgical skin marker (in the breast implant surgery outbreak), were identified as the infection sources. Molecular typing of the strains with a variable number tandem repeat typing assay confirmed the tap water as the infection source but the molecular typing technique excluded the skin marker. We discuss the results and make a call for the implementation of stringent hygiene and disinfection guidelines for cosmetic procedures in Venezuela.

Tityus zulianus and Tityus discrepans venoms induced massive autonomic stimulation in mice

Venezuelan scorpion envenomation is a public health problem produced by Tityus discrepans (TD) and Tityus zulianus (TZ) species. Patients-envenomend by TD developed gastrointestinal and pacreatic disorders and scorpion accidents involving TZ are associated with high mortality rate, which showed cardiopulmonary clinical disorders may be associated to the high levels of plasma catecholamines levels. This distinctive clinical output seems to be associated to a toxin repertoire diversity, which has been previously demonstrated. Trying to mimic the human-envenomation, some toxinological studies have been performed using TD and TZ venoms in several biomedels such as mice and anesthetized rams. The purpose of this study was to evaluate, in vivo using biomodels (mice), the role of autonomic nervous system (sympathetic) stimulation producing some of the clinical signs, via the catecholamines release, on the patho-physiology of the TZ and TD induced envenomation. Thus, a clinical signs here reported during a period of 1 hr, after a single intra-peritoneal injection of sub-lethal doses of TZ or TD venom, which are related with diarrhea, diaphoresis, intense salivation, dehydratation, dyspnea and spasticity in hind limbs. However, these animals did not exhibit vomiting, which is the most frequent human-envenomed TD patients. All animals inoculated with (TD or TZ) venoms develped diarrhea being more pronounced in TD group. Diaphoresis, sialorrhea and dehydratation were mainly observed in TD group. Dyspnea and the hind limb spasticity were only developed in TZ mice. These clinical manifestations (diarrhea, sialorrhea, dehydratation and intense salivation) are related to an activation of autonomic nervous system, via an intense release of their related neurotransmitters. Thus, autonomic stimulation (sympathetic) was evaluated following the catecholamine (Nor-Epinephrine) (NE) plasma levels in a function of envenomation time. We found a significant increments at 1 hr,...

El escorpionismo en Venezuela es un problema actual de salud pública producido por las especies de Tityus discrepans (TD) y Tityus zulianus (TZ). Los pacientes que presentan escorpionismo producido por TD desarrollan trastornos gastrointestinales y pancreáticos mientras que los afectados por TZ presentan una alta mortalidad y muestran una sintomatología relacionada a desordenes cardiopulmonares, los cuales parecen estar asociados a niveles elevados de las catecolaminas plasmáticas. Esta clínica diferente parece estar asociada a una composición distinta de toxinas de dichos venenos, lo cual ha sido previamente demostrado. En un intento de mimetizar o reproducir el escorpionismo en humanos se han realizado estudios toxinológicos con los venenos de TZ y TD utilizando varios biomodelos como son ratones y carneros anestesiados. El propósito de este trabajo fue evaluar, “in vivo” usando un Biomodelo (ratones), el papel de la estimulación del sistema nervioso autónomo (simpático) para producir algunos signos clínicos, vía la liberación de catecolaminas, en la fisiopatología del escorpionismo producido por TZ y TD. Así, los signos clínicos aquí descritos y observados durante 1 hr., después de la inyección de una dosis sub-letal de los venenos de TZ y TD, fueron la presencia de diarrea, diaforesis, salivación intensa, deshidratación, disnea y parálisis en las extremidades posteriores. Sin embargo, estos animales no presentaron vómitos, el cual es uno de los signos más frecuentemente observado en los pacientes con accidentes escorpiónicos por TD. Todos los animales inyectados con los venenos de TD y TZ presentaron diarrea especialmente en grupo TD. La disnea y la parálisis en los miembros posteriores fueron sólo observadas en el grupo de ratones inyectados con TZ. Las manifestaciones clínicas como son diarrea, diaforesis y la salivación intensa están asociadas a una activación del sistema nervioso autónomo...

