Search

In this study we describe the design and implementation of a novel low-density oligonucleotide microarray (the "Mytox-chip"). It consists of 24 mussel genes involving both normalizing elements and stress response related genes, each represented on the array with one or two different 50 mer oligonucleotide-probe reporters spotted in replicated samples on glass-activated slides. Target genes were selected on the basis of their potential involvement in mechanisms of pollutant and xenobiotic response. They are implicated in both basic and stress related cellular processes such as shock response, biotransformation and excretion, cell-cycle regulation, immune defense, drug metabolism, etc. The microarray was tested on mussels exposed to sublethal concentrations of mercury or a crude North Sea oil mixture. RNA samples were extracted from digestive glands of control and treated mussels for the synthesis of fluorescence labeled cDNAs to be used in dual color hybridizations. Transcription rates of two metallothionein iso-genes (mt10 and mt20), a p53-like gene and actin were quantitatively estimated also by real-time PCR to confirm microarray data. Significant alterations in the gene transcription patterns were seen in response to both treatments.

Amoebic Dictyostelium discoideum cells were employed in a bioassay to evaluate stress responses after exposures to the polyaromatic hydrocarbon benzo[a]pyrene (B[a]P) and two heavy metals (copper and mercury). Furthermore, we developed a recombinant cell line expressing a labile Green Fluorescent Protein (GFP) variant expressed under the control of an actin promoter to monitor stress-related protein degradation. Finally, cell viability was monitored to discriminate lethal exposure concentrations. The results demonstrated that exposure to sub-micromolar concentrations of mercury rendered significant changes in all studied physiological parameters, whereas B[a]P became toxic at low micromolar, and copper at high micromolar concentrations. Exposure to 0.5 microM mercury significantly reduced lysosomal membrane stability (LMS), endocytosis rate, GFP expression, and further resulted in the elevation of cytosolic free Ca(2+) ([Ca(2+)](i)). LMS in mercury-treated cells that had been pre-incubated with a specific Ca(2+)-dependent phospholipase A2 blocking agent was however not affected by the exposure, indicating that the toxic action of mercury is linked to the activation of phospholipase A2 via a Ca(2+)-signaling pathway. Exposure to 20 microM B[a]P significantly reduced LMS, endocytosis rate, and GFP expression, however without affecting [Ca(2+)](i), suggesting a calcium-independent route of toxicity for this compound. None of the physiological parameters were significantly affected by copper exposure at concentrations <400 microM, demonstrating a high resistance to this metal. Our results further showed that neither cell growth nor viability was affected by concentrations altering the studied physiological parameters. LMS, endocytosis rate, and [Ca(2+)](I), therefore, appear sensitive biomarkers of pollutant-related stress in amoebic cells.

Background: Fetal tachycardia is an uncommon condition that if sustained may lead to fetal death. There is no consensus regarding the optimum treatment. The aim of this study was to evaluate the safety and efficacy of sotalol in the treatment of fetal tachycardia., Methods: This was a retrospective study of patients treated for fetal tachycardia with sotalol in a pediatric cardiology department over a ten-year period., Results: There were eight fetuses treated for supraventricular tachycardia and sotalol was used in six of them. Mean gestational age was 30 weeks. None of them had congenital heart disease; two fetuses had hydrops and one had hydrocephalus. All had supraventricular tachycardia and two had atrial flutter. Drug treatment was successful in establishing sinus rhythm in five of the six fetuses treated with sotalol and no adverse effects were recorded in the mothers. There were no deaths. Supraventricular tachycardia was present in three infants at birth., Conclusions: In this study sotalol was successful and safe in the treatment of fetal tachycardia, but given the small sample size, more studies are needed to validate this conclusion.

Unlabelled: Cavopulmonary connections have been extensively used in the palliation of complex forms of congenital heart disease requiring some form of right heart bypass. We examine the mid term outcomes of pulmonary ventricle bypass operations in a single institution and performed by the same surgical team., Population: Between March 1999 and April 2006, 62 patients underwent pulmonary ventricle bypass operations: bidirectional cavopulmonary anastomosis (Glenn procedure), total cavopulmonary connections (Fontan procedure) and one and a half ventricle correction in two cases. Age at operation averaged three years (range: 0.42-25 years) for the Glenn procedure and seven years (range: 3-14 years) for the Fontan procedure. There were 36 male patients (58%) and 26 female patients (42%). The most common indication for surgery was the single ventricle defect, present in 66% of patients. Associated lesions included: transposition of the great arteries in 16 patients (35.6%), bilateral superior vena cava in four patients (8.9%), situs ambigus in five patients (11%), situs inversus in another patient (2.2%), Ebstein disease in one patient (2.2) and coronary fistula in another patient (2.2%). Sub-aortic stenosis was present in one patient (2.2%). Palliative surgery was performed in all, but three patients (5%), before the Fontan procedure., Results: Thirty two patients underwent bidirectional cavopulmonary anastomosis and thirty patients underwent cavopulmonary connections, total or 2nd stage. Mean cardiopulmonary bypass times were 50.6+/-21.9 minutes for the Glenn procedure and 88.5+/-26.3 minutes for the Fontan procedure. There was no intra-operative mortality, but two patients (3.2% (died in the first month after surgery; one due to failure of the Glenn circuit and sepsis and the other due to a low cardiac output syndrome and multi-organ dysfunction. Mean ventilation time was 5.2+/-1.7 hours for the Glenn operation and 6.2+/-3.2 hours for the Fontan operation. The mean length of stay in ICU was 3.4+/-2.8 days for patients undergoing the Glenn operation and 4.6+/-3.1 days for patients undergoing the Fontan operation and the mean length of hospital stay was 10.6+/-5.8 days for the Glenn operation and 19.1+/-12.6 days for the Fontan operation respectively. The mean follow up time was 4+/-2.1 years (minimum 0 years and maximum seven years), most patients being in NYHA class I. Epicardiac pacemakers were implanted in three patients due to arrhythmias. Two re-operations (6.7%) were needed, both in the same patient, after the Fontan procedure, this patient eventually died a few years after surgery., Conclusions: The immediate and mid term outcomes of pulmonary ventricle bypass operations can have excellent results. From our point of view there has been an improvement, namely in the use of the extracardiac conduit technique in the 2nd stage of the Fontan operation.

