RESUMEN

Seedling establishment is a critical step in environment colonisation by higher plants that frequently occurs under adverse conditions. Thus, we carried out an integrated analysis of seedling growth, water status, ion accumulation, reserve mobilisation, metabolite partitioning and hydrolase activity during seedling establishment of the native Caatinga species Piptadenia moniliformis (Benth.) Luckow & R.W. Jobson under salinity. Two-day-old seedlings were cultivated in vitro for 4 days in water agar (control) or supplemented with 50 or 100 mm NaCl. Biochemical determinations were performed according to standard spectrophotometric protocols. We found that 100 mm NaCl stimulated starch degradation, amylase activity and soluble sugar accumulation, but limited storage protein hydrolysis in the cotyledons of P. moniliformis seedlings. Although Na+ accumulation in the seedling affected K+ partitioning between different organs, it was not possible to associate the salt-induced changes in reserve mobilisation with Na+ toxicity, or water status, in the cotyledons. Remarkably, we found that starch content increased in the roots of P. moniliformis seedlings under 100 mm NaCl, probably in response to the toxic effects of Na+ . The mobilisation of carbon and nitrogen reserves is independently regulated in P. moniliformis seedlings under salt stress. The salt-induced delay in seedling establishment and the resulting changes in the source-sink relationship may lead to storage protein retention in the cotyledons. Possibly, the intensification of starch mobilisation in the cotyledons supported starch accumulation in the root as a potential mechanism to mitigate Na+ toxicity.

Asunto(s)

Carbono/metabolismo , Moniliformis/metabolismo , Nitrógeno/metabolismo , Plantones/metabolismo , Animales , Cotiledón/efectos de los fármacos , Cotiledón/metabolismo , Moniliformis/efectos de los fármacos , Salinidad , Plantones/efectos de los fármacos , Sodio/metabolismo , Cloruro de Sodio/farmacología

RESUMEN

Mumps, a common childhood disease in the pre-vaccine era that causes swelling of the parotid salivary glands, can lead to orchitis, viral meningitis, and sensorineural deafness. While the incidence of disease decreased dramatically after the vaccine was added to standard vaccination schedules, the disease has made a substantial resurgence in recent years. As a result, it becomes critical to examine the factors involved in recurring outbreaks. Although low and incomplete vaccination coverage may be a key reason, it does not fully explain the issue due to the high rate of occurrence in populations with high vaccination coverage rates. Multiple studies suggest that waning immunity and secondary vaccine failure play a large role, the effects of which were previously masked by subclinical boosting. Significant knowledge gaps persist around the exact role and mechanism of waning immunity and demonstrate the need for more research in this area, as well as a reevaluation of mumps vaccine policy.

Asunto(s)

Enfermedades Transmisibles Emergentes/epidemiología , Enfermedades Transmisibles Emergentes/inmunología , Brotes de Enfermedades , Vacuna contra la Parotiditis/inmunología , Paperas/epidemiología , Paperas/inmunología , Enfermedades Transmisibles Emergentes/prevención & control , Salud Global , Humanos , Paperas/prevención & control , Vacuna contra la Parotiditis/administración & dosificación , Insuficiencia del Tratamiento , Cobertura de Vacunación

RESUMEN

Reserve mobilisation, metabolite partitioning and reserve-degrading enzyme activity were studied in sunflower seedlings cultivated in vitro under a 12-h photoperiod or in the dark to investigate the involvement of source-sink relation and carbon starvation in the regulation of reserve mobilisation under continuous darkness. Reserves, metabolites and enzyme activity were determined with standard spectrophotometric methods. At the first 24 h of treatment (acclimation phase), darkness did not affect growth, but restricted carbon and nitrogen use, as indicated by sugar and amino acid accumulation in the different seedling parts. After 5 days of treatment (survival phase), extended darkness limited growth and retarded storage lipid mobilisation due to carbon starvation, as evidenced by the depletion of carbohydrates in cotyledons and hypocotyl, as well as the consumption of amino acids in hypocotyls and roots. Alterations in the source-sink relationship might have been a response to prolonged darkness, instead of a mechanism used to regulate reserve mobilisation, as these alterations cannot be associated with negative feedback mediated by metabolite accumulation. Storage lipid degradation depends, at least in part, on mechanisms that co-ordinately regulate the activities of lipases and isocitrate lyase. Taking these results together, it is possible that reserve mobilisation in sunflower seedlings cultivated in the dark might be regulated by mechanisms that perceive the absence of light and predict carbon starvation, adjusting reserve use according to future energy demands to allow, at least in the short term, seedling survival.

Asunto(s)

Enzimas/metabolismo , Helianthus/fisiología , Plantones/crecimiento & desarrollo , Plantones/metabolismo , Carbono/metabolismo , Carotenoides/metabolismo , Clorofila/metabolismo , Cotiledón/crecimiento & desarrollo , Oscuridad , Metabolismo de los Lípidos , Fotoperiodo , Proteínas de Plantas/metabolismo , Raíces de Plantas/crecimiento & desarrollo , Plantones/fisiología

RESUMEN

The aim of this work is to draw attention to possible injuries of the eye and the facial skeleton caused by firefighting sport. There was a group of 9 patients presented who were treated from 2006 to 2015 in the Department of Ophthalmology at the University Hospital in Pilsen and diagnosed with severe eyeball contusion after being hit by a jet of water and/or a water pipe. Three cases are presented in detail.

Asunto(s)

Traumatismos en Atletas/etiología , Contusiones/etiología , Lesiones Oculares/etiología , Huesos Faciales/lesiones , Traumatismos Faciales/etiología , Bomberos , Fracturas Craneales/etiología , Adolescente , Traumatismos en Atletas/diagnóstico por imagen , Traumatismos en Atletas/cirugía , Conjuntiva/lesiones , Conjuntiva/cirugía , Contusiones/diagnóstico por imagen , Contusiones/cirugía , Lesiones Oculares/diagnóstico por imagen , Lesiones Oculares/cirugía , Huesos Faciales/diagnóstico por imagen , Traumatismos Faciales/diagnóstico por imagen , Traumatismos Faciales/cirugía , Femenino , Estudios de Seguimiento , Humanos , Presión Hidrostática , Masculino , Midriasis/diagnóstico por imagen , Midriasis/etiología , Midriasis/cirugía , Complicaciones Posoperatorias/etiología , Desprendimiento de Retina/diagnóstico por imagen , Desprendimiento de Retina/etiología , Desprendimiento de Retina/cirugía , Factores de Riesgo , Fracturas Craneales/diagnóstico por imagen , Fracturas Craneales/cirugía , Tomografía Computarizada por Rayos X , Adulto Joven

RESUMEN

Muir-Torre syndrome is a rare autosomal dominant subtype of hereditary nonpolyposis colorectal carcinoma and is characterized by the simultaneous occurrence of sebaceous gland neoplasms with visceral and urogenital malignancies. This article describes the case of a 72-year-old patient who was referred to our clinic for removal of an upper eyelid tumor, showing the course from the clinical findings to the rare diagnosis of Muir-Torre syndrome.

Asunto(s)

Síndrome de Muir-Torre/genética , Síndrome de Muir-Torre/cirugía , Procedimientos Quirúrgicos Oftalmológicos/métodos , Neoplasias de las Glándulas Sebáceas/patología , Neoplasias de las Glándulas Sebáceas/cirugía , Anciano , Humanos , Masculino , Síndrome de Muir-Torre/patología , Mutación/genética , Resultado del Tratamiento

RESUMEN

Two-dimensional silicon nanodome arrays are prepared on large areas up to 50 cm² exhibiting photonic band structure effects in the near-infrared and visible wavelength region by downscaling a recently developed fabrication method based on nanoimprint-patterned glass, high-rate electron-beam evaporation of silicon, self-organized solid phase crystallization and wet-chemical etching. The silicon nanodomes, arranged in square lattice geometry with 300 nm lattice constant, are optically characterized by angular resolved reflection measurements, allowing the partial determination of the photonic band structure. This experimentally determined band structure agrees well with the outcome of three-dimensional optical finite-element simulations. A 16% photonic bandgap is predicted for an optimized geometry of the silicon nanodome arrays. By variation of the duration of the selective etching step, the geometry as well as the optical properties of the periodic silicon nanodome arrays can be controlled systematically.