Concentraciones de lípidos y lipoproteínas en menopáusicas tratadas con raloxifeno / Lipids and lipoproteins concentrations in postmenopausal women treated raloxifene

Objetivo Determinar las concentraciones de colesterol, triglicéridos (TG), lipoproteínas de baja densidad (LDL) y lipoproteínas de alta densidad (HDL) en menopáusicas tratadas con raloxifeno luego de 3 meses de tratamiento. Método Se seleccionaron 45 mujeres menopáusicas que fueron tratadas con 60mg/día de raloxifeno oral por 3 meses y se determinaron las concentraciones de colesterol, TG, LDL y HDL. Resultados La edad promedio de las menopáusicas fue de 49,3±3,9 años y el promedio del índice de masa corporal de 28,1±3,7kg/m2. Las concentraciones de FSH y estradiol fueron de 91,7±11,6Ul/ml y 20,1±11,8pg/ml, respectivamente. Las concentraciones de colesterol (231,3±36,8mg/dl al inicio y 216,5±21,3mg/dl luego de 3 meses) y LDL (154,6±11,2mg/dl al inicio y 138,9±14,6mg/dl luego de 3 meses) presentaron disminuciones significativas (del 6% y del 10%, respectivamente) luego de 3 meses del uso de raloxifeno (p<0,05). No se encontraron modificaciones significativas en las concentraciones de TG y HDL luego del uso de raloxifeno (p=ns). Conclusión El uso de raloxifeno en menopáusicas produce disminuciones significativas en las concentraciones de colesterol y LDL, sin modificar las concentraciones de TG y LDL, luego de 3 meses de tratamiento (AU)

Objective To determine cholesterol, triglyceride, low-density lipoprotein (LDL) and high-density lipoprotein (HDL) concentrations in postmenopausal women treated with raloxifene after 3 months of treatment. Methods Forty-five postmenopausal women were treated with 60mg/day of oral raloxifene for 3 months. Cholesterol, triglyceride, LDL, and HDL concentrations were assessed.Results The mean age of the postmenopausal women was 49.3±3.9 years and the mean body mass index was 28.1±3.7Kg/m2. Follicle-stimulating hormone and estradiol concentrations were 91.7±11.6UI/ml and 20.1±11.8pg/ml, respectively. Cholesterol (231.3±36.8mg/dl at baseline and 216.5±21.3mg/dl after 3 months) and LDL concentrations (154.6±11.2mg/dl at baseline and 138.9±14.6mg/dl after 3 months) were significantly reduced (6% and 10%, respectively) after 3 months of raloxifene use (p<0.05). There were no significant variations in triglycerides or HDL concentrations after raloxifene use (p=ns) .Conclusion Raloxifene use in postmenopausal women significantly reduces cholesterol and LDL concentrations without modifying triglyceride and LDL concentrations after 3 months of treatment (AU)

Clonamiento molecular de las asas intracelulares de los receptores muscarínicos m2 y m3 implicadas en la interacción con proteínas g en el músculo liso traqueal de bovino / Molecular cloning of the intracullular ases of the receptors muscarinic m² y mü implecated in the interation with proteins in the muscle smooth tracheal of bovine

En el músculo traqueal de bovino (MLTB) se ha propuesto una vía de señalización celular asociada con la actividad de una guanililciclasa de membrana plasmática (GCm) la cual se encuentra regulada por dos subtipos de receptores muscarínicos (mAChRs) m2 y m3 acoplados a proteínas G de manera opuesta. El objetivo del presemte estudio fue la identificación de las secuencias primarias de las regiones intracelulares de los receptores muscarínicos implicadas en la interacción con las proteínas G que regulan a esta GCm. El cDNA del MLTB fue usado para la amplificación de las regiones intracelulares de los subtipos m2 y m3 utilizando oligonucleótidos cebadores específicos. Los productos de amplificación fueron identificados en geles de agarosa y posteriormente secuenciados, encontrándose un 99 por ciento de similitud con las secuencias obtenidas del bGen Data Bank de los mACHRs en cerebro de bovino. Este es el primer clonamiento molecular para los mACHRs presentes en MLTB y sugiere posibles similitudes con el cerebro de bovino en relación a la interacción receptor/proteína G

Presencia de guanilil ciclasas sensibles a los péptidos natriuréticos ANP y CNP en el músculo liso traqueal de bovino / Guanylyl cyclases sensibility to natriuretic peptide ANP and CNP in the tracheal muscle smooth of bovine

La producción de GMP cíclico en el músculo liso traqueobronquial de bovino (MLTB) es catalizada por guanilil ciclasas soluble (sGC) y particulada (mGC). Para la identificación de la mGC involucrada en la regulación muscarínica, via receptores M2 y M3 del tono de MTLB, se amplificó a partir de cDNA obtenido del MLTB una región conservada en el dominio catalítico de todas las GC. La secuenciación de los productos de RT-PCR reveló que el 76 por ciento de los transcriptos codifican para la subunidad ß1 de sGC y el 24 por ciento para la isoforma B (sensible al péptido CNP) de la mGc. RT-PCRs con oligonucléotidos isoforma-específicos mostraron que las isoformas sensibles a los péptidos ANP y guanilina también se expresan en el MLTB. La activación máxima de mGC obtenida con CNP resultó significativamente (p<0.001) superior a la lograda con ANP, indicando que la isoforma B es la mGC predominante en este tejido

Molecular and biochemical characterization of a CNP-sensitive guanylyl cyclase in bovine tracheal smooth muscle.

Muscarinic activation of bovine tracheal smooth muscle (BTSM) is involved in cyclic guanosine monophosphate (cGMP) production mediated through soluble (sGC) and membrane-bound (mGC) guanylyl cyclases. A muscarinic- and NaCl-sensitive mGC exists in BTSM regulated by muscarinic receptors coupled to G proteins. To identify the mGCs expressed in BTSM, reverse transcriptase/polymerase chain reaction (RT-PCR) from total RNA was performed using degenerate oligonucleotides for amplification of a region conserved among GC catalytic domains. Cloning of amplification products revealed that 76% of all BTSM GC transcripts corresponded to the sGC beta1 subunit and 24% to the B-type (C-type NP 1-22 [CNP]-sensitive) GC receptor. cGMP production by BTSM membrane and soluble fractions confirmed that sGC activity is 3-fold with respect to mGC activity. RT-PCR using specific oligonucleotides revealed that A (atrial NP-sensitive) and C (guanylin-sensitive) mGC subtypes are also expressed in BTSM. Stimulation of basal plasma membrane GC activity by CNP was higher than that by ANP, whereas guanylin showed no effect, indicating that CNP-sensitive guanylyl cyclase (GC-B) is the predominant functional BTSM mGC subtype. Strong adenosine triphosphate inhibition of CNP-stimulated mGC activity supports the finding that the tracheal mGC isoform belongs to the natriuretic peptide-sensitive mGCs. Additionally, CNP was able to reverse the chloride inhibition of BTSM mGC activity, suggesting that this is a novel G protein-coupled GC-B receptor.

Effects of 1H-[1,2,4]oxadiazolo[4,3-a]quinoxalin-1-one (ODQ) and Nomega(6)-nitro-L-arginine methyl ester (NAME) on cyclic GMP levels during muscarinic activation of tracheal smooth muscle.

The effects of carbachol on the cyclic GMP (cGMP) content of bovine tracheal smooth muscle in the absence of phosphodiesterase inhibitors were evaluated. Carbachol (1 x 10(-5) M) induced two cGMP peaks, at 20 and 60 sec. Both cGMP signals were carbachol concentration-dependent (1 x 10(-11) to 1 x 10(-5) M), the first being higher than the second. The cGMP signal induction was studied using an inhibitor of the soluble guanylyl cyclase (GC), 1H-[1,2,4]oxadiazolo[4,3-a]quinoxalin-1-one (ODQ), and a nitric oxide (NO) synthase inhibitor, Nomega(6)-nitro-L-arginine methyl ester (NAME). ODQ (1 x 10(-7) M) did not affect the second cGMP peak but abolished the first peak, suggesting that a soluble GC may be involved. NAME (1 x 10(-4) M) did not affect the cGMP signals, but changed their 2:1 ratio and also induced a time-shift of the first peak to 10 sec and the second to 50 sec. These results indicate that the NO-soluble GC cascade is not responsible for these muscarinic effects on cGMP levels.

Two opposite signal transducing mechanisms regulate a G-protein-coupled guanylyl cyclase.

Membrane-bound guanylyl cyclase (GC) is regulated by muscarinic receptors (mAChRs). Carbamylcholine (CC) induces a "dual" biological response on GC activity. Thus, an activation is observed at 0.1 nM and a maximal response at 1 nM CC. However, at higher agonist concentration (> 100 nM), there is an agonist-dependent inhibition of GC. This CC dual response is affected by 4-DAMP and HDD (M3 antagonists), which produce a right-shift of the CC curve; the maximal CC dose response with 4-DAMP is more potent than that with HDD. Moreover, AFDX-DS (an M2 antagonist) increases basal activity and decreases the agonist-dependent inhibition. Neither the CC response nor the CC maximal dose responses are affected by pirenzepine (PZ, M1 antagonist). The agonist-dependent stimulation of GC activity is inhibited by 4-DAMP showing a -log IC50 = 8.4 +/- 0.4, while AFDX116 DS poorly inhibits such activity with a -log IC50 = 5.0 +/- 0.2. The agonist-independent (basal) GC activity also was inhibited by 4-DAMP, in a dose-dependent manner, with an IC50 = 8.5 +/- 0.2. Nonetheless, other muscarinic antagonists (PZ and HDD) were not able to inhibit this basal GC. Pertussis toxin treatment produces a complete blockade of the agonist-dependent inhibition of GC with a full expression of the agonist-dependent activation of membrane-bound GC. These results indicate that membrane-bound GC is regulated by muscarinic agents through two opposite signaling pathways; one involves the activation of GC via an M3 mAchR coupled to a PTX-insensitive G protein, while the GC inhibition is mediated through a PTX-sensitive Gi/o protein possibly coupled to an M2 mAChR.

Biochemical characterization of a V-ATPase of tracheal smooth muscle plasma membrane fraction.

A biochemical characterization of a Mg(2+)-ATPase activity associated with a plasma membrane fraction isolated from airway (tracheal) smooth muscle was performed. This enzyme is an integral part of the membrane remaining tightly bound after 0.6 M KCl extraction. This enzyme activity showed a cold inactivation in the presence of ATP and Mg2+. Also, this Mg(2+)-ATPase was stimulated by monovalent anions being Cl-, the best anion for such stimulation, even though Br- and I- were good substitutes and F- was ineffective. This Cl--stimulated activity showed a powerful nucleosidetriphosphatase activity having the following divalent cation specificity: Mg2+ > Mn2+ > Ca2+, where Zn2+ and Fe2+ were ineffective. This ATPase activity was not inhibited by ouabain oligomycin C and vanadate indicating that neither P- or F-ATPases were associated with this enzyme activity. However, the existence of a V-ATPase was shown by the significant inhibition causes by bafilomycin A1. Additionally, this V-ATPase seems to be coupled to Cl- conductor because duramycin inhibited this ATPase activity. The presence of a H+ pump associated to this V-ATPase was shown indirectly, through the stimulatory effect produced by uncouplers such as FCCP and 1799, which were able to produce significant stimulation of this V-ATPase indicating the existence of a H(+)-ATPase. Finally, the immunodetection of a 72 kDa polypeptide using a specific antibody against the A subunit (72 kDa) of V-ATPase from chromaffin granule demonstrated the presence of a V-ATPase in this plasma membrane fraction.

A Ca2+/CAM protein kinase associated with Ca2+ transport in sarco(endo)plasmic vesicles from tracheal smooth muscle.

