[Third case of human hepatic capillariasis in Mexico]. / Tercer caso de capilariasis hepática humana en México.

A case of hepatic capillariasis in a 54-year-old woman confined to a mental institution is reported. The patient was transferred to the Hospital General de México for terminal care of a breast cancer; she died 12 days after admission. Hepatomegaly was observed clinically and numerous Capillaria hepatica eggs were found at autopsy. The laboratory examinations did not show eosinophilia or other abnormalities. Twenty-six cases of human hepatic capillariasis have been recorded in the world literature. This is the third case reported in Mexico: the previous two in children. Since the patient had a psychiatric condition she may have had aberrant alimentary habits. The features of C hepatica eggs stained with Jone's silver methenamine, which allows the demonstration of an internal multilayered sheath and an external layer endowed with multiple radiated canaliculi, are described in this patient.

Low levels of hepatic cytochrome P-450 in Mexicans with uncomplicated cholelithiasis.

The multienzymatic complex known as cytochrome P-450 represents one of the most important hemoprotein families of the liver. It participates in the metabolism of steroids, fatty acids, prostaglandins and liposoluble vitamins, and also plays a role in the bioactivation of xenobiotic compounds (generates reactive metabolites which produce acute and chronic lesions in liver tissue). This is a report on the low concentrations of total microsomal P-450 (0.093 +/- SD = 0.069 nMoles/mg protein) found in liver biopsies of 19 mexican patients diagnosed as having biliary lithiasis, as compared to an anglosaxon population with the same liver pathology (0.415 +/- 0.105 nMoles/mg protein). These low values are in agreement with the observation of a high incidence in normal mexicans (91.7%) of poor nifedipine metabolizers. Our findings justify an analyses of hepatic RNAm and cDNA of mexican individuals according to ethnic background, diet and environmental contaminants.

Verapamil does not block the spastic response of Praziquantel on the larvae of Taenia pisiformis.

This paper describes that the previous addition of Verapamil does not block the spastic response to Praziquantel (Pz) in larvae of Taenia pisiformis kept in vitro, where opposite results were found in the literature using mammalian tissue. It is possible that Pz stimulates other Ca++ transport channels not sensitive to Verapamil action and promotes Ca++ liberation from calcareous corpuscles stimulating phospholipase C of the tegument surface generating inositol triphosphate. These hypotheses require experimental approaches to define the exact mechanism of action.

Humoral immune response in patients with cerebral parenchymal cysticercosis treated with praziquantel.

The humoral immune response to treatment with praziquantel (PZQ) was studied in eight patients with parenchymal cerebral cysticercosis (CC). In the serum and in the cerebrospinal fluid (CSF) before, during and after the administration of the drug, the following were quantitated (a) levels of specific anticysticercous antibodies measured in optical densities by the ELISA method; (b) levels of IgG, IgM, IgA and IgE; (c) levels of complement fraction C3, C4; (d) presence of immune complexes; (e) total number of white blood cells in the CSF. It was found that after treatment with PZQ, the level of specific anticysticercous antibodies and the level of IgG rose significantly in the CSF but not in the blood. The levels of the fractions of the complement and the immunoglobulins IgM, IgA and IgE did not change significantly either in the serum or in the CSF. The blood-brain barrier was found ruptured in three patients before therapy and in five patients after the therapy as measured by the albumin index. Nevertheless, the IgG index showed that there was local production of IgG in five patients before treatment and in seven after the end of it. The relative specific antibody index was greater than 1.0 in five patients before therapy and in seven after therapy. This data strongly supports the idea that the specific antibodies are produced intrathecally and are not derived from the serum pool through a ruptured blood-brain barrier. It was concluded that patients with parenchymal CC have an elevation of specific anticysticercous probably due to a combination of a ruptured blood-brain barrier and intrathecal synthesis. The relatively small rupture of the blood-brain barrier and the high IgG and relative specific antibody index suggest that intrathecal synthesis is the most important mechanism. The humoral immune response may be of importance not only in the elimination of the parasite but also in the genesis of the illness.

Anticysticercous antibodies in serum and cerebrospinal fluid in patients with cerebral cysticercosis.

Fifty-one cases of cerebral cysticercosis proved by surgery or CT scanning were studied prospectively with the ELISA test in order to detect anticysticercous antibodies in blood and CSF. The ELISA test was also performed for detection of antibodies in 20 control patients who had CSF withdrawn during a myelogram and in 119 serum samples of asymptomatic subjects. We found an overall sensitivity of the ELISA test in the blood of 87% with a specificity of 90%. In the CSF we found a sensitivity of 87% with a specificity of 100%. However, when we compared patients with cerebral cysticercosis of a benign type with patients with cerebral cysticercosis of a malignant type we found a serum sensitivity of 75% for the benign group as compared to 93% of the malignant group. The CSF sensitivity was 80% in the benign group and 93% in the malignant group. This difference was statistically significant.

Presencia de esterasas y peptidasas en el tegumento intacto de vesiculas de Cysticercus cellulosae. / Presence of esterases and peptidases in the intact tegument of vesicles of Cysticercus cellulosae

En este informe se describe el comportamiento de seis hidrolasas relacionadas con el tegumento intacto de las vesiculas de C. cellulosae analizadas por espectrofotometria utilizando equipos comerciales que liberan grupos cromogenos a 405 nm. Las actividades guardan relacion lineal con el numero de vesiculas y el tiempo de exposicion. Los valores representan la actividad relativa comparada con el suero humano normal, y corresponden a la de una vesicula. La acetilcolinesterasa (1,800 U/I) es de 10 a 20 veces mas activa que la seudocolinesterasa (0.5 U/ml); la fosfatasa acida representa la enzima de mayor actividad (30 mU/ml), mientras que la fosfatasa alcalina (2.5 U/1) la gamma - glutamil transferasas (3.0 U/1) y la leucilamino-peptidasa (3.5 U/1) muestra los niveles mas bajos

Presencia de colinesterasas en la membrana de las vesiculas de Cysticercus cellulosae. / Presence of cholinesterases in the vesicle membrane of Cysticercus cellulosae

En este estudio se demostro que Cysticercus cellulosae contiene seudocolineterasas y acetilcolinesterasa. Los sitios de localizacion de estas enzimas son las partes externa e interna del tegumento de la vesicula. El cisticerco completo muestra niveles menores de enzima en relacion con la cantidad obtenida en membrana. Los niveles obtenidos de acetilcolinesterasa son mayores que los de seudocolinesterasas. El escolex contiene acetilcolinesterasa en cantidades detectables, pero los niveles registrados de seudocolinesterasas son tan bajos que podrian corresponder a restos de celulas del tegumento que circundan el escolex. De lo anterior se derivan las bases establecidas para el tratamiento de la cistecercosis con substancias anticolinesterasicas, como lo es el metrifonato

Experimental treatment of cysticercosis with metrifonate.

Thirty cysticercous patients were treated with metrifonate in doses of 7.5 mg/kg given for five consecutive days, with intervals of two weeks until completion of six series. The symptoms originated by drug reaction were mild and transitory. The results obtained after treatment demonstrated the effectivity in cerebral ocular and musculocutaneous cysticercosis, corroborated by clinical evaluations like: neurological, ophtalmological and psychiatric examinations; routine laboratory tests; special examinations like indirect immunofluorescence and hemagglutination, immunoglobulin quantitation and cholinesterase activity and by special cabinet studies like electroencephalogram, retinal fluorangiography, axial computerized tomography. The postreatment observation time varied from six months to nine years; in no case reactivation was observed.

Tratamiento experimental con metrifonato en la cisticercosis. / Experimental treatment of cysticercosis with metrifonate

A 30 pacientes cisticercosos se les administro metrifonato a la dosis de 7,5 mg/kg de peso durante cinco dias consecutivos. Se repitio el tratamiento despues de dos semanas hasta completar un numero de seis series. La sintomatologia indeseable del medicamento fue transitoria en los casos que la presentaron, y cedio al terminar la serie. Los resultados obtenidos demostraron que el medicamento fue eficaz en la cisticercosis cerebral, ocular y musculocutanea, lo que se corroboro por evaluaciones clinicas como examenes neurologicos, oftalmologicos y psiquiatricos, examenes de laboratorio, examenes sistematicos y pruebas especiales como inmunofluorescencia y hemaglutinacion indirecta, cuantificacion de inmunoglobulinas y actividad enzimatica de colinesterasa, y por estudios especiales de gabinete que incluyeron electroencefalograma, fluoroangiografia retiniano y tomografia axial computarizada. El tiempo de observacion postratamiento vario entre seis meses y nueve anos,sin que en ningun caso se presentara reactivacion de la sintomatologia

Indirect immunofluorescense reaction in cysticercosis.

The indirect immunofluorescence reaction (IIR) was used to investigate cysticercosis in the serum of 604 subjects; control group I, with 100 subjects gave the following results: 2 per cent positive, 3 per cent weak positive and 95 per cent negative. Group II had 35 cases of cysticercosis, showing 94.28 per cent positive, 5.71 per cent weak positive and 0 per cent negative. In group III, with 100 patients, other diseases were studied showing 5 per cent positive, 7 per cent weak positive and 88 per cent negative. Group IV, with 364 cases with possible cysticercosis, showed 48.90 per cent positive, 10.98 per cent weak positive and 40.10 per cent negative. In group V, five cases of Taenia saginata parasitosis were studied showing a weak positive reading.