A model for lymphocyte activation in open versus laparoscopic surgery in colorectal cancer patients in enhanced recovery after surgery (ERAS) protocols.

PURPOSE: Given the high mortality and morbidity associated with colon cancer worldwide and the advantages inherent to the use of the laparoscopy technique with respect to open surgery in oncological colorectal surgery, a study was designed to observe and compare the lymphocyte activation model between open surgery (OS) and laparoscopic surgery (LS) for this type of patient as part of an ERAS protocol. METHODS: A prospective study was conducted with 38 patients who underwent surgery due to colorectal disease and were included in an ERAS protocol. The patients were divided into two groups: G1 (patients who had undergone OS; n = 19) and G2 (patients who had undergone LS; n = 19). The lymphocyte activation model was studied at three times: immediately prior to surgery and on post-operative days 1 and 3 (POD0, POD1 and POD3). RESULTS: The Th lymphocyte activation markers studied (CD25, CD69, HLADR) exhibited a significantly higher mean value on POD0 for CD69 in OS than in LS (p = 0.037) and a significantly lower mean HLADR value on POD3 for OS than for LS (p = 0.040). No statistically significant differences were observed in either the evolution or in the mean values for the intracellular cytokines studied responsible for a Th1, Th2 or Th17 response. A Th1 response pattern was observed in both OS and LS. CONCLUSIONS: The lymphocyte activation model in OS and LS is a Th1 response in both cases. The findings for the Th lymphocyte activation markers could indicate a better preserved immunity in LS with respect to OS.

Bloqueo del cordón espermático como tratamiento del dolor crónico testicular / No disponible

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Lidocaína endovenosa como coadyuvante en el tratamiento inicial de la neuralgia postherpética. Bases fisiopatológicas del uso de anestésicos locales en el tratamiento del dolor neuropático / Endovenous lidocaine as co-adjuvant in the initial treatment of post-herpetic neuralgia. Physiopathological basis of the use of local anesthetics for the treatment of neuropathic pain

Introducción:La neuralgia postherpética es el cuadro álgico que permanecetras desaparecer las vesículas del episodio agudodel herpes zóster, habiendo pasado un periodo mínimo detiempo de 8-12 semanas. Hasta un 50% de los pacientescon edad superior a 70 años, lo desarrollará tras el episodio agudo de herpes zóster. Sus bases fisiopatológicas nohan sido aclaradas, por lo que su prevención es difícil y sutratamiento sintomático.Material y métodos:Se estudiaron 100 pacientes incluidos de forma aleatoriaen uno de los grupos diseñados (n = 25): grupo A1, pacientesmenores de 70 años, tratados con gabapentina adosis crecientes; grupo A2, pacientes mayores de 70 años,tratados con gabapentina a dosis crecientes; grupo B1, pacientesmenores de 70 años tratados con gabapentina y lidocaínaendovenosa; grupo B2, pacientes mayores de 70años tratados con gabapentina y lidocaína endovenosa. Seevaluó el dolor referido por el paciente en cuatro momentosa lo largo de las cuatro primeras semanas.Resultados:Se observaron diferencias estadísticamente significativas,p < 0,05, en las medias de EVA referido por los pacientes,presentando una EVA menor los grupos tratadoscon lidocaína endovenosa y pacientes menores de 70 añosen ambos grupos.Conclusiones:El tratamiento de la neuralgia postherpética es un tratamientosintomático. Los anestésicos locales han sido utilizadoscon éxito en algunos tipos de dolor neuropático. Lalidocaína endovenosa puede ser útil como coadyuvante enel periodo inicial del tratamiento de la neuralgia posthetpética,al reducir significativamente la EVA referida por lospacientes. Los pacientes de edad avanzada respondieronpeor al uso de lidocaína, aunque presentaron medias deEVA inferiores a los pacientes a los que no se administró lidocaína

Introduction:Post-herpetic neuralgia is the algic condition that remainswhen the vesicles of an acute episode of herpeszoster have disappeared after a minimum period of 8-12weeks. Up to 50% of patients older than 70 years will developthis condition after an acute episode of herpes zoster.Its physiopathological basis is still unclear, so its preventionis difficult and its treatment is aimed to symptoms.Materials and methods:One hundred patients were randomized to one of thestudy groups (n = 25): group A1, patients 70 years of age treated with gabapentin and endovenouslidocaine; group B2, patients > 70 years of agetreated with gabapentin and endovenous lidocaine. Painreported by the patient was assessed at four time pointsduring the first four weeks.Results:Statistically significant differences were observed (p <0,05) in the mean VAS scores reported by the patients,with a lower VAS score within the groups treated with endovenouslidocaine and in patients < 70 years of age inboth groups.Conclusions:The treatment of post-herpetic neuralgia is aimed tosymptoms. Local anesthetics have been successfully usedfor some types of neuropathic pain. Endovenous lidocainecan be useful as co-adjuvant during the initial treatment ofpost-herpetic neuralgia, since it significantly reduces theVAS score reported by patients. Aged patients had a poorerresponse to the use of lidocaine, as well as lower meanVAS scores, compared to patients that did not received lidocaine

HLA genes in Arabic-speaking Moroccans: close relatedness to Berbers and Iberians.

The gene profile of Arabic-speaking Moroccans has been compared with those of other Mediterranean populations in order to provide additional information about the history of their origins. Our HLA data suggest that most Moroccans are of a Berber (Imazighen) origin and that Arabs who invaded North Africa and Spain in the 7th century A.D. did not substantially contributed to the gene pool; however, they imposed their advanced culture and their religion. Present-day Egyptians are also related to Moroccan Berbers and this supports an ancient Saharan origin for part of the present-day Mediterraneans, particularly for the Arabic-speaking ones (also Algerians) and also for the older substratum of Mediterranean people.

HLA genes in Mexican Mazatecans, the peopling of the Americas and the uniqueness of Amerindians.

The HLA allele frequency distribution of the Mexican Mazatecan Indians (Olmec culture) has been studied and compared with those of other First American Natives and worldwide populations (a total of 12,100 chromosomes; 6,050 individuals from 59 different populations). The main conclusions are: 1) An indirect evidence of Olmec and Mayan relatedness is suggested, further supporting the notion that Olmecs may have been the precursors of Mayans; 2) Language and genetics do not completely correlate in microenvironmental studies; and 3) Peopling of the Americas was probably more complex than postulated by Greenberg and others (three peopling waves). Significant genetic input from outside is not noticed in Meso and South American Amerindians according to the phylogenetic analyses; while all world populations (including Africans, Europeans, Asians, Australians, Polynesians, North American Na-Dene Indians and Eskimos) are genetically related. Meso and South American Amerindians tend to remain isolated in the Neighbor-Joining, correspondence and plane genetic distance analyses.

HLA in the Azores Archipelago: possible presence of Mongoloid genes.

The HLA profile of the Azoreans has been compared with those of other world populations in order to provide additional information regarding the history of their origins. The allele frequencies, genetic distances between populations, correspondence analyses and most frequent haplotypes were calculated. Our results indicate that the Azorean population most likely contains an admixture of high-frequency Caucasoid, Mongoloid and, to a lesser degree, Negroid HLA genes. The middle Atlantic Azores Archipelago was officially colonized by the Portuguese after 1439 and historical records are concordant with the existence of Caucasoid and Negroid population. However, Mongoloid genes were not suspected, but the Oriental HLA haplotypes A24-B44-DR6-DQ1, A29-B21-DR7-DQ2 and A2-B50-DR7-DQ2 are the fourth, fifth and sixth most frequent ones in Azores. A correspondence analysis shows that the Azorean population is equidistant from Asian and European populations and genetic distances are in some cases closer to the Asian than to European ethnic groups, and never are significantly different; also, B*2707 subtype is found in Asians and Azoreans (but not in Europeans) and the same Machado-Joseph Disease founder haplotypes (Chr 14) are found in both Japanese and Azoreans. It is proposed that a Mongoloid population exists in Azores; whether, the arrival occurred prior to discovery is undetermined.

Cyclic expression of HLA class I and II molecules on the surface of purified human spermatozoa and their control by serum inhibin B levels.

HLA class I and class II expression was analyzed weekly by cytofluorometry on spermatozoa samples from four donors during a 15-wk trial. On the same day that semen samples were studied, and to analyze whether this expression was hormone-controlled, serum levels of testosterone, LH, FSH, inhibin B, activin, and pro-alphaC on the one hand, and seminal plasma levels of inhibin B, activin, and alpha-inhibin on the other, were also measured. Inhibin B and related peptides were quantitated using a novel two-site assay with monoclonal antibodies to the alpha and beta subunits of inhibin. Our results showed that HLA class I and class II molecules were expressed on the spermatozoa's surface, following a cyclic pattern, and that there was a simultaneous and coordinated expression of both types of molecules (r = 0.801, P < 0.0001). Furthermore, when the expression of these molecules was plotted against the different hormone levels, serum inhibin B showed a clear inverse correlation with HLA class I (r = -0.612, P < 0.0001) and class II (r = -0.534, P < 0.0001). This finding reveals unexpected functions of inhibin B, which may be relevant in the fertilization process and on male fertility control.

The origin of Cretan populations as determined by characterization of HLA alleles.

The Cretan HLA gene profile has been compared with those of other Mediterranean populations in order to provide additional information regarding the history of their origins. The allele frequencies, genetic distances between populations, relatedness dendrograms and correspondence analyses were calculated. Our results indicate that the Indoeuropean Greeks may be considered as a Mediterranean population of a more recent origin (after 2000 B.C.), while all other studied Mediterraneans (including Cretans) belong to an older substratum which was present in the area since pre-Neolithic times. A significant Turkish gene flow has not been detected in the Greek or Cretan populations, although Greeks and Turks have two high frequency HLA-DRB-DQB haplotypes in common. It is proposed that Imazighen (Caucasoid Berbers living at present in the North African coast and Saharan areas) are the remains of pre-Neolithic Saharan populations which could emigrate northwards between about 8000-6000 B.C., when desert desiccation began. They also could be part of the stock that gave rise to Sumerians, Cretans and Iberians; this is supported by both linguistic and HLA genetic data.

Evolutionary relationships between HLA-B alleles as indicated by an analysis of intron sequences.

The HLA-B locus is the most polymorphic of the class I genes encoded within the human major histocompatibility complex. This polymorphism is mainly located in exons 2 and 3, which code for the molecule's alpha1 and alpha2 domains and includes the antigenic peptide binding site. However, information about adjacent non-coding regions (introns 1 and 2) has not been extensively reported but could be very important in establishing an understanding of the evolutionary mechanisms involved in the polymorphism generation of HLA-B and the Mhc loci. In the present work, introns 1 and 2 of 14 HLA-B alleles are studied and their significance is discussed; 10 have been sequenced in our own laboratory and the other 4 have been previously reported by others. Different serological families share the complete intron 1 sequence; at this region, 12 out of 14 HLA-B alleles could be included in four groups with the same intron 1 sequence: a) B*0702, B*4201, B*4801; b) B*27052, B*4002, B*4011; c) B*40012, B*4101, including B*4501, B*5001 (these latter two alleles have specific characteristics in both introns 1 and 2, which may reflect a common evolutionary pathway); and d) B*44031, B*44032. The other alleles, B*1402, and B*1801, do not have identical intron 1 sequences compared to any of the described groups, but share many similarities with them. The B*1801 evolutionary pathway seems to be very specific since it branches separately from other alleles both in intron 1 and intron 2 dendrograms. On the other hand, HLA-B allelic group distribution and similarities according to intron 1 sequences were not confirmed when using intron 2, especially in the cases of B*4002, B*4101 and B*4801. This would suggest that both point mutations fixed by genetic drift and gene conversion events are involved in HLA-B diversification. The latter events could be supported by the strong homology between intron 1 and, to a lesser extent, intron 2, and also the CG content within them. Finally, the precise knowledge of these non-coding regions could be important for developing DNA base typing strategies for the HLA-B alleles.

C4d DNA sequences of two infrequent human allotypes (C4A13 and C4B12) and the presence of signal sequences enhancing recombination.

The DNA sequences of the polymorphic region (C4d) that belong to the infrequent complement C4 allotypes C4A13 and C4B12 have been obtained. In addition, C4A4 and C4B2 C4d sequences have been completed. C4A13 shows a new combination of amino acids at the following polymorphic positions: Asp1054, Pro1101 Cys1102, Leu1105, Asp1106, Asn1157, Ala1188, and Arg1191. These amino acids conform to the antigenic determinants Chido 1 and Rodgers 3; thus C4A13 is the only allele described thus far that carries both Ags. C4A13 and C4A4 carry the motif "ggctc*" (* means "deletion") at positions 14 to 19 in their intron 28; this motif had previously been reported only in C4B alleles. The C4B12 nucleotide sequence is analogous to C4B1b and C4B3 sequences, except for codon 1076, which is GCC in C4B1b and C4B3 and GGA in C4B12, which is coding for glycine in both cases. A recombination model for the generation of C4 alleles is formulated based on the analysis of these new sequences. One recombination would take place between positions 1157 and 1186 and would give rise to C4A13 and C4B5 or C4A3 (or C4A6) and C4B2; another one would occur between positions 1054 and 1076 and would generate C4A3 (or C4A6) and C4B12 or C4A2 and C4Bnew. Analysis of 1157 to 1186 and 1054 to 1076 fragments reveals the presence of putative sequence signals for recombination (similar to Escherichia coli chi recombination signal); the accumulation of such signals in fragments 1054 to 1076 supports the notion that a recombination hot spot for the C4 gene may exist and it also enhances new allele generation and intraspecies C4 gene homogenization.

Description of two species of nassophorean ("Hypostome") ciliates, Nassulopsis elegans (Ehrenberg, 1833) and Zosterodasys derouxi n.sp., with comments on their systematic and phylogenetic affinities.

Most of the so-called "lower hypostomes", nassophorean ciliates in the most recent classifications of the phylum Ciliophora, have been little studied in modern times (e.g., employing methods of silver impregnation, a technique widely considered indispensable in comparative taxonomic work on these protists today). In this paper, we present descriptions of two species, a new strain of Nassulopsis elegans (Ehr., 1833) and Zosterodasys derouxi n.sp., based primarily on use of the pyridinated silver carbonate method of Fernández-Galiano. From our own data, especially on the oral hypostomial frange of the first organism and the true somatic synhymenium of the second, and review of the relevant literature, we suggest that the phylogenetic affinities of these forms need to be reassessed. We also tentatively propose some changes in the suprafamilial classification of the ciliate groups involved. While recognizing the need for additional information that can be supplied only by future ultrastructural studies and comparative morphogenetic investigations, we briefly offer the following two speculative ideas at this time: (1) that Nassulopsis be removed from the order Synhymeniida and be considered an evolutionarily primitive genus of the "higher" order Nassulida; and (2) that Zosterodasys be considered a "pivotal" primitive nassophorean that may have given rise, phylogenetically, not only to the more evolved groups of its own class (the Nassophorea) but also to the (primitive groups of the) entire neighboring class Phyllopharyngea.