Estrous cycle phase and gonadal hormones influence conditioned fear extinction.

Gonadal hormones modulate fear acquisition, but less is known about the influence of gonadal hormones on fear extinction. We assessed sex differences and the influence of gonadal hormone fluctuations and exogenous manipulations of estrogen and progesterone on acquisition, extinction learning and extinction recall in a 3 day auditory fear conditioning and extinction protocol. Experiments were conducted on males and naturally cycling female rats. Regarding female rats, significant differences in fear extinction were observed between subgroups of females, depending on their phase of the estrous cycle. Extinction that took place during the proestrus (high estrogen/progesterone) phase was more fully consolidated, as evidenced by low freezing during a recall test. This suggests that estrogen and/or progesterone facilitate extinction. In support of this, injection of both estrogen and progesterone prior to extinction learning in female rats during the metestrus phase of the cycle (low estrogen/progesterone) facilitated extinction consolidation, and blockade of estrogen and progesterone receptors during the proestrus phase impaired extinction consolidation. When comparing male to female rats without consideration of the estrous cycle phase, no significant sex differences were observed. When accounting for cycle phase in females, sex differences were observed only during extinction recall. Female rats that underwent extinction during the metestrus phase showed significantly higher freezing during the recall test relative to males. Collectively, these data suggest that gonadal hormones influence extinction behavior possibly by influencing the function of brain regions involved in the consolidation of fear extinction. Moreover, the elevated fear observed in female relative to male rats during extinction recall suggests that gonadal hormones may in part play a role in the higher prevalence of anxiety disorders in women.

Intensity of FDG uptake is not everything: synchronous liposarcoma and fibrous dysplasia in the same patient on FDG PET-CT imaging.

A growing number of studies have demonstrated the usefulness of FDG PET-CT in the preoperative assessment of soft tissue sarcomas. We report a case of a patient with a known low-grade liposarcoma demonstrating only mild hypermetabolism on a FDG PET-CT study. An incidental osseous lesion was found in the distal tibia of the same extremity during the initial workup. This tibial lesion was significantly more intense on the FDG PET-CT study than the primary sarcoma. Further investigation showed this to be an unexpected benign fibrous dysplasia. We present this case as an example of the discrepancy of FDG activity, which may exist between truly malignant and benign lesions that may arise from soft tissue and osseous structures. A benign process should remain in the differential diagnosis for hypermetabolic lesions when evaluating a case of known malignancy, especially when the degree of uptake of that lesion differs significantly from that of the primary lesion.

Helicobacter pylori vacA s1a and s1b alleles from clinical isolates from different regions of Chile show a distinct geographic distribution.

AIM: To establish the most common vacA alleles in Helicobacter pylori (H pylori) strains isolated from Chilean patients and its relationship with gastritis and gastroduodenal ulcers. METHODS: Two hundred and forty five H pylori clinical isolates were obtained from 79 biopsies from Chilean infected patients suffering from gastrointestinal diseases. An average of 2-3 strains per patient was isolated and the vacA genotype was analyzed by PCR and 3% agarose electrophoresis. Some genotypes were checked by DNA sequencing. RESULTS: The most prevalent vacA genotype in Chilean patients was s1b m1 (76%), followed by s1a m1 (21%). In contrast, the s2 m2 genotype was scarcely represented (3%). The s1b m1 genotype was found most frequently linked to gastropathies (P<0.05) rather than ulcers. Ulcers were found more commonly in male and older patients. Curiously, patients living in cities located North and far South of Santiago, the capital and largest Chilean city, carried almost exclusively strains with the s1b m1 genotype. In contrast, patients from Santiago and cities located South of Santiago carried strains with either one or both s1a m1 and s1b m1 genotypes. Regarding the s2 m2 genotype, comparison with GenBank sequences revealed that Chilean s2 sequence was identical to those of Australian, American, and Colombian strains but quite different from those of Alaska and India. CONCLUSION: Differences in geographic distribution of the s and m vacA alleles in Chile and a relationship of s1b m1 genotype with gastritis were found. Sequence data in part support a hispanic origin for the vacA genotype. Asymmetric distribution of genotypes s1b m1 and s2 m2 recedes H Pylori strain distribution in Spain and Portugal.

[Characterization of a group of patients with cryptococcosis of the central nervous system]. / Caracterizacion de un grupo de pacientes con criptococosis del sistema nervioso central.

