Transportation fuel production by combination of LDPE thermal cracking and catalytic hydroreforming.

Fuel production from plastics is a promising way to reduce landfilling rates while obtaining valuable products. The usage of Ni-supported hierarchical Beta zeolite (h-Beta) for the hydroreforming of the oils coming from LDPE thermal cracking has proved to produce high selectivities to gasoline and diesel fuels (>80%). In the present work, the effect of the Ni loading on Ni/h-Beta is investigated in the hydroreforming of the oils form LDPE thermal cracking. h-Beta samples were impregnated with Ni nitrate, calcined and reduced in H2 up to 550°C to achieve different Ni contents: 1.5%, 4%, 7% and 10%. Larger and more easily reducible metal particles were obtained on Ni 7%/h-Beta and Ni 10%/h-Beta. Hydroreforming tests were carried out in autoclave reactor at 310°C, under 20 bar H2, for 45 min. Ni content progressively increased the amount of gases at the expenses of diesel fractions, while gasoline remained approximately constant about 52-54%. Maximum selectivity to automotive fuels (∼81%) was obtained with Ni 7%/h-Beta. Ni loading also enhanced olefins saturation up to Ni 7%/h-Beta. High cetane indices (71-86) and octane numbers (89-91) were obtained over all the catalysts. Regarding the different studied Ni contents, Ni 7%/h-Beta constitutes a rather promising catalyst for obtaining high quality fuels from LDPE thermal cracking oils.

Synthesis strategies in the search for hierarchical zeolites.

Great interest has arisen in the past years in the development of hierarchical zeolites, having at least two levels of porosities. Hierarchical zeolites show an enhanced accessibility, leading to improved catalytic activity in reactions suffering from steric and/or diffusional limitations. Moreover, the secondary porosity offers an ideal space for the deposition of additional active phases and for functionalization with organic moieties. However, the secondary surface represents a discontinuity of the crystalline framework, with a low connectivity and a high concentration of silanols. Consequently, hierarchical zeolites exhibit a less "zeolitic behaviour" than conventional ones in terms of acidity, hydrophobic/hydrophilic character, confinement effects, shape-selectivity and hydrothermal stability. Nevertheless, this secondary surface is far from being amorphous, which provides hierarchical zeolites with a set of novel features. A wide variety of innovative strategies have been developed for generating a secondary porosity in zeolites. In the present review, the different synthetic routes leading to hierarchical zeolites have been classified into five categories: removal of framework atoms, surfactant-assisted procedures, hard-templating, zeolitization of preformed solids and organosilane-based methods. Significant advances have been achieved recently in several of these alternatives. These include desilication, due to its versatility, dual templating with polyquaternary ammonium surfactants and framework reorganization by treatment with surfactant-containing basic solutions. In the last two cases, the materials so prepared show both mesoscopic ordering and zeolitic lattice planes. Likewise, interesting results have been obtained with the incorporation of different types of organosilanes into the zeolite crystallization gels, taking advantage of their high affinity for silicate and aluminosilicate species. Crystallization of organofunctionalized species favours the formation of organic-inorganic composites that, upon calcination, are transformed into hierarchical zeolites. However, in spite of this impressive progress in novel strategies for the preparation of hierarchical zeolites, significant challenges are still ahead. The overall one is the development of methods that are versatile in terms of zeolite structures and compositions, capable of tuning the secondary porosity properties, and being scaled up in a cost-effective way. Recent works have demonstrated that it is possible to scale-up easily the synthesis of hierarchical zeolites by desilication. Economic aspects may become a significant bottleneck for the commercial application of hierarchical zeolites since most of the synthesis strategies so far developed imply the use of more expensive procedures and reagents compared to conventional zeolites. Nevertheless, the use of hierarchical zeolites as efficient catalysts for the production of high value-added compounds could greatly compensate these increased manufacturing costs.