RESUMEN

We describe a clinical case of ARDS in an HIV infected patient. ARDS was associated to a respiratory syncytial virus infection that triggered a suspected Pneumocystis infection that despite missing etiologic proofs was treated with antimycotics. As rather limited information on RSV associated ARDS in HIV patients is available in the current literature, this case is of significant interest.

Asunto(s)

Antifúngicos/uso terapéutico , Infecciones por VIH/complicaciones , Síndrome de Dificultad Respiratoria/complicaciones , Infecciones por Virus Sincitial Respiratorio/complicaciones , Adulto , Diagnóstico Diferencial , Humanos , Masculino , Neumonía por Pneumocystis/diagnóstico , Neumonía por Pneumocystis/tratamiento farmacológico , Síndrome de Dificultad Respiratoria/diagnóstico , Síndrome de Dificultad Respiratoria/tratamiento farmacológico , Infecciones por Virus Sincitial Respiratorio/diagnóstico , Infecciones por Virus Sincitial Respiratorio/tratamiento farmacológico

RESUMEN

OBJECTIVE: To compare two reduced dose indinavir (IDV) + ritonavir (RTV) combinations guided by therapeutic drug monitoring (TDM) in treatment-naive HIV1-infected patients. METHODS: HIV1-infected treatment naive patients were prospectively randomized to treatment with IDV 600 mg or 400 mg BID each in combination with RTV 100 mg BID. Boosted IDV was combined with 2 NRTI, and patients were followed for 48 weeks. IDV-trough levels and initially also peak levels (C2h) were performed to allow dose modification of IDV following a specified protocol. RESULTS: 14 patients were randomized (age 38 +/- 10.4 years; mean +/- SD; 3 female, 11 male). 8 were treated with 600 mg (group 1), 6 with 400 mg IDV BID (group 2). Efficacy of treatment was good: CD4-cell count increased from 198/microl (14-523; median, range) to 371/microl (214-927) after 48 weeks (p<0.01). All but one patient with adherence problems achieved a viral load below the limit of detection. At the beginning two patients had plasma levels below 0.1 mg/l, most likely due to adherence problems. However, in the course of the observation period all patients had adequate plasma levels. 3 patients in group 1 could further reduce their IDV dose to 400 mg BID due to high plasma (peak and trough) levels. Rate of discontinuation was high (1: 4 pat., 2: 2 pat.), but only one discontinuation was possibly associated with IDV (alopecia; group 2). There were no significant changes in laboratory parameters (bilirubin, triglycerides, cholesterol) or suspicious urine results. Incidence and severity of adverse events was lower than in previous studies. CONCLUSION: Despite the low number of patients it seems reasonable to state, that boosted IDV may be used in significantly reduced dose. Efficacy seemed not to be altered, whereas tolerability was improved.

Asunto(s)

Síndrome de Inmunodeficiencia Adquirida/tratamiento farmacológico , Monitoreo de Drogas/métodos , Inhibidores de la Proteasa del VIH/uso terapéutico , VIH-1/aislamiento & purificación , Indinavir/uso terapéutico , Ritonavir/uso terapéutico , Adulto , Recuento de Linfocito CD4 , Relación Dosis-Respuesta a Droga , Quimioterapia Combinada , Femenino , Inhibidores de la Proteasa del VIH/farmacocinética , VIH-1/genética , Humanos , Indinavir/farmacocinética , Masculino , Persona de Mediana Edad , Estudios Prospectivos , ARN Viral/análisis , Ritonavir/farmacocinética , Resultado del Tratamiento