In this work, we show evidence to support the existence of a Ca2+ calmodulin (CAM) dependent protein kinase and a substrate, a 17 kilodaltons (KDA) polypeptide being both associated to sarco(endo)plasmic reticulum vesicles from tracheal smooth muscle. Anti-CAM drugs such as compound 48/80 inhibited this protein kinase activity and this inhibition was reversed in the presence of Ca2+CAM. Moreover, as a result of this phosphorylation, there is a significant increase in the ATP dependent Ca2+ transport in these sarco(endo)plasmic vesicles.

G-protein-sensitive guanylyl cyclase activity associated with plasma membranes.

A mammalian plasma-membrane-bound guanylyl cyclase is inhibited by NaCl and this inhibition is dependent on GTP concentrations and independent of the chloride salt type. This chloride inhibition is reversed by GTP analogs such as GTP gamma S, suggesting the involvement of G proteins. When the ability of bacterial toxins to affect this chloride-sensitive guanylyl cyclase was examined, pertussis toxin decreased the basal activity and the chloride sensitivity was greatly reduced. Cholera toxin induced a slight activation of the basal activity, without significant changes in the NaCl inhibition. These data indicate that G proteins regulate the chloride sensitivity of this guanylyl cyclase activity. Another property described here is the ability of ATP and analogs to inhibit the basal activity. However, these nucleotides did not modify the chloride sensitivity of the membrane-bound guanylyl cyclase activity.

Subcellular distribution and pharmacological characterization of muscarinic receptors in tracheal smooth muscle.

Subcellular fractions isolated from tracheal smooth muscle have been identified using biochemical markers and measuring the [3H]QNB muscarinic receptor binding activity in these fractions. This muscarinic receptor (mAchR) activity was slightly enriched 1.6 times in the crude mitochondrial fraction (M), 2.6 times in the crude microsomal fraction (P), and greatly enriched in the highly purified plasma membranes fractions, being 5.3 times in a heavy plasma membrane fraction designed as P2 and 9.1 times in a light plasma membrane fraction named P1 fraction. The muscarinic receptor subtypes present in the subcellular fractions were identified using competition experiments. The binding of five selective antagonists, pirenzepine, AF-DX 116, hexahydrodifenidol, methoctramine and 4-DAMP were examined. In this sense, the M1 antagonist pirenzepine showed pKi's values between 6.44-7.45 and the M2 antagonist AF-DX 116 showed pKi's values ranging from 6.75 to 7.45 being the lowest pKi's values here described. The antagonist hexahydrodifenidol showed higher affinities than pirenzepine-derivated compounds with pKi's values from 7.25 to 7.65. The antagonist 4-DAMP exhibited pKi's values from 8.18-8.41. Finally, methoctramine showed similar affinities as 4-DAMP, with pKi's ranging from 8.09 to 8.22 suggesting the existence of M2 receptors in these fractions. These data suggest that M2 mAchR are present in all particulate fractions here studied. It is important to emphasize that the M2 muscarinic receptor presents in the light plasma membrane fraction (P1) shows poor selectivity towards the muscarinic antagonists being different from the M2 mAchRs associated with other subcellular fractions isolated from bovine tracheal smooth muscle.

Methoctramine binding sites sensitive to alkylation on muscarinic receptors from tracheal smooth muscle.

The binding of L-[benzilic-4,4'-3H]quinuclidinyl benzilate was studied in the plasma membrane fraction of bovine tracheal smooth muscle treated with the alkylating agent N-ethylmaleimide (NEM). It was found that NEM (2.5 mM) reduced significantly the Bmax from 1116 to 853 fmol/mg protein and increased the KD values of the muscarinic acetylcholine receptor (mAchR) activity from 36 to 61 pM. The mAchR subtypes in these plasma membranes were studied using competition experiments with selective antagonists. Pirenzepine displayed low competitive activity, having a pKi of 6.91 +/- 0.03, which was similar to that of AF-DX 116 (11[[2-[(diethylamino)methyl]- 1-piperidinyl]-acetyl]-5,11-dihydro-6H-pyrido[2,3- b][1,4]benzodiazepine-6-one); (pKi = 6.90 +/- 0.04), whereas hexahydrodifenidol (HDD) and its p-fluoro-derivative (p-FHHSiD) showed higher affinities than pirenzepine, having pKi values of 7.45 +/- 0.05 and 7.17 +/- 0.06, respectively. The antagonist 4-diphenylacetoxy-N-methylpiperidine methobromide (4-DAMP) showed a pKi of 8.25 +/- 0.03, which did not differ significantly from the affinity shown by methoctramine (pKi = 8.00 +/- 0.04). These data indicate that the mAchR associated with the plasma membrane fraction isolated from bovine airway smooth muscle can be classified as an M2 subtype muscarinic receptor. NEM treatment altered the affinities of the mAchR towards specific antagonists, such as methoctramine (Ki increased 3 times), and the results indicated that the alkylated mAchR behaves as a chemically modified M2 subtype. This suggests the presence of thiol groups controlling the antagonist binding activity of this muscarinic receptor subtype.

[Role of H+ ATPases in plasma membranes of airway smooth muscle]. / Papel de las H+ ATPasas en las membranas plasmaticas del musculo liso de las vias aereas.

Protons generated inside the cells during metabolic activity have to be extruded through active mechanisms from the intracellular to the extracellular space. One of the systems involved in proton transport across membranes are the V-ATPases, which are oligomeric complexes that have been found in several subcellular organelles energizing such organelle through a proton gradient and a membrane potential. In this paper, a V-ATPase activity has been described at the plasma membranes fractions isolated from airway smooth muscle. This activity was measured as a Cl- stimulated Mg2+ ATPase. This Cl- activating effect was also shared by others halogens as I- and Br- but not F-. This Cl- stimulated ATPase is a nucleotide triphosphatase being unable to hydrolyze mono and dinucleotides. The divalent cations showed the following sequence of activation (Mg2+ > Mn2+ > Ca2+) of the Cl- activated Mg2+ ATPase. This Cl- stimulated Mg2+ ATPase was insensitive to ouabain, vanadate, sodium azide and rutamicina. NEM (N-ethylmaleimide) partially inhibited this activity but a complete inhibition was observed with p-CMB (p-chloromercurbenzoate ). Several specific proton transport inhibitors were employed to show the presence of a H+ pump activity. Thus, the strong inhibition induced by DCCD suggest the existence of hydrophobic subunits related to a proton channel. In addition, protonophores as 1799 and FCCP stimulated the Cl- stimulated ATPase indicating the presence of a H+ pump in these plasma membranes vesicles. The chloride requirement could be explained by the existence of a chloride conductor coupled to the proton pump (H+ ATPase-type V) due to the inhibitory effect of duramycin.(ABSTRACT TRUNCATED AT 250 WORDS)

Receptor specific for certain nucleotides stimulates inositol phosphate metabolism and Ca2+ fluxes in A431 cells.

We have recently reported that extracellular ATP induces a transient rise in cytosolic free Ca2+ [( Ca2+]i) in individual human epidermoid carcinoma A431 cells (Gonzalez et al: Journal of Cellular Physiology 135:269-276, 1988). We have now studied nucleotide specificity and desensitization for several early responses. Extracellular ATP (5-100 microM) caused the rapid formation of inositol trisphosphate and later its metabolites, inositol bisphosphate and inositol monophosphate. ATP also induced the efflux of 45Ca2+ from pre-loaded cells. In addition, an increase in the rate of influx of 45Ca2+ stimulated by extracellular ATP was detected. Based on measurements of 45Ca2+ efflux and influx, desensitization studies, and chlortetracycline fluorimetry, we conclude that ATP mobilizes Ca2+ from internal stores and also stimulates entry across the plasma membrane. These effects were also displayed by UTP and to a lesser extent by ITP, while other nucleoside triphosphates as well as ADP, AMP, and adenosine, were inactive. Furthermore, desensitization of the response to ATP and UTP was seen after prolonged exposure to either nucleotide. This was specific for the nucleotide receptor since a response to bradykinin was not affected by the ATP pretreatment, although pretreatment with phorbol ester inhibited responses to both the nucleotides and bradykinin. Quantitative data on rate of recovery from the desensitized state and the response of desensitized cells to greatly elevated levels of ATP are presented. Extracellular ATP stimulated another early change previously reported for epidermal growth factor, namely, the phosphorylation of an 81-kDa cytoskeletal protein. The stimulation of these events involves an ATP receptor whose properties differ from other ATP receptors that have been described.

