Diagnóstico mediante imagen multimodal en síndrome paquicoroideo peripapilar: a propósito de un caso / Diagnosis by multimodal imaging in peripapillary pachychoroid syndrome: A case report

Se presenta el caso de un varón de 73 años con el recientemente descrito síndrome paquicoroideo peripapilar. Este síndrome se incluye dentro de las enfermedades paquicoroideas, que constituyen una entidad relativamente novedosa caracterizada por un aumento del grosor coroideo con atenuación de la capa coriocapilar situada por encima de vasos coroideos dilatados. Asocia mal funcionamiento progresivo del epitelio pigmentario retiniano junto con neovascularización. Se presenta el caso con imagen multimodal, en la que algunas pruebas muestran signos no descritos previamente. Además, se describe la evolución asimétrica de ambos ojos tras múltiples tratamientos, ya que el ojo izquierdo presenta una afectación muy severa y refractaria al tratamiento

The case is reported of a 73-year-old male presenting with the recently described peripapillary pachychoroid syndrome. This syndrome is included in the pachychoroid diseases, which is a relatively new condition characterised by increased choroidal thickness with attenuation of the choriocapillary layer located above dilated choroidal vessels. It is associated with progressive malfunction of the retinal pigment epithelium and neovascularisation. The case is presented with a multimodal image, in which some tests show signs not previously described. In addition, a description is presented of the asymmetric outcome of both eyes after multiple treatments, since the left eye has a very severe affectation, and is refractory to the treatment

Diagnosis by multimodal imaging in peripapillary pachychoroid syndrome: A case report. / Diagnóstico mediante imagen multimodal en síndrome paquicoroideo peripapilar: a propósito de un caso.

The case is reported of a 73-year-old male presenting with the recently described peripapillary pachychoroid syndrome. This syndrome is included in the pachychoroid diseases, which is a relatively new condition characterised by increased choroidal thickness with attenuation of the choriocapillary layer located above dilated choroidal vessels. It is associated with progressive malfunction of the retinal pigment epithelium and neovascularisation. The case is presented with a multimodal image, in which some tests show signs not previously described. In addition, a description is presented of the asymmetric outcome of both eyes after multiple treatments, since the left eye has a very severe affectation, and is refractory to the treatment.

Feasibility study on the use of soil washing to remediate the As-Hg contamination at an ancient mining and metallurgy area.

Soils in abandoned mining sites generally present high concentrations of trace elements, such as As and Hg. Here we assessed the feasibility of washing procedures to physically separate these toxic elements from soils affected by a considerable amount of mining and metallurgical waste ("La Soterraña", Asturias, NW Spain). After exhaustive soil sampling and subsequent particle-size separation via wet sieving, chemical and mineralogical analysis revealed that the finer fractions held very high concentrations of As (up to 32,500 ppm) and Hg (up to 1600 ppm). These elements were both associated mainly with Fe/Mn oxides and hydroxides. Textural and geochemical data were correlated with the geological substrate by means of a multivariate statistical analysis. In addition, the Hg liberation size (below 200 µm) was determined to be main factor conditioning the selection of suitable soil washing strategies. These studies were finally complemented with a specific-gravity study performed with a C800 Mozley separator together with a grindability test, both novel approaches in soil washing feasibility studies. The results highlighted the difficulties in treating "La Soterraña" soils. These difficulties are attributed to the presence of contaminants embedded in the soil and spoil heap aggregates, caused by the meteorization of gangue and ore minerals. As a result of these two characteristics, high concentrations of the contaminants accumulate in all grain-size fractions. Therefore, the soil washing approach proposed here includes the grinding of particles above 125 µm.

[First experiences with a miniaturized heart-lung-machine]. / First experiences with a miniaturized heart-lung-machine.

Conventional heart-lung-machines (HLM) used for many cardiosurgical procedures lead to an impaired function of nearly all organs. This deleterious effect may be reduced by miniaturized HLMs. Therefore we report on our first experiences in 9 patients (4 women, 5 men) undergoing beating heart coronary artery bypass grafting from 10/01 to 04/02 in our department employing a miniaturized HLM with the Deltastream extracorporeal rotary blood pump. Eight patients had an uneventful postoperative course, one patient died on the first postoperative day. Using this miniaturized HLM beating heart coronary artery bypass grafting was successful in all patients. Further studies are necessary to support these results.

[Lumbar plexopathy secondary to pelvic hydatid cyst]. / Plexopatía lumbar secundaria a quiste hidatídico pélvico.

INTRODUCTION: Hydatidosis is a zoonosis caused by larvae of the hydatid tapeworm Echinococcus granulosus, which usually affects the liver, lung, myocardium, brain and bones. On rare occasions hydatid cysts give rise to peripheral neurological manifestations. CASE REPORT: Male, aged 72, who had received a pacemaker as a consequence of a complete auriculoventricular block. During implantation, one hepatic and two pelvic hydatid cysts were discovered. Consulted doctor about right inguinal pain, which irradiated to the lumbar region and along the inner and posterior sides of the thigh, down to the ankle. Exploration revealed a lump in the right iliac fossa and in the lower right limb, hypaesthesia in the anterior side of the thigh, paresis on bending the hip and on extension of the knee, and patellar areflexia. Computerised axial tomography revealed growth of the pelvic cysts and compression of the gluteal veins. Electromyographic exploration of the right quadriceps showed denervation and reinnervation activity. CONCLUSION: Of all cases of abdominal hydatidosis, 6.7% presented extra hepatic affectation and only 0.7% were seen to have pelvic hydatid cysts. These usually give rise to disorders due to local compression of the genital organs, the urinary tracts, and vascular and bony structures. Lesions in the lumbosacral plexus, however, have only been reported on very few occasions

The defect in the metabolism of erythritol of the Brucella abortus B19 vaccine strain is unrelated with its attenuated virulence in mice.

The role of the defect in erythritol catabolism in the attenuated virulence of Brucella abortus B19 vaccine strain in mice was investigated by means of five different strains: (i) the erythritol sensitive B19 vaccine strain; (ii) a natural erythritol tolerant (NET) mutant obtained spontaneously from B19; (iii) an erythritol resistant derivative from B19 (FJS19) obtained by gene replacement of the deleted ery region; (iv) the erythritol resistant B. abortus 2308 reference virulent strain; and (v) an erythritol sensitive mutant (227 strain) obtained from strain 2308 by transposon insertion in the chromosomal ery region. Besides virulence for mice, erythritol oxidation as well as other phenotypic markers were tested in all the strains. The 2308 and FJS19 strains grew in the presence of erythritol and oxidized the sugar, whereas the B19 and 227 strains did not. The NET strain grew in presence of erythritol but was unable to oxidize it. The B19 vaccine strain and its two erythritol resistant derivatives, NET and FJS19, showed similar residual virulence and splenic time courses in mice. Moreover, the virulent strain 2308 and its erythritol sensitive derivative (227 strain) exhibited similar levels of splenic infection. Altogether, these results demonstrate that the genetic region implicated in erythritol catabolism is not related to the low virulence exhibited by B19 in mice.

[Adrenocortical tumors in children]. / Tumores adrenocorticales en niños.

Adrenocortical tumors are uncommon in childhood. The incidence of these tumors is about 0.3-0.4% of all the solid tumors in childhood. Because of its low incidence, there are no established protocols or uniform histological classification. Most of these endocrine tumors are hormone producing, causing virilization, Cushing's syndrome, feminization, hiperaldosteronism or hipoglicemy. Only a few of these do not produce hormones. The treatment is always surgical. The efficacy of another treatments (chemotherapy or radiotherapy) has not been demonstrated in infancy. It prognosis depends on the age and the resectability.

[Early or late orchidopexy? An evaluation of germ cell proliferation by PCNA immune expression]. / Orquidopexia precoz o tardía? Valoración de la proliferación de las células germinales mediante inmunoexpresión de PCNA.

A immunocytochemical study for detection of proliferating cell nuclear antigen (PCNA) in order to quantify the number of PCNA-positive spermatogonia, and cytophotometric determination of spermatogonial DNA were performed in cryptorchid and control testes. The number of PCNA-positive spermatogonia, and the average DNA content of spermatogonia in the cryptorchid testes were altered from first years of age. These precocious spermatogonial alterations suggest that the early surgical testicular descent doesn't prevent lesions of germ cells.

Analysis and genetic manipulation of Shigella virulence determinants for vaccine development.

Shigellosis is a major public health problem in developing countries. Current epidemics of Shigella dysenteriae serotype 1 strains are particularly serious and are characterized by high mortality rates. A high proportion of the isolates are resistant to many of the antibiotics currently in use in these countries, a feature which seriously compromises clinical treatment of the infections. Efficacious vaccines are thus urgently needed. Basic studies on Shigella virulence factors, infections in laboratory models, and host responses has led to the development of several strategies for the production of vaccines. All of these are live oral vaccines involving bacteria capable of at least limited survival in the animal intestine and of carrying selected antigens to the mucosal immune system. One type of vaccine involves non-pathogenic shigellae, attenuated either by introduction of a requirement for aromatic amino acids (aroD) or by loss of the large plasmid that specifies bacterial invasion of the mucosal epithelium. S. dysenteriae 1 strains under development as vaccines need to be engineered to eliminate high level Shiga toxin production, and a rapid and effective method to achieve this was recently elaborated. The second type of vaccine is represented by hybrid strains consisting of a carrier organism, such as an attenuated Salmonella or an Escherichia coli K-12 strain carrying the Shigella invasion plasmid, and the selected foreign antigen that it produces, in all cases so far the Shigella O antigen polysaccharide.

Broad-host range expression vectors containing manipulated meta-cleavage pathway regulatory elements of the TOL plasmid.

The construction of pERD20 and pERD21, two broad-host range expression vectors, is described. The vectors contain the Pm promoter of the meta-cleavage pathway operon of the TOL plasmid pWWO; this promoter is present within a polylinker which provides a number of downstream cloning sites close to the transcription initiation site. Transcription from the Pm promoter in these vectors is controlled not by the natural positive regulator of Pm, the Xy1S protein, but by an Xy1S mutant analogue, Xy1S2tr6, which inhibits an altered effector specificity and can mediate a 3-8-fold higher level of transcription than can Xy1S in a wide range of temperatures. Controlled expression of cloned genes can be achieved in a broad spectrum of Gram negative bacteria grown at a wide range of temperatures.

Biological activities specified by antibiotic resistance plasmids.

Bacteria can display resistance to a wide spectrum of noxious agents and environmental conditions, and these properties are often mediated by genes located on extrachromosomal DNA elements called plasmids. Replication, vertical and horizontal transmission and evolution of these elements are discussed, and examples of the genes responsible for the resistance phenotypes are given. Selective forces that drive the evolution of new combinations of bacterial properties of particular importance in clinical situations are analysed.

Purification of alpha-hemolysin from an overproducing E. coli strain.

The genetic determinant of the alpha-hemolysin encoded by plasmid pHly152 has been cloned in both orientations in plasmid pBR322 giving rise to plasmids pSU157 and pSU158. E. coli strains carrying either of these recombinant Hly plasmids produced about 20 times more hemolysin activity than the parental plasmid pHly152, when grown in minimal medium supplemented with hemoglobin. Thus high hemolytic activity is not lethal to the cells, contrary to previous assumptions. alpha-Hemolysin was purified from culture supernatants of strain SU100 (pSU157) by ammonium sulfate precipitation and gel filtration in Sephacryl S-200 in the presence of 6 M urea. When purified alpha-hemolysin preparations were subjected to electrophoretic analysis in denaturing conditions, a single 107 kdal polypeptide was observed. This probably corresponds to the alpha-hemolysin protein, since an isogenic E. coli strain carrying plasmid pSU161, an Hly- mutant derivative of pSU157, did not synthesize the 107 kdal polypeptide.