RESUMEN

OBJECTIVE: Treatment with indinavir/ritonavir (IDV/RTV) is very effective but hampered by frequent development of IDV-associated adverse events (mainly nephrotoxicity and skin changes). We tested whether dose reduction of IDV guided by therapeutic drug monitoring resulted in improved tolerability without compromising antiviral efficacy. PATIENTS: HIV-infected patients with any IDV/RTV regimen who suffer from IDV-related adverse events were included. Viral load had to be adequately controlled for at least 2 months prior to inclusion. Dose reduction from 800 mg to 600 or 400 mg IDV b.i.d. followed a specified protocol. IDV-related toxicity and IDV plasma concentrations were monitored for 24 weeks. IDV concentrations were quantified with a validated high performance liquid chromatography method. RESULTS: Twenty patients were included. Reasons for inclusion were: skin abnormalities 11, nephrotoxicity five, metabolic disturbances three, and hypertension one. IDV dose could be lowered to 400 mg b.i.d. in 13, to 600 mg b.i.d. in two patients. Five patients discontinued the treatment. Overall tolerability improved with respect to incidence and severity of adverse events. Median trough concentrations decreased from 1.02 mg/l (range 0.08-7.1) at baseline to 0.48 mg/l (0.11-1.4) after 24 weeks (p = 0.03) and remained above the critical threshold of 0.1 mg/l at any time after dose reduction. There was no change of CD4 cell counts or viral suppression. There were no significant changes in other laboratory parameters (creatinine, bilirubin, triglycerides, cholesterol, blood count, and urinalysis). CONCLUSION: Dose reduction of IDV improved tolerability of IDV-containing highly active antiretroviral treatment (HAART). Sufficient IDV trough concentrations were maintained in all patients as was virologic control.

Asunto(s)

Infecciones por VIH/tratamiento farmacológico , Inhibidores de la Proteasa del VIH/administración & dosificación , Inhibidores de la Proteasa del VIH/efectos adversos , VIH-1/efectos de los fármacos , Indinavir/administración & dosificación , Indinavir/efectos adversos , Ritonavir/administración & dosificación , Adulto , Anciano , Terapia Antirretroviral Altamente Activa , Recuento de Linfocito CD4 , Cromatografía Líquida de Alta Presión , Relación Dosis-Respuesta a Droga , Monitoreo de Drogas , Femenino , Alemania , Infecciones por VIH/inmunología , Infecciones por VIH/metabolismo , Infecciones por VIH/virología , Inhibidores de la Proteasa del VIH/farmacocinética , VIH-1/enzimología , Humanos , Hipertensión/inducido químicamente , Indinavir/farmacocinética , Enfermedades Renales/inducido químicamente , Masculino , Enfermedades Metabólicas/inducido químicamente , Persona de Mediana Edad , Estudios Prospectivos , Índice de Severidad de la Enfermedad , Enfermedades de la Piel/inducido químicamente , Factores de Tiempo , Resultado del Tratamiento , Carga Viral

RESUMEN

BACKGROUND: The immunological and clinical benefits of structured treatment interruptions (STIs) during primary HIV-1 infection remain largely unclear. PATIENTS AND METHODS: Eight patients identified during primary HIV-1 infection were immediately treated with HAART and underwent subsequent STIs after reaching complete viral suppression of HIV-RNA in peripheral plasma. HAART was re-initiated if either HIV-1 RNA >5000 copies/ml, CD4-cells <200 cells/microl or symptomatic HIV-1 disease was observed. RESULTS: After treatment discontinuation, four of eight patients were able to persistently control HIV-1 viremia below 5000 copies/ml until the last time point of follow-up (median 3 years). CD4-cell counts were within the interquartile range of untreated individuals compared to historical reference data from the MACS cohort. In the remaining study subjects persistent virological control was not reached despite repeated STIs. Moreover, compared to the MACS cohort repetitive virological failures during STIs appeared to induce an accelerated decline of CD4-cells. CONCLUSION: Spontaneous HIV-1 control after treated primary HIV-1 infection was possible in four out of eight individuals, however, if STIs after treated primary infection ameliorate the overall HIV-1 disease progression remains unknown. In the absence of viral control, repetitive viral exposure during STIs might be associated with accelerated decline of CD4-cell counts.

Asunto(s)

Fármacos Anti-VIH/uso terapéutico , Seropositividad para VIH/tratamiento farmacológico , VIH-1/genética , ARN Viral/genética , Enfermedad Aguda , Adulto , Terapia Antirretroviral Altamente Activa/métodos , Linfocitos T CD4-Positivos/inmunología , Linfocitos T CD8-positivos/inmunología , Quimioterapia Combinada , Femenino , Estudios de Seguimiento , Seropositividad para VIH/inmunología , Seropositividad para VIH/virología , Prueba de Histocompatibilidad , Humanos , Lamivudine/uso terapéutico , Lopinavir , Masculino , Pirimidinonas/uso terapéutico , Estudios Retrospectivos , Estavudina/uso terapéutico , Resultado del Tratamiento , Zidovudina/uso terapéutico

RESUMEN

BACKGROUND: Within this open-label, uncontrolled prospective trial we evaluated safety, efficacy and development of genotypic resistance under the new protease inhibitor lopinavir/ritonavir (LPV/r) in antiretroviral (ARV) HIV patients. PATIENTS AND METHODS: 58 patients with virological failure under their current ARV therapy were started on a LPV/r containing regimen. Median baseline HIV RNA and CD4 count were 4.6 log(10) cps/ml (range 2.1-6.4) and 128 x 10(6)/l (0-767), respectively. CD4 count, HIV RNA and metabolic parameters were assessed at weeks 0, 4, 8, 12, 16, 24, 32, 40, 48. Genotypic resistance testing was performed at baseline and again at weeks 12, 24 and 48 in the event of virological failure. RESULTS: Until week 48, viral load (VL) decreased by a median of 1.9 log(10) cps/ml (-0.8-3.8). A VL below 80 cps/ml was found in 20/58 patients (34.5%) at week 48. In parallel, CD4 cells increased to a median of 332 x 10(6)/l (8-905). Nine patients discontinued study treatment. At 48 weeks, median triglyceride and cholesterol levels increased significantly. While the median number of overall protease mutations at baseline was four in all patients, it was six in patients virologically failing on LPV/r. The average number of mutations increased significantly to eight at week 48. Several mutations were detected considerably more often in the event of failure than in response to treatment, e. g. at amino acid positions 10, 24, 54, 71, 82, 84. CONCLUSION: LPV/r is effective in heavily pretreated patients. Discontinuation due to adverse events is infrequent. No individual mutation can be associated with failure on LPV/r. However, a greater number of protease mutations at baseline is associated with poorer treatment outcome and several mutations seem to be related to treatment failure.

Asunto(s)

Farmacorresistencia Viral Múltiple/genética , Infecciones por VIH/tratamiento farmacológico , Inhibidores de la Proteasa del VIH/administración & dosificación , VIH-1/efectos de los fármacos , Pirimidinonas/administración & dosificación , Ritonavir/administración & dosificación , Adulto , Anciano , Relación Dosis-Respuesta a Droga , Esquema de Medicación , Femenino , Estudios de Seguimiento , Infecciones por VIH/diagnóstico , Humanos , Lopinavir , Masculino , Pruebas de Sensibilidad Microbiana , Persona de Mediana Edad , Farmacogenética , Probabilidad , Estudios Prospectivos , ARN Viral/análisis , Medición de Riesgo , Índice de Severidad de la Enfermedad , Resultado del Tratamiento , Carga Viral

RESUMEN

OBJECTIVES: To evaluate safety and efficacy of the protease inhibitor combination ritonavir/indinavir 100/800 mg twice daily plus 2-3 nucleoside reverse transcriptase inhibitors (NRTI) in antiretroviral-naive patients. METHODS: Within this open-label, uncontrolled multicentre trial, antiretroviral-naive patients (n = 57) with median baseline HIV-RNA of 308,000 copies/mL (range 170-3.01 million copies/mL) and median CD4 cell count of 50 cells/microL (range 0-853 cells/microL) were started on 2-3 NRTIs plus ritonavir/indinavir 100/800 mg twice daily. CD4 cell counts and HIV-RNA were determined at weeks 0, 4, 8, 12, 16, 20, 24 and 48. Statistical analysis was performed on treatment as well as intent-to-treat. RESULTS: Viral load decreased by a median of 3.79 log10 copies/mL (range 2.0-4.60 log10 copies/mL) until week 48. At week 48, 23/57 (40%, intent-to-treat) patients showed a viral load

Asunto(s)