Muscarinic agents modify kinetics properties of membrane-bound guanylyl cyclase activity.

Plasma membranes from bovine tracheal smooth muscle show guanylyl cyclase activity, which can be stimulated by muscarinic agonists such carbamylcholine and oxotremorine and blocked by atropine. This stimulation was observed in the presence of 150 mM NaCl. In the absence of this salt, guanylyl cyclase activity was considerably higher but was not affected by muscarinic agonists. Carbamylcholine decreased the apparent Km but did not change the Vmax of this enzyme. When plasma membrane fractions were extracted with 1% octylglucoside, guanylyl cyclase activity was preserved, however the muscarinic activation was abolished, despite a muscarinic receptor capable of [3H]quinuclidinylbenzilate binding being present in the extract. The detergent extraction changed the affinity of guanylyl cyclase for GTP but the Mn2+ kinetics was unaltered. Based on these findings and on current information in the literature, we propose that another component is required to restore the link between the muscarinic receptor and guanylyl cyclase, however the nature of this component remains to be established.

Clinical trial with clofazimine for treating erythema dyschromicum perstans. Evaluation of cell-mediated immunity.

Eight patients were studied to determine the possible use of clofazimine for treating erythema dyschromicum perstans (EDP). The T-helper/T-suppressor cytotoxic ratio (CD-4/CD-8) and the in vitro lymphoproliferative response on stimulation with phytohemaglutin (PHA) and concanavalin A (Con A) were determined in peripheral blood before and after treatment. Of the eight patients studied, seven had excellent to good responses, whereas only one had a marginal response. The immunologic evaluation before and after treatment showed a significant change in the CD-4/CD-8 ratio, a decrease of the response to PHA, and no change in the response to Con A. The results obtained show that clofazimine is useful for treating this nosologic entity because of its cosmetic effect, and also because it induces changes in cell-mediated response, which could be very important therapeutically.

Estudio comparativo de la utilidad del ungüento de vitaminas A y D contra su excipiente en el tratamiento de diversas dermatosis / Comparative study of the usefulness ointment of vitamins A and D versus its excipient different dermatosis treatment

Se practica un estudio clínico doble ciego entre el ungüento de vitaminas A y D contra su excipiente en 62 pacientes con diferentes dermatosis de caracter eczematoso. Se evaluaron diferentes parámetros subjetivo y objetivos. Aunque no se pudo lograr una completa efectividad del excipiente más vitaminas A y D sobre el grupo control, los resultados sugieren una mayor efectividad de este medicamento

[Generalized lichen planus with erosive lesions of the penis, treated with thalidomide. Report of a case and review of the literature]. / Liquen plano generalizado con lesión erosiva del pene, tratado con talidomida. Reporte de un caso y revisión de la literatura.

A patient with generalized lichen planus with lesions in the infrequent localization like face, palms, soles and an extensive erosion of glans penis, is described in a 46 year old patient. He had received various treatment which include systemic steroids, without improvement. After treatment with thalidomide (initial doses 300 mg/day for 2 weeks and 200 mg/day for further 10 weeks) he presents resolution of his lesions and symptomatology. A review of lichen planus etiopathogenesis, making emphasis in the immunological hypothesis is made. As well as the different uses and action mechanism of thalidomide in various inflammatory dermatoses.

[Clear cell acanthoma. Presentation of a case]. / Acantoma de células claras. Presentación de un caso.

A case of a 72 year-old woman, with a verrucous lesion was presented. The lesion was characterized by a purple colour and measured 2 X 1.5 cm. in diameter. The patient had the lesion for 1 year and reported previous repetitive traumas, suggesting a clinical diagnosis of traumatic seborrheic keratosis. The histological study reveal a clear cell acanthoma.