Actividades para promover la gestión crítica de la información de Internet aplicadas a estudiantes de farmacia / Activities to promote critical information management over Internet in pharmacy students

Con el fin de promover la adquisición de habilidades y destrezas que permitan al estudiante de Farmaciadesarrollar una actitud activa y crítica frente a la información disponible en Internet, así como saberseleccionar las fuentes de información de Internet adecuadas para su formación, se ha llevado a cabo unproyecto de innovación docente (2008PID-UB/115) cuyo objetivo final es fomentar la gestión crítica de lainformación. Para ello se han diseñado una serie de ejercicios integrados en una actividad basada en casosclínicos, que forma parte de la evaluación continuada de la asignatura de Fisiopatología de la Licenciaturade Farmacia (UB). Se ha evaluado el proyecto a través de las calificaciones obtenidas en las actividades ylas encuestas de opinión de un total de 379 estudiantes. Los resultados evidencian que la mayoría deestudiantes (90%) valoran muy positivamente las actividades planteadas, considerando que favorecen suaprendizaje y formación personal, y les aportan criterios útiles y provechosos para el análisis y selecciónde información biomédica a través de Internet. Por último, cabe destacar que el proyecto planteado hademostrado ser aplicable a un grupo numeroso de estudiantes de Grado y constituye una estrategia válidapara fomentar competencias transversales relacionadas con la gestión de la información, de granrelevancia para el futuro profesional farmacéutico(AU)

It has been carried out an educational innovation project (2008PID-UB/115) whose ultimate goal was topromote critical management information. Its specific objectives were to promote the acquisition of skillsand abilities to allow the student of Pharmacy, on the one hand, to develop active and critical attitudetowards the information available on Internet and, on the other hand, to select the Internet informationsources suitable for their formation. For these purposes, we set up some activities based on a clinical caseas a part of the continuous assessment of the subject of Pathophysiology of the Bachelor of Pharmacy(UB). The project was assessed by the scores on the activities and the opinion surveys of a total of 379students. The results show that most students (90%) highly value the activities planned and they considerthat these kinds of activities promoted their learning and their professional training. The students also statethat the exercises provided them useful and helpful criteria for the analysis and selection of biomedicalinformation over Internet. Finally, it is noteworthy that the proposed project has proved to be applicable toa large group of undergraduate students. Moreover, it is a valid strategy to promote cross-curricularcompetencies related to management of information, which is of great relevance for the future pharmacist(AU)

Homocysteinemia in hypertensive patients with renal target organ damage (mild renal dysfunction).

The prevalence of high plasmatic levels of homocysteine in hypertensive patients with mild renal dysfunction (MRD) defined by 2003 European Hypertension Society Guidelines (men plasmatic creatinine between 1.3 and 1.5; women plasmatic creatinine between 1.2 and 1.4 mg/dl) has not been previously reported. To evaluate this item 18 MRD patients were recruited (54% males, mean age 59.2 +/- 17.3 years, mean plasmatic creatinine 1.30 +/- 0.12 mg/dl). They were compared with a control group of hypertensives with normal renal function (n = 87, 42,9% males, mean age 53.6 +/- 12.3 years, mean plasmatic creatinine 0.83 +/- 0.21 mg/dl) and a group of 29 chronic renal failure patients (51.7% males, mean age 56.9 +/- 15.0 years, mean plasmatic creatinine 2.39 +/- 0.95 mg/dl). Age and sex differences are not significant, plasmatic creatinine levels are different among three groups (p <0.001, t student test). Basal homocysteine levels of CRF (19.3 +/- 7.1 micromol/l) were higher than those of control group (11,0 +/- 4,3 micromol/l) and MRD patients (14.8 +/- 5.5 micromol/l; p = 0.027 vs. CRF and p = 0.007 vs. control, Mann-Whitney test). Mean creatinine clearance was 30.3 +/- 11.5 ml/min for CRF group, significantly lower than MRD patients creatinine clearance (54.5 +/- 9.4 ml/min, p <0.001, t student test) and control ones (88,9 +/- 18,9 ml/min, p <0.001, t student test). Hypertensive patients with mild renal dysfunction showed higher and pathological levels of homocysteinemia as compared with controls, this finding might be related to the higher cardiovascular risk described in this group of patients.