Infecciones por VIH/tratamiento farmacológico , Inhibidores de la Proteasa del VIH/administración & dosificación , Indinavir/administración & dosificación , Inhibidores de la Transcriptasa Inversa/administración & dosificación , Ritonavir/administración & dosificación , Adulto , Terapia Antirretroviral Altamente Activa/efectos adversos , Recuento de Linfocito CD4 , Quimioterapia Combinada , Femenino , Estudios de Seguimiento , Alemania , Infecciones por VIH/inmunología , Infecciones por VIH/virología , Inhibidores de la Proteasa del VIH/efectos adversos , Humanos , Indinavir/efectos adversos , Masculino , Persona de Mediana Edad , Estudios Prospectivos , ARN Viral/sangre , Inhibidores de la Transcriptasa Inversa/efectos adversos , Ritonavir/efectos adversos , Resultado del Tratamiento , Carga Viral

RESUMEN

BACKGROUND: Primary sclerosing cholangitis and sarcoidosis are rarely associated diseases. CASE REPORT: We report the case of an 42-year-old woman with primary sclerosing cholangitis confirmed by endoscopic cholangiography, biopsy of the liver and serum neutrophil cytoplasmatic antibodies. Furthermore radiological and histological signs of pulmonary and hepatic manifestation of sarcoidosis were observed, besides there were alopecia areata and choledocholithiasis. CONCLUSION: The present case report gives a brief survey of the literature, reflects the theories to unknown etiology and reports actual aspects of diagnosis and therapy of both diseases.

Asunto(s)

Colangitis Esclerosante/complicaciones , Hepatopatías/complicaciones , Sarcoidosis Pulmonar/complicaciones , Sarcoidosis/complicaciones , Adulto , Alopecia Areata/diagnóstico , Biopsia , Colangitis Esclerosante/diagnóstico , Femenino , Cálculos Biliares/diagnóstico , Humanos , Hígado/patología , Hepatopatías/diagnóstico , Sarcoidosis/diagnóstico , Sarcoidosis Pulmonar/diagnóstico

RESUMEN

UNLABELLED: Numerous extraintestinal manifestations in various organ systems have been reported to be associated with inflammatory bowel disease (IBD). Aim of the present paper was to evaluate the frequency of cutaneous manifestations in Crohn's disease (CD) and ulcerative colitis (UC) with respect to their location, the activity and location of the underlying disease, the treatment options and the time to remission. METHODS: The medical records of 1043 inpatients with CD and UC were screened retrospectively for extraintestinal symptoms with special regard to cutaneous manifestations. RESULTS: The prevalence of cutaneous manifestations in IBD was 22/1043 (2.1%; 18 women, 4 men; age: 31.41 +/- 9.9 [21-51] yrs.). In 15/22 patients (68.2%) the cutaneous manifestations were associated with CD, in 7/22 patients (31.8%) UC was confirmed. In 6/22 patients (27.3%) pyoderma gangrenosum (PG) was diagnosed, in 16/22 patients (72.7%) erythema nodosum (EN). EN and PG predominately occurred at the lower legs: in 68.1% the tibia was the main affection site. Other locations like breast or anus were rare. In 16/22 patients (72.7%) an acute phase of the underlying disease was evident, in 6/22 patients (27.3%) CD or UC were in remission. In patients with CD a colonic involvement was found in 86.7%. Arthritis was the most frequent coexisting extraintestinal manifestation in CD (53.3%) and UC (28.8%). Drug treatment was performed with high doses of glucocorticoids and salicylates. The time to remission in patients with EN was significantly shorter as compared to PG (5.3 +/- 1.8 vs. 19.6 +/- 14.2 weeks; p < 0.001). In 5/22 patients (22.7%) cutaneous manifestations reoccurred after a symptom-free interval. All efflorescenses reoccurred during an active phase of the underlying disease at the same manifestation site as the initial presentation. CONCLUSION: In this series the prevalence of cutaneous manifestations in IBD was 22/1043 (2.1%). EN and PG were more frequent in women with IBD, in CD, and during the acute phases of the underlying disease. EN and PG predominately affect the lower legs. Cutaneous manifestations respond well to an acute phase therapy of the underlying disease. The time to remission was significantly shorter in EN as compared to PG. However, relapses have to be considered in a relevant subgroup of patients.

Asunto(s)

Colitis Ulcerosa/diagnóstico , Enfermedad de Crohn/diagnóstico , Enfermedades de la Piel/diagnóstico , Adulto , Diagnóstico Diferencial , Eritema Nudoso/diagnóstico , Femenino , Humanos , Dermatosis de la Pierna/diagnóstico , Masculino , Persona de Mediana Edad , Piodermia Gangrenosa/diagnóstico , Recurrencia , Estudios Retrospectivos

RESUMEN

BACKGROUND/AIMS: Vascular endothelial growth factor (VEGF), a potent angiogenic, permeability-enhancing cytokine plays an important role in tissue repair and chronic inflammatory disorders. Peripheral blood mononuclear cells (PBMCs) and the inflamed mucosa have been demonstrated to be main sources of the recently described circulating VEGF in patients with inflammatory bowel disease (IBD). There is no current information about the influence of immunoregulatory cytokines on VEGF in IBD. The present study examines the effect of interleukin-4 on the increased VEGF production of PBMCs in patients with IBD. METHODOLOGY: Unstimulated PBMCs from 17 patients with Crohn's disease, 16 patients with ulcerative colitis and 8 healthy controls were cultured with or without IL-4. VEGF production was measured in the supernatant using an enzyme-linked immunosorbent assay. RESULTS: IL-4 led to a significant reduction of the VEGF production by PBMCs of both active Crohn's disease patients (471.7 +/- 377.5 pg/mL vs. 208.2 +/- 123.2 pg/mL, P = 0.018, n = 7) and active ulcerative colitis patients (177.1 +/- 79.4 pg/mL vs. 87.4 +/- 77.2 pg/mL, P = 0.008, n = 9). IL-4 inhibited significantly the VEGF production by PBMCs of patients with inactive Crohn's disease (179.2 +/- 133.9 pg/mL vs. 87.7 +/- 56.6 pg/mL, P = 0.005, n = 10). There was no significant difference of VEGF release by PBMCs cultured with IL-4 in patients with active Crohn's disease or active ulcerative colitis compared with PBMCs cultured without IL-4 in patients with inactive disease and healthy controls (112.6 +/- 41.9 pg/mL, n = 8). CONCLUSIONS: IL-4 has been shown to reduce the increased VEGF production of PBMCs in patients with IBD to normal levels. The known defective immunosuppressive effect of IL-4 in IBD may contribute to the pathogenic cascade leading to inflammation by VEGF mediated mechanisms.

Asunto(s)

Factores de Crecimiento Endotelial/antagonistas & inhibidores , Enfermedades Inflamatorias del Intestino/inmunología , Interleucina-4/farmacología , Leucocitos Mononucleares/metabolismo , Linfocinas/antagonistas & inhibidores , Adulto , Células Cultivadas , Ensayo de Inmunoadsorción Enzimática , Femenino , Humanos , Leucocitos Mononucleares/efectos de los fármacos , Masculino , Persona de Mediana Edad , Factor A de Crecimiento Endotelial Vascular , Factores de Crecimiento Endotelial Vascular

RESUMEN

BACKGROUND/AIMS: Vascular endothelial growth factor (VEGF) is a heparin-binding glycoprotein with potent angiogenic, mitogenic and vascular permeability-enhancing activities specific for endothelial cells. Recent studies have shown significantly increased VEGF serum levels in patients with active Crohn's disease and ulcerative colitis. The origin of the circulating VEGF is not yet completely described. The present investigation examines the VEGF production of colonic mucosa in consideration of mucosal disease activity in patients with inflammatory bowel disease. METHODOLOGY: Fifteen patients with inflammatory bowel disease were studied, 9 patients with Crohn's disease and 6 patients with ulcerative colitis. Biopsies were taken from endoscopically inflamed and non-inflamed colonic mucosa. Therefore, an analysis of the spontaneous VEGF production of cultured biopsies without stimulus and of the histological grade of inflammation scored on a scale of 0-3 (normal mucosa--severe chronic colitis) were performed. Eight patients with irritable bowel syndrome served as controls. VEGF levels in the supernatant of cultured mucosal biopsies were measured using an enzyme linked immunosorbent assay. RESULTS: VEGF production is expressed as pg/mg wet weight of the biopsies. Inflamed mucosa of patients with active ulcerative colitis (16.27 +/- 10.39, p = 0.003, n = 6) and active Crohn's disease (9.88 +/- 5.98, p < 0.012, n = 9) showed a significantly higher spontaneous production of VEGF by colonic mucosa than normal mucosa of controls (3.16 +/- 1.63, n = 8). In addition, there was an increased unstimulated VEGF production by cultured inflamed mucosa of patients with Crohn's disease compared with non-inflamed mucosa (3.88 +/- 3.66, p < 0.015, n = 9). In both Crohn's disease and ulcerative colitis, there was no significant difference between VEGF production by non-inflamed mucosa and normal mucosa of controls. CONCLUSIONS: The present study identifies the intestinal mucosa as one of the origins of the elevated VEGF serum levels in patients with active inflammatory bowel disease and verifies the findings of recent studies about the importance of VEGF in Crohn's disease and ulcerative colitis.

Asunto(s)

Colitis Ulcerosa/patología , Enfermedad de Crohn/patología , Factores de Crecimiento Endotelial/análisis , Mucosa Intestinal/patología , Linfocinas/análisis , Adulto , Biopsia , Colon/patología , Técnicas de Cultivo , Femenino , Humanos , Masculino , Factor A de Crecimiento Endotelial Vascular , Factores de Crecimiento Endotelial Vascular

Asunto(s)

Mucocele/diagnóstico , Enfermedades de la Lengua/diagnóstico , Diagnóstico Diferencial , Femenino , Humanos , Imagen por Resonancia Magnética , Persona de Mediana Edad , Mucocele/diagnóstico por imagen , Intensificación de Imagen Radiográfica , Tomografía Computarizada por Rayos X , Enfermedades de la Lengua/diagnóstico por imagen

RESUMEN

Myositis of the skeletal muscle is a rare complication of inflammatory bowel disease. We report about a 33-year-old woman with quiescent ulcerative colitis known since 1995. She had suffered from recurring fever and pain in the thighs for about 4 weeks. Electromyography of quadriceps and deltoid muscles revealed myopathic changes. Diagnosis of polymyositis was confirmed by magnetic resonance imaging indicating edematous changes in the distal extremity muscles. The symptoms rapidly responded to high doses of steroids. Review of the literature indicates only a few cases describing an association of ulcerative colitis and myositis, most of them during acute exacerbations of the disease. In contrast, the present patient was in remission. Diagnosis of myositis should be considered in inflammatory bowel disease patients complaining of myalgia or muscular weakness. Magnetic resonance imaging may show specific features and can be used in addition to laboratory investigations and muscle biopsy for diagnosis of polymyositis.

Asunto(s)

Colitis Ulcerosa/complicaciones , Músculo Esquelético/patología , Polimiositis/etiología , Adulto , Colitis Ulcerosa/diagnóstico , Relación Dosis-Respuesta a Droga , Electromiografía , Femenino , Estudios de Seguimiento , Humanos , Imagen por Resonancia Magnética , Músculo Esquelético/fisiopatología , Polimiositis/diagnóstico , Polimiositis/tratamiento farmacológico , Esteroides/administración & dosificación , Resultado del Tratamiento

Asunto(s)

Anestesia por Circuito Cerrado/instrumentación , Anestesia General/instrumentación , Apnea/fisiopatología , Capacidad Residual Funcional/fisiología , Oximetría/instrumentación , Terapia por Inhalación de Oxígeno/instrumentación , Oxígeno/fisiología , Humanos , Nitrógeno/fisiología , Alveolos Pulmonares/fisiopatología , Relación Ventilacion-Perfusión/fisiología

RESUMEN

The preliminary results of a multicenter study designed to determine the utility of the processed EEG in combination with heart rate and blood pressure for estimating anesthetic depth are reported. The study is planned to include 1,000 ASA I, II, and III patients undergoing surgery with at least a 60-minute duration of anesthesia. The preliminary results indicate that the use of EEG and clinical signs may provide better control of anesthetic depth. The study design provides ideal conditions for determining whether spectral edge frequency is a useful criterion for management of routine general anesthesia in a typical clinical environment.

Asunto(s)

Anestesia General , Anestesia por Inhalación , Electroencefalografía , Monitoreo Intraoperatorio/métodos , Humanos