INTRODUCTION: Incidence of cryptococcosis of the central nervous system has risen sharply since AIDS became pandemic; from early 1998, the Instituto de Neurología y Neurocirugía in Havana has beaten its own record in the number of cases attended. AIM: To describe the clinical epidemiological characteristics of patients with this disease who were hospitalised in this centre between 1991 and 2000. PATIENTS AND METHODS: We present a descriptive study of 16 adult individuals who were admitted for this reason. Data on variables related with aspects concerning their epidemiology, clinical features, treatment and evolution were collected from a review of the clinical records and a survey conducted by post. RESULTS: It was found that in no cases did the disease appear as an epidemic outbreak, in 75% of the patients there was some kind of link with pigeons, none of the patients were HIV positive, and 50% displayed other causes of immunosuppression. Clinical behaviour varied and forms of meningitis and meningoencephalitis were prevalent; 37.5% of the patients displayed mild forms of the disease and 62.5% had more serious forms. The initial symptom in most cases was headache. The most constant CSF pattern was a raised protein level in the cerebrospinal fluid with scarce cellularity. 87.5% of the patients were cured of the disease by treatment involving amphotericin B, in some cases associated with fluconazole. Death and the presence of post treatment sequelae were observed in patients with serious clinical forms and late diagnoses

Caracterización de un grupo de pacientes con criptococosis del sistema nervioso central / Characterization of a group of patients with cryptococcosis of the central nervous system

Introducción. La criptococosis del sistema nervioso central ha tenido un alza vertiginosa a partir de la pandemia del sida; en el Instituto de Neurología y Neurocirugía de la Habana se han recibido, desde principios de 1998, un número de casos superior a su registro histórico. Objetivo. Describir las características clinicoepidemiológicas de los pacientes hospitalizados con esta enfermedad en este centro entre 1991 y el 2000. Pacientes y métodos. Se realizó un estudio descriptivo de los 16 individuos adultos que se ingresaron por esta causa, y se recogieron variables relacionadas con aspectos epidemiológicos, clínicos, del tratamiento y su evolución, a partir de la revisión de las historias clínicas y una encuesta aplicada por correo postal. Resultados. La enfermedad no se presentó en ningún caso en forma de brote epidémico, en el 75 por ciento de los pacientes se encontró alguna relación con palomas, ningún enfermo fue positivo al VIH, y se demostraron en el 50 por ciento otras causas de inmunosupresión. El comportamiento clínico varió, y predominaron las formas de meningitis y meningoencefalitis; el 37,5 por ciento de los pacientes presentó formas leves de la enfermedad, y el 62,5 por ciento formas más graves; la cefalea fue el síntoma inicial en la mayoría de los casos. El patrón del LCR más constante fue una hiperproteinorraquia con escasa celularidad. El 87,5 por ciento de los pacientes logró la cura de la enfermedad con un esquema de tratamiento con anfotericina B, en algunos casos asociado a fluconazol. La muerte y la presencia de secuelas postratamiento se observó en pacientes con formas clínicas graves y diagnóstico tardío (AU)

Introduction. Incidence of cryptococcosis of the central nervous system has risen sharply since AIDS became pandemic; from early 1998, the Instituto de Neurología y Neurocirugía in Havana has beaten its own record in the number of cases attended. Aim. To describe the clinical-epidemiological characteristics of patients with this disease who were hospitalised in this centre between 1991 and 2000. Patients and methods. We present a descriptive study of 16 adult individuals who were admitted for this reason. Data on variables related with aspects concerning their epidemiology, clinical features, treatment and evolution were collected from a review of the clinical records and a survey conducted by post. Results. It was found that in no cases did the disease appear as an epidemic outbreak, in 75% of the patients there was some kind of link with pigeons, none of the patients were HIV positive, and 50% displayed other causes of immunosuppression. Clinical behaviour varied and forms of meningitis and meningoencephalitis were prevalent; 37.5% of the patients displayed mild forms of the disease and 62.5% had more serious forms. The initial symptom in most cases was headache. The most constant CSF pattern was a raised protein level in the cerebrospinal fluid with scarce cellularity. 87.5% of the patients were cured of the disease by treatment involving amphotericin B, in some cases associated with fluconazole. Death and the presence of post-treatment sequelae were observed in patients with serious clinical forms and late diagnoses (AU)

[Renal angiomyolipoma. Ultrasonography and computerized tomography findings]. / Angiomiolipomas renales. Reflexión sobre los hallazgos por ultrasonido y tomografía computerizada.

OBJECTIVE: To analyze the US and CT findings and their value in the diagnosis and follow-up of renal angiomyolipoma. METHODS/RESULTS: The clinical features, US and CT findings in 17 cases of renal angiomyolipoma were reviewed. Patient mean age was 49.1 years, 15 were asymptomatic and two presented with spontaneous bleeding. Two patients with Bourneville's disease presented bilateral lesions. The presumptive diagnosis was based on the US findings in 15 patients and on the CT findings in 16 patients. The remaining patient was evaluated by MRI. Three patients underwent partial nephrectomy and three other patients required total nephrectomy. CONCLUSIONS: Ultrasound is useful in the diagnosis of renal angiomyolipoma and it is probably the method of choice for follow-up. Two thirds were echogenic, although an echogenic lesion is not necessarily fat or viceversa. It is therefore necessary to perform a CT evaluation to make the diagnosis, especially if the tumor produces symptoms. In this series, detection of fat on CT evaluation was diagnostic of renal angiomyolipoma, although fatty tissue can also be found in other tumors or inflammatory lesions. Occasionally, the densitometric findings may not be conclusive due to the artefact of partial volume. The use of 5 mm slices without contrast and volumetric acquisitions for reconstruction can enhance the spatial resolution. It must also be taken into account that the fat content of a lesion can be scanty and may be undetected or not distinguished from other tumors.

[Acute pancreatitis and acquired immunodeficiency syndrome]. / Pancreatitis aguda y síndrome de inmunodeficiencia adquirida.

Viral acute pancreatitis in Human Immunodeficiency Virus (HIV) infected patients has been occasionally described. We studied nine patients with HIV antibodies and acute pancreatitis attributed to Cytomegalovirus and/or Cryptosporidium infection. In four patients the clinical picture was consistent with acute pancreatitis while in five clinical manifestations were unspecific, and diagnosis was based on ultrasonography and/or computed tomography findings. In the HIV infected patient pancreatic evaluation by imaging techniques may disclose acute pancreatitis even in the absence of abdominal pain.

Maternal administration of granulocyte colony-stimulating factor improves neonatal rat survival after a lethal group B streptococcal infection.

Maternally administered recombinant human granulocyte colony-stimulating factor (rhG-CSF) has been shown to cross the placenta and induce a peripheral neutrophilia and increases in the marrow and spleen neutrophil storage pools in fetal and newborn rats. In the present study, we have used this model system to investigate the efficacy of prenatally administered rhG-CSF on neonatal defense to a lethal challenge with Group B-beta hemolytic Streptococcus (GBS). Pregnant rats were injected with rhG-CSF twice daily beginning 6 days before parturition. At birth, all pups were infected with a dose of GBS that is lethal for 90% of infected pups (LD90). Survival was monitored daily for 5 days. Survival of infected pups from saline-treated mothers beyond 60 hours after infection was 10%. No difference in survival was observed among pups from mothers treated 2 and 4 days before parturition. In contrast, we determined that survival was 82.5% among infected pups from mothers treated for 6 days before parturition with rhG-CSF. Our results demonstrate that maternal administration of rhG-CSF augments neonatal defenses against a lethal bacterial challenge.

[Are there subpolar tuberculoid cases?]. / Existen los casos tuberculoides subpolares?

The idea of the existence of subpolar tuberculoid cases is supported on the spectral conception of Ridley and Jopling who included the subpolar lepromatous patients between LL and BL cases. According with Languillon, we have studied 40 tuberculoid cases to find out clinical, bacteriological, immunological and histopathological parameters of subpolar T cases. The subpolar T cases do exist, they are unstable cases which can slide through the immunological spectrum towards the L pole. These cases are characterized by numerous, symmetrical, dysesthetic tuberculoid lesions with an important neural involvement. Bacilli can be found in a small number in the smears of nasal mucosae in some cases. Mitsuda reaction is always positive and histopathologically the granulomas, lymphocytes and epithelioid cells are in less number without the epidermotropism which is very often seen in polar T cases.

[Lucio-Latapí leprosy and the Lucio phenomenon]. / La lèpre de Lucio-Latapí et le phénomène de Lucio.

The Lucio-Latapí's leprosy or diffuse lepromatous leprosy is a clinical variety of lepromatous leprosy first described by Lucio and Alvarado in 1852 and reidentified by Latapí in 1936. It is frequent in Mexico (23%) and in Costa Rica and very rare in other countries. It is characterized by a diffuse infiltration of all the skin which never is transformed into nodule, by a complete alopecia of eyebrows and eyelashes and body hair, by anhydrotic and dysesthesic zones of the skin and by a peculiar type of lepra reaction named Lucio's phenomenon or necrotic erythema which is a vascularitis of vessels especially of the dermohypodermic union and of the hypodermis. Clinically this vascularitis is represented by well-shaped erythematous spots, later becoming necrotic with scabs, ulcerations and scars. Three points of confusion are stressed: the differences between nodules and nudosities, Lucio's leprosy and Lucio's phenomenon and necrotic erythema and necrotic erythema nodosum leprosum. The differences between the pure and primitive form of Lucio's leprosy and the secondary one is also discussed such as the laboratory findings, histopathological data, pronostic and treatment. Lucio's leprosy is considered the most anergic one of the all immunological spectrum of leprosy.

Granuloma facial. Comunicacion de un caso y revision de la literatura. / Facial granuloma. Report of a case and review of the literature

Se comunica un caso de granuloma facial en un hombre de 43 anos de edad, que presentaba en la cara 2 placas infiltradas cafe rojizas de un ano de evolucion. Como tratamiento se le prescribio D.D.S. a la dosis de 100 mgrs. al dia con medianos resultados. Por otra parte, se efectuo la revision bibliografica del tema debido a que es un padecimiento poco conocido y ademas de que en nuestro pais no encontramos ninguna publicacion al respecto