[Either calcium carbonate or sevelamer decreases urinary oxalate excretion in chronic renal failure patients]. / Carbonato cálcico o sevelamer reducen la excreción urinaria de oxalato en pacientes con insuficiencia renal avanzada.

The rate of oxalate absorbed from intestine is highly influenced by calcium intake in healthy subjects. It is unknown whether commonly used phosphate binders modify intestinal absorption and renal excretion of oxalate in chronic kidney disease (CKD) patients. This study aims to determine if calcium carbonate or sevelamer influences on urinary oxalate excretion. Twenty patients with CKD (stage 4 and 5 pre-dialysis) were included. Two treatment (1500 mg of calcium carbonate or 2400 mg of sevelamer), two-period (21 days each), crossover study with balanced assignment of the order of administration, and two washout periods were the main characteristics of this study design. Laboratory analyses in each phase included: serum creatinine, calcium, phosphorus, bicarbonate, total cholesterol, and 24 h urinary excretion of oxalate, creatinine, and urea. Creatinine clearance, protein catabolic rate (PNNA), total urinary oxalate excretion, and urinary oxalate / creatinine ratio were determined. Seventeen patients completed both treatment sequences. Total urinary oxalate excretion and urinary oxalate / creatinine ratios decreased significantly with respect to washout periods either after sevelamer or calcium carbonate treatment. The decrease in urinary oxalate excretion was greater after calcium carbonate (41.2+/-17.4%) than after sevelamer treatment (30.4+/-23.8%). There were not significant changes in renal function or PNNA values throughout the study periods. In conclusion, either calcium carbonate or sevelamer significantly reduces urinary oxalate excretion in CKD patients. Further studies will be needed to ascertain whether the type of phosphate binder influences on the accumulation of oxalate in CKD patients.

Hyperhomocysteinemia in patients with mild chronic renal failure.

BACKGROUND: The aim of this study was to evaluate the prevalence of high plasma levels of homocysteine in patients with mild renal failure. METHODS: Forty-six chronic renal failure patients (25 males and 21 females, mean age 55.6+/-14.4 years) were recruited for the study. Mean plasma creatinine was 2.1+/-1.0 mg/dl and mean creatinine clearance was 50.6+/-26.3 ml/min. Patients with severe renal failure were excluded. Patients were compared with a control group with normal renal function (n=35, 22 men and 13 women, mean age 50.0+/-11.5 years). Plasma homocysteine values were measured in both groups at baseline and after an oral overload of methionine. RESULTS: Baseline homocysteine levels of patients were higher than those of controls (16.5+/-7.3 vs. 10.4+/-4.2 micromol/l, p<0.0001). Some 34 patients and 4 controls had increased plasma homocysteine levels at baseline. After the oral overload, 4 more patients had abnormally increased homocysteine levels, meaning that 83% of the patients with chronic renal failure had hyperhomocysteinemia. CONCLUSIONS: Hyperhomocysteinemia is a very common finding among patients with mild renal failure. The need for vitamin supplementation should be evaluated in the first stage of chronic renal failure.

Evolution of the renal function is a better predictor of long-term survival than serum creatinine.

BACKGROUND: In recent years acute rejection has decreased to 10% to 20%. Therefore it is necessary to look for new endpoints in renal transplantation. Serum creatinine and changes in creatinine have been reported to be powerful predictors of long-term kidney transplant survival. Chronic renal allograft nephropathy is the primary cause of long-term graft failure but may appear at any stage in the evolution. METHODS: Data from 315 patients receiving cadaver donor renal transplants between February 1987 and March 2001 that functioned for 1 year were examined for the influence of demographic characteristics and transplant variables. Creatinine clearance was estimated using the Cockroft-Gault formula. Survival was assessed with the actuarial method. The multivariate analyses were performed using Cox proportional hazard models. RESULTS: The 10-year graft survival showed a relative risk of 2.5 in the univariate analysis when there was more than 10% decrease in renal function at 3 months compared with nadir values. When the decrease was more than 25% of creatinine clearance at the third month, during the evolution and serum creatinine at 3 months introduced in the multivariate model, the latter was not significant, while the other variables had a RR of 4.4 and 10, respectively. CONCLUSION: The evolution of renal function at 3 months and throughout the evolution were better predictors of graft failure than an isolated serum creatinine value.

Changes in renal transplantation: comparison between two different series.

BACKGROUND: New immunosuppressives have improved the results of renal transplants. However, the features of donors and recipients have changed, producing an increased age in both cases and more donors dying from strokes. We analyzed the impact of donor and recipient profile on survival of graft in recipients treated with new immunosuppressive agents. METHODS: Data from 343 patients receiving cadaveric renal transplants functioning for 1 year on February of 1987 and March of 2001 when cyclosporine was incorporated in the immunosuppressive regimen. Two series were distinguished from the point of view of immunosuppression: an historical series and a current series. Graft survival rates were analyzed using the actuarial method. Multivariate analysis was achieved with Cox proportional hazards model. RESULTS: Actuarial survival at 5 years was lower in the current series, 77%, as opposed to 82% in the historic series. Donor and recipient age, proteinuria, and losses in immediate postoperative period were significantly higher in the current series. However, acute rejection episode dropped from 54% to 21%. Delayed graft function also decreased from 18% to 10% in the current series. When multivariate analysis was performed of grafts functioning at 1 year, the relative risk was 3.12 in the historical series adjusted for other variables. CONCLUSION: The data suggested that new immunosuppressive regimens counteract suboptimal features for donors and recipients.

Techniques for small-bone lengthening in congenital anomalies of the hand and foot.

The purpose of this study is to analyse three different lengthening techniques used in 31 small bones for congenital malformations of the hand and foot: 15 metacarpals, 12 metatarsals, 1 foot stump and 3 spaces between a previously transplanted phalanx end of the carpus or the metacarpal. Progressive lengthening with an external fixator device was performed in 23 cases: the callus distraction (callotasis) technique was used in 15 cases, whereas in the other 8 cases the speed of lengthening was faster and the defect bridged with a bone graft as a second stage. In another eight cases, a one-stage lengthening was performed. In the callotasis group, the total length gained ranged from 9 mm to 30 mm and the percentage of lengthening obtained (compared with the initial bone length) averaged 53.4%; in the fast lengthening group, the length gained ranged from 8 mm to 15 mm, and the average percentage of lengthening was 53.1%; and in the one-stage group, the length gained ranged from 7 mm to 15 mm, and the average percentage of lengthening was 43%. The overall complication rate was 22.5%.

Efficacy of low dose schedule pamidronate infusion in children with osteogenesis imperfecta.

BACKGROUND: Osteogenesis imperfecta (OI) is a rare condition in which bones are abnormally brittle with frequent fractures. A variety of therapeutic agents has been used with low efficacy. In this study, we present three patients treated for 4 years with i.v. pamidronate. PATIENTS AND METHODS: Three prepubertal patients, aged 9 (M), 9 (F) and 11 (F) years old, with OI, were treated with 30-60 mg i.v. pamidronate every 6 months over four years. Determinations were made of plasma 1,25-dihydroxycholecalciferol, 25-hydroxycholecalciferol, insulin-like growth factor-I (IGF-I) and its transport protein (IGFBP3), osteocalcin, total alkaline phosphatase and its osseous fraction, and parathormone (PTH) at baseline and after every pamidronate infusion, Densitometry and X-ray of the vertebral column were performed at the same intervals. RESULTS: Significant reductions of number of bone fractures and pain were observed in all patients, despite lack of any modification in biochemical parameters. Lumbar X-ray and densitometry showed a striking improvement by the end of the treatment period. CONCLUSION: Pamidronate seems to be useful in the treatment of patients with osteogenesis imperfecta.

Antigen loading of MHC class I molecules in the endocytic tract.

Major histocompatibility complex (MHC) class I molecules bind antigenic peptides that are translocated from the cytosol into the endoplasmic reticulum by the transporter associated with antigen processing. MHC class I loading independent of this transporter also exists and involves peptides derived from exogenously acquired antigens. Thus far, a detailed characterization of the intracellular compartments involved in this pathway is lacking. In the present study, we have used the model system in which peptides derived from measles virus protein F are presented to cytotoxic T cells by B-lymphoblastoid cells that lack the peptide transporter. Inhibition of T cell activation by the lysosomotropic drug ammoniumchloride indicated that endocytic compartments were involved in the class I presentation of this antigen. Using immunoelectron microscopy, we demonstrate that class I molecules and virus protein F co-localized in multivesicular endosomes and lysosomes. Surprisingly, these compartments expressed high levels of class II molecules, and further characterization identified them as MHC class II compartments. In addition, we show that class I molecules co-localized with class II molecules on purified exosomes, the internal vesicles of multivesicular endosomes that are secreted upon fusion of these endosomes with the plasma membrane. Finally, dendritic cells, crucial for the induction of primary immune responses, also displayed class I in endosomes and on exosomes.

The steroidogenic acute regulatory protein homolog MLN64, a late endosomal cholesterol-binding protein.

MLN64 is a transmembrane protein that shares homology with the cholesterol binding domain (START domain) of the steroidogenic acute regulatory protein. The steroidogenic acute regulatory protein is located in the inner membrane of mitochondria, where it facilitates cholesterol import into the mitochondria. Crystallographic analysis showed that the START domain of MLN64 is a cholesterol-binding domain. The present work was undertaken to determine which step of the intracellular cholesterol pathway MLN64 participates in. Using immunocytofluorescence, MLN64 colocalizes with LBPA, a lipid found specifically in late endosomes. Electron microscopy indicates that MLN64 is restricted to the limiting membrane of late endosomes. Microinjection or endocytosis of specific antibodies shows that the START domain of MLN64 is cytoplasmic. Deletion and mutagenesis experiments demonstrate that the amino-terminal part of MLN64 is responsible for its addressing. Although this domain does not contain conventional dileucine- or tyrosine-based targeting signals, we show that a dileucine motif (Leu(66)-Leu(67)) and a tyrosine residue (Tyr(89)) are critical for the targeting or the proper folding of the molecule. Finally, MLN64 colocalizes with cholesterol and Niemann Pick C1 protein in late endosomes. However, complementation assays show that MLN64 is not involved in the Niemann Pick C2 disease which, results in cholesterol lysosomal accumulation. Together, our results show that MLN64 plays a role at the surface of the late endosomes, where it might shuttle cholesterol from the limiting membrane to cytoplasmic acceptor(s).

Polidactilia sin pulgar / Thumbless polydactyly

Objetivo: Estudiar seis casos de malformación de la mano (polidactilia y ausencia del pulgar) para buscar otros elementos de coincidencia.Resultados: Dos casos (3 y 6) presentaban cinco dedos trifalángicos, con un primer dedo hipoplásico, siendo unilaterales. Un caso (5) también unilateral, era una típica mano en espejo y presentaba dos cúbitos. Tres casos (1, 2 y 4) eran bilaterales y tenían afectadas las manos y los pies, aunque sus características eran algo diferentes. Tres casos (2, 4 y 6) combinaban la polidactilia con la sindactilia. Si bien dos casos (2 y 4) presentaban sólo anomalías distales, en los demás el antebrazo o la pierna formaban parte de la malformación. El tratamiento fue la pulgarización de un dedo radial y extirpación de los dedos supernumerarios, con resultados globales aceptables, aunque con movilidad activa escasa del pulgar.Conclusiones: 1) la polidactilia sin pulgar tiene diferentes formas de presentación; 2) se hace difícil clasificar los casos, aunque se pueden distinguir las pentadactilias, la mano en espejo típica y formas en que se combinan con malformaciones semejantes en los pies y suelen ser bilaterales, y 3) algunos casos se combinan con anomalías en antebrazo o pierna, afectando al radio o la tibia (AU)

Characterization of a peptide-loading compartment by monoclonal antibodies.

Whether or not peptide-loading compartments are classical or specialized compartments of the endocytic pathway of antigen presenting cells is still a matter of debate. One way to solve this discrepancy would be to characterize specific markers for the peptide-loading compartment. We chose to generate monoclonal antibodies against the peptide-loading compartment that we previously characterized as lysozyme loading compartment (LLC) [Escola, J.M., Grivel, J.C., Chavrier, P., Gorvel, J.P., 1995. Different endocytic compartments are involved in the tight association of class II molecules with processed hen egg lysozyme and ribonuclease A in B cells. J. Cell Sci. 108, 2337; Escola, J.M., Deleuil, F., Stang, E., Boretto, J., Chavrier, P., Gorvel, J.P., 1996. Characterization of a lysozyme-major histocompatibility complex class II molecule-loading compartment as a specialized recycling endosome in murine B lymphocytes. J. Biol Chem. 271, 27360]. A preliminary screening by dot blot enabled us to identify several monoclonal antibodies recognizing the LLC and not early and late endosomes. One of these antibodies, the 20C4, was then characterized. It is directed against mature class II molecules of all murine haplotypes. By electron microscopy, 20C4 labeling was restricted to both the plasma membrane and the LLC. These reagents may be useful in the further characterization of the specialized function of these intracellular organelles.

[Reduction in the rates of restenosis after coronary angioplasty with simvastatin and probucol]. / Reducción en las tasas de reestenosis después de una angioplastia coronaria con simvastatina y probucol.

INTRODUCTION AND OBJECTIVES: The restenosis rates after coronary angioplasty persist as an important problem even though multiple drug therapies and different devices have been tried. The reduction of the cholesterol and low density lipoproteins levels (and their oxidation) have proved to have a beneficial effect on atherosclerosis evolution. Both the lipid lowering and antioxidant agents have caused a reduction in the neointimal formation generated with the angioplasty balloon in animals, and their combination to improve endothelial dysfunction in humans. The aim of the present study is to prove whether the whole administration of two potent agents such as simvastatin and probucol, which reduce the lipid levels and their oxidation, are able to lessen the restenosis related process. PATIENTS AND METHODS: Thirty five consecutive patients with coronary angioplasty with no stent to whom 20 mg simvastatin and 500 mg probucol bid were given (group-A) were studied in a prospective non-randomized study. They were compared to a historic group of 40 patients under the standard treatment (group-B). Both groups were angiographically evaluated to determine the restenosis percentage. A lipid profile was performed on group-A patients. RESULTS: The restenosis occurred in 4 (11.4%) in group-A and in 17 (42.5%) in group-B patients and in 4 (10.0%) and 18 (39.1%) lesions respectively (p < 0.01). A new PTCA was performed on 2 (5.7%) group-A patients vs 13 (32.5%) in group-B (p < 0.01). There was a reduction in residual stenosis (34.2 +/- 19.7% vs 48.8 +/- 23.5%, p < 0.01) and a greater minimum luminal diameter (1.76 +/- 0.59 vs 1.46 +/- 0.70 mm, p < 0.05) in group-A than in group-B patients. CONCLUSIONS: Although studies with more patients are required, a combined lipid lowering and antioxidant therapy could achieve a reduction in angioplasty coronary restenosis.

Selective enrichment of tetraspan proteins on the internal vesicles of multivesicular endosomes and on exosomes secreted by human B-lymphocytes.

Association of major histocompatibility complex (MHC) class II molecules with peptides occurs in a series of endocytic vacuoles, termed MHC class II-enriched compartments (MIICs). Morphological criteria have defined several types of MIICs, including multivesicular MIICs, which are composed of 50-60-nm vesicles surrounded by a limiting membrane. Multivesicular MIICs can fuse with the plasma membrane, thereby releasing their internal vesicles into the extracellular space. The externalized vesicles, termed exosomes, carry MHC class II and can stimulate T-cells in vitro. In this study, we show that exosomes are enriched in the co-stimulatory molecule CD86 and in several tetraspan proteins, including CD37, CD53, CD63, CD81, and CD82. Interestingly, subcellular localization of these molecules revealed that they were concentrated on the internal membranes of multivesicular MIICs. In contrast to the tetraspans, other membrane proteins of MIICs, such as HLA-DM, Lamp-1, and Lamp-2, were mainly localized to the limiting membrane and were hardly detectable on the internal membranes of MIICs nor on exosomes. Because internal vesicles of multivesicular MIICs are thought to originate from inward budding of the limiting membrane, the differential distribution of membrane proteins on the internal and limiting membranes of MIICs has to be driven by active protein sorting.

[Treatment with pravastatin of dyslipidemia associated with diabetic nephropathy]. / Tratamiento con pravastatina de la dislipemia asociada a nefropatía diabética.

OBJECTIVE: Patients with type II diabetes mellitus have an increased risk of coronary he disease. We investigated the efficacy and safety of pravastatin in the treatment of patients with diabetic nephropathy and hypercholesterolemia. METHOD: In this 6-months study, 12 patients (4 men, 8 women, mean age 60.5 +/- 10.8 years), with diabetic nephropathy and hypercholesterolemia (fasting plasma low-density lipoprotein cholesterol levels -LDL-C- > 130 mg/dl) received pravastatin 10 mg/day. The dose could be doubled after 4 weeks. Seven patients have chronic renal failure. RESULTS: Significant reductions in LDL-C (-19.1%, p < 0.05), total cholesterol (-16%, p < 0.01), very-low-density lipoprotein cholesterol (-29.2%, p < 0.05), apolipoprotein B (-21.5%, p < 0.05), and triglycerides (-26.0%, p < 0.01) were noted. No changes were found either in high-density-cholesterol or its fractions (HDL2 and HDL3) or in apolipoprotein A plasmatic levels. Pravastatin was well tolerated and no one side effect was detected. No clinically significant changes on the control of diabetes, renal function, as assessed by plasmatic creatinin and creatinin clearance, and proteinuria were seen during the follow-up time. CONCLUSIONS: The results of the study demonstrate that pravastatin is well tolerated and effective in lowering total cholesterol and LDL-C in patients with diabetic nephropathy and hypercholesterolemia.

Congenital tibial aplasia with preaxial polydactyly. A case report.

An anatomical study of a left lower limb with congenital tibial aplasia and preaxial polydactyly amputated at 10 months of age was carried out. The tibia was replaced by a fibrous band (a band of connective tissue) and there were four cuneiforms, six metatarsal bones and seven toes. The second metatarsal bone showed characteristics of the hallux. An intermuscular septum which showed an orifice for the anterior tibial artery was found on the medial side of the leg and foot. All the muscles of the leg and foot were present except for the tibialis posterior muscle, which was replaced by two atypical muscles. No muscular attachments reached the fibrous band. Several intertendinous connection bands were found. Also, an accessory muscular belly split from the tibialis anterior tendon and attached to the common flexor tendinous sheet of the foot. An unusual motor branch of the deep peroneal nerve ran together with this belly to supply the intrinsic muscles of the hallux. We also observed other minor anomalies of the nerve pattern. The arterial pattern was complete, except for some arteries which showed both an anomalous origin and course. The findings of this study suggest that the development of the skeletal elements plays an important role in the differentiation of the muscles, tendons, arteries and nerves. We postulate that a dysmorphogenic event involving the development of the tibial field of the limb could give rise to both defective histodifferentiation of the tibia and defective programmed cell death in the pre-hallucial anlage. These anomalies would determine secondary adaptations of muscles, tendons, vessels and nerves of the limb.