Factor tisular en células mononucleares y resistencia a la proteína C en pacientes con preeclampsia / Tissue factor in mononuclear cells and resistance to protein C among patients with pre-eclampsia

Hay evidencia de la presencia de alteraciones en la coagulación que pueden agravar el estado de preeclampsia. Por una parte se ha involucrado a las células mononucleares y por tanto a la generación de factor tisular y por otra a la resistencia a la proteína C como mecanismos en la etiopatogenia de problemas trombóticos. El objetivo del presente trabajo fue evaluar estos factores en una muestra de 20 mujeres embarazadas con preeclampsia y 20 mujeres embarazadas sanas. Estadísticamente no se encontraron diferencias con relacion a uno y otro grupo, con la salvedad de 2 mujeres del grupo con preeclampsia que mostraron resistencia a la proteína C. (AU)

Effects of concanavalin A on protein-C activity.

Concanavalin A interacts specifically with the oligosaccharides from protein-C and modifies its anticoagulant activity. The lectin activates the protein-C activity in a dose dependent manner as demonstrated by in vitro and in vivo assays. Concanavalin A at low concentration (0.1 to 2 microg/mL) induces an increase on the catalytic activity of protein-C; at higher concentrations (5 to 20 microg/mL), the catalytic activity returns to the baseline. The effect of concanavalin A was prevented by incubating the protein-C with alpha-methyl-mannoside or by treating the purified protein-C with alpha-mannosidase; furthermore, cleavage of mannosidic residues diminishes its catalytic activity. Our results indicate that the oligomannosidic portion of protein-C participates in the regulation of the catalytic activity of this protein.

La tuberculosis en el año 2000 / Tuberculosis in 2000

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[Lymphangioleiomyomatosis and tuberous sclerosis: a casual association or a causative one?]. / Linfangioleiomiomatosis y esclerosis tuberosa: una asociación casual o causal?

Lymphangioleiomyomatosis (LAM) is a rare lung disease that mainly affects women of childbearing age. Pulmonary disease that is indistinguishable from LAM appears in 1% of patients with tuberous sclerosis (TS). At present we can not say whether we are looking at an association of two rare diseases or at a single disease with different clinical profiles. To date, open lung biopsy has been required for definitive diagnosis. We report the case of a women with TS and LAM in whom a diagnosis of pulmonary involvement was based on clinical signs and high resolution computerized tomography of the chest.

[Bronchoesophageal fistula and broncholithiasis]. / Fístula broncoesofágica y broncolitiasis.

Bronchoesophageal fistulas (BEF) in an adult, whether acquired or congenital, are uncommon but bronchoesophageal perforation secondary to broncholithiasis caused by calcified mediastinal adenopathy and leading to the formation of a fistulous tract is extremely rare. We present a case of acquired BEF in a 57-years-old women who presented cough with expectoration of broncholiths, hemoptysis and cough after swallowing liquid or solid hemoptysis and cough after swallowing liquid or solid foods. The chest film and computed tomographic scan showed calcified mediastinal adenopathy. Endoscopic examination of the esophagus revealed no mucosal abnormality. A bronchial esophageal fistula was identified at the level of the 1/3 midesophagus just below the carina in the esophagogram. The bronchoscopy showed a polypoid area located in the medial side of the right main bronchus. There was no evidence of neoplasm. The patient underwent excision of fistula and interposition of pleural bundle after completing a right posterolateral thoracotomy. The postoperative course was uneventful and the patient has been doing well on follow-up.

A case of dirhythmic breathing.

We describe a case of dirhythmic breathing in a 60-year-old man after neurosurgery. A large hemangioblastoma was removed from the cerebellum at the level of the fourth ventricle. The spirometric tracings showed two types of respiratory cycles: the rhythm. A was stable with a short inspiratory time; sometimes a second type of respiratory cycle, B, was present or erratically coupled with the A rhythm. It had very small tidal volume and mean inspiratory flow with phasic variations similar to those observed in Cheyne-Stokes breathing pattern.

[2 cases of bilateral diaphragmatic paralysis]. / Dos casos de parálisis diafragmática bilateral.

Bilateral diaphragmatic paralysis is characterized by severe dyspnea in decubitus, with or without known respiratory or cardiac disorders. In both patients clinical diagnosis was confirmed by measuring the transdiaphragmatic pressure which was approximately zero. The first patient, previous to the clinical onset, had an episode of gastroenteritis and later developed a pneumonia; in the second patient, clinical manifestations started after neck surgery and both the clinical and functional disorders recovered within the following eight months.