We report a case of a newborn with a prenatal diagnosis of hypoplastic left heart syndrome (HLHS), referred at 37 weeks of gestation. The fetal echocardiogram had shown classic morphologic aspects of HLHS with patent mitral valve and aortic valve atresia. The atrial septum was thickened and the foramen ovale (FO) appeared to be patent. It was a normal full-term delivery, with birth weight of 2540 g. Orotracheal intubation and mechanical ventilation were immediately necessary, as well as intravenous prostaglandin, due to clinical deterioration. Transthoracic echocardiography performed in the first hour of life confirmed the diagnosis, but doubts were raised about the patency of the FO. Cardiac catheterization was performed and Rashkind balloon atrial septostomy was attempted, without success. The baby died and pathologic examination revealed HLHS with intact atrial septum, dilated coronary sinus and pulmonary lymphangiectasia. In this case, the dilated coronary sinus led to a mistaken prenatal diagnosis of FO patency with left-to-right shunt.

Unlabelled: The Ross procedure has been used in children and young adults for aortic valve replacement and the correction of complex obstruction syndromes of the left ventricular outflow tract. We report the mid-term results of the Ross procedure in a single institution and performed by the same surgical team., Population: Between March 1999 and December 2005, 18 patients were operated on using the Ross procedure. The mean age at the time of surgery was 12 years, being 12 patients male (67%). The primary indication for surgery was isolated aortic valve disease, being the predominant abnormality in 58% of cases aortic regurgitation and in 42% left ventricular outflow tract obstruction. Associated lesions included sub-aortic membrane in 3 patients (16%), small VSD in 2 patients (11%), bicuspid aortic valve in 4 patients (22%) and severe left ventricular dysfunction and mitral valve regurgitation in 1 patient (6%). Ten of the 18 patients (56%) had been submitted to previous surgical procedures or percutaneous interventions., Results: Early post-operative mortality was not seen, but two patients (11%), had late deaths, one due to endocarditis, a year after the Ross procedure, and the other due to dilated cardiomiopathy and mitral regurgitation. The shortest time of follow-up is 6 months and the longest 72 months (median 38 months). Of the 16 survivors, 14 patients are in class I of the NYHA and 2 in class II, without significant residual lesions or need for re-intervention. The 12 patients with more than a year of follow up revealed normal coronary perfusion in all patients and no segmental wall motion abnormalities. Nevertheless, two of the 12 patients developed residual dynamic obstruction of LVOT and in three patients aortic regurgitation of a mild to moderate degree was evident. Significant gradients were not verified in the RVOT., Conclusions: The Ross procedure, despite its complexity, can be undertaken with excellent immediate results. Aspects such as the dilation of the neo aortic root and homograft evolution can not be considered in a study of this nature, seeing that the mean follow up time does not exceed 5 years.

Objectives: Atrio-ventricular septal (AVSD) defects include a variable spectrum of congenital malformations with different forms of clinical presentation. We report the surgical results, from a single institution, with this type of congenital cardiac malformation. Patients with hypoplasia of one of the ventricles were excluded from this analysis., Population: Between November of 1998 and June of 2005, 49 patients with AVSD were operated on by the same team and in the same department. The average age was 37.3 months (medium 6 months) and 31 patients were female. In 38 patients (78%) an inter-ventricular communication was present (AVSD-complete) and of these, 26 were of the type A of Rastelli, being 13 of type B or C. The age for defect correction of the complete form was of 5.5 months, palliative surgery was not carried out on any of the patients. Associated lesions included: Down's syndrome in 22 patients (45%), patent arterial duct in 17 patients (35%), severe AV regurgitation in 4 patients (8%), tetralogy of Fallot in two (4%) and sub-aortic stenosis in one patient (2%). Pre-operatively 10 patients presented severe congestive heart failure and two were mechanically ventilated., Results: Complete biventricular correction was carried out in all patients. The average time on bypass (ECC) was 74.1+/-17.5 min. and time of aortic clamping was 52.0+/-12.9 min. The complete defects were corrected by the double patch technique, and in all patients the mitral cleft was closed, except in two with single papillary muscle. There was no intra-operative mortality, but hospital mortality was 8%(4 patients), due to pulmonