[Extra-facial Lever granuloma on a herpes zoster scar: Wolf's isotopic response]. / Granulome de Lever extra-facial sur cicatrice de zona : une réaction isotopique de Wolf.

BACKGROUND: Granuloma faciale (GF), or facial granuloma of Lever, is an uncommon dermatosis occurring classically on the face. We report a case of a GF on zoster scars located on the trunk, which is a highly particular isotopic response. PATIENTS AND METHODS: A 60-year-old man with a sole history of left lumbar zoster presented with a skin lesion present for two months. Clinical examination revealed a 2.5-cm papular erythematous lesion that was both infiltrated and pruritic. This lesion was situated precisely on zoster scars. Lab tests revealed no abnormalities. Histopathologic examination showed an inflammatory process without neovessels but rich in eosinophils with chronic vasculitis and polymorphic infiltrate, on which basis GF was diagnosed. DISCUSSION: GF is a localized form of cutaneous small-vessel vasculitis. Although it usually affects the face, extra-facial locations also exist. The original character of this presentation, aside from the location, is the occurrence of this GF on a zoster scar, which corresponds to Wolf's isotopic response. This phenomenon, described by R. Wolf, comprises the occurrence of a new skin disorder at the site of another unrelated and already healed skin disease, usually herpes. The physiopathology is still unclear. This differs from isomorphic reactions such as Koebner's reaction, which consists of the appearance at an injury site of skin lesions typical of an existing dermatosis but not a new disorder. CONCLUSION: This is a rare case of Wolf's isotopic response with GF, of which, to our knowledge, there are no reports in the literature.

[Fibroepithelial polyp of the vagina. Report of a case]. / Polipo fibroepitelial de la vagina. Informe de un caso.

Fibro epithelial polyp of the vagina is a rare lesion. Although benign, it can be confused with Sarcoma botryoides, rhabdomyosarcoma and mixed mesodermal tumor because of its bizarre histology. A case is reported of a women 27 years old with a great pedunculated polyp of the vagina which measured 8 x 12 cm. The microscopy examination revealed fibro epithelial polyp of the vagina. Treatment is simple local excision. Recurrence is uncommon.

[Para-tubal cysts: frequency and clinical, ultrasonographic and histological correlations]. / Quistes paratubarios: Frecuencia y correlación clínica, ultrasonográfica e histológica.

We Reviewed 5,100 biopsies, between November 1994 to November 1995 We found 100 paratubval cysts. The 80% of the cases were surgical findings. The 40% of the cases had pain. The 3% of the patients had acute pain, that made necessary an urgent surgery. The ultrasonogram revealed an ovarian cyst in 38% of the cases and it couldn't detect them in 63% of the cases. The cysts sizes were: 6 cm. (84%) *12% 9 between 6-12 cm. and 43% between 12-18 cm. The histopathology report was: 57% of serous cyst and 43% simple cyst.

[Obesity as a risk factor in surgery for urinary incontinence]. / La obesidad como factor de riesgo en la cirugía anti-incontinencia.

There is controversy in the literature related with the prognosis of incontinent obese patient. The objective of this study was to demonstrate if obesity has influence on the relapse of postsurgical incontinence in genuine urinary incontinence. 148 patients were included measuring their Body Mass Index and divided in two groups: Group "A" 74 patients without relapse and Group "B" 74 patients with relapse. The results showed in the obese patients the double of surgical failures than in those with our it (P < 0.05). In conclusion obesity is a adverse prognostic factor in the postsurgical evolution in these patients.

[Stress urinary incontinence. A comparison of of 4 methods of cystourethropexy. A 2-year follow-up]. / Incontinencia urinaria de esfuerzo. Comparación de cuatro métodos de cistouretropexia. Seguimiento a dos años.

All successful operations for relief of genuine stress urinary incontinence (SUI) have three objectives: elevation and retropubic maintenance during stress of the urethrovesical junction. The present study was realized at the Urogynecologic Service of the "Luis Castelazo Ayala" hospital IMSS to evaluate the results in a two years follow up of 597 patients that suffered from SUI treated by retropubic urethropexy, from February 1984 to May 1991. Patients were studied according to the service norms, previously published. We realized four types of procedures: Pereyra (379 cases), Burch (90 cases), Marchall-Marchetti-Kratz (60 cases) and Powell surgery (68 cases). Vaginal approach was realized in cases of pelvigenital statics disturbances like cysto- or rectocele; and abdominal approach was indicated in patients with enlarged uterus or pelvic masses. The complications rate was 15.3%. Success rate was 87.06% for all procedures and not statistic significance was found (p > or = 0.1 and X2 = 6.15), the best rate to the Burch and Pereyra procedures. We conclude the most important tip to successful rate in SUI surgery is correct choice of the procedure according to the patient.

[An epidemiological study of 1000 sterile couples]. / Estudio epidemiológico en mil parejas estériles.

Our purpose was to study the characteristics of our infertile population, to evaluate prognostic fertility parameters and to know our pregnancy rates. One thousand infertile couples were studied under a protocol by factors. We found the highest alteration in the ovarian factor (35%), followed by the tuboperitoneal factor (28%) and male factor (26%). The woman's age, the duration of infertility and multifactorial infertility (17.6%), were of prognostic importance. Our pregnancy rate of 61.4% compares with the reported in the literature. We believe that establishing an infertility protocol with a multidisciplinary approach, helps to a more precise diagnosis and more specific treatments with better results.

Multiple conformations of deoxyribonuclease A. Their separation at alkaline pH and low ionic strength in the presence of Ca2+.

Gel filtration on Sephadex G-100 at pH 9.0 in 1 mM Tris buffer produces denaturation and inactivation of pancreatic DNAase A. Limiting concentrations of Ca2+ in the suspension and elution buffer, reactivates some of the enzyme molecules in an amount proportional to the calcium added. Stable active and inactive forms were separated on Sephadex columns. A model for the conformational role of Ca2+ on DNAase A demonstrates that at least one Ca2+ is involved (Kapp = 8.3 . 10(-5) M) in the correct folding of the polypeptide chain. Na+ was unable to reactivate the enzyme.

The role of Ca2+ on pH-induced hydrodynamic changes of bovine pancreatic deoxyribonuclease A.

DNase A studied by gel filtration on Sephadex G-100 at pH 7.4 in 40 mM Tris-HCl buffer, behaves hydrodynamically as a spherical monomeric macromolecule of around 31,000 molecular weight, with a Stokes radius = 24.7 A, f/fo = 1.19, and D20,W = 8.69. Similar results were obtained by analytical dialysis using zinc chloride-modified cellophane membranes. The elution volume of DNase A decreases as the pH increases between pH 4.7 and pH 9.5. This effect has been attributed to a change in the tridimensional structure of the protein and interpreted as a modification in the axial ratio due to unfolding of the polypeptide chain with increase in the apparent Stokes radius. The addition of Ca2+ produce reversion of the pH-induced changes at pH 9.5. The transition occurs when Ca2+ binds to at least two binding sites (n = 1.66 in a Hill plot) with a Kd = 8.9 X 10(-5) M and the effect appears to be cooperative. These findings support the hypothesis that Ca2+-binding to DNase A causes a conformational change that maintains a more active structure of the enzyme, especially when the pH-induced unfolding reduces its activity.

A study of the binding of Mn2+ to bovine pancreatic deoxyribonuclease I and to deoxyribonucleic acid by electron paramagnetic resonance.

EPR studies of Mn2+ binding to bovine pancreatic deoxyribonuclease I show that the enzyme can bind three Mn2+ ions at pH 7.5 and 2 degrees. Two sites bind Mn2+ strongly, with a Kd of 10(-4)M, and the third binds Mn2+ weakly, with a Kd of 10(-3)M. Ca2+ competes with the two strong sites, whereas Mg2+ competes only with one of them, indicating that both sites are not equivalent. Mn2+ binding to DNA has been confirmed by EPR measurements. Two types of sites, with different affinities for Mn2+ binding, were found on DNA molecules, one with a Kd of 1.2 times 10(-4)M and the other with a Kd of 10(-3)M. Mg2+ ions can displace Mn2+ from the high affinity sites, but not from the low affinity sites. These results suggest the Mn2+ binds not only to the phosphate groups, but also to the electron donor groups of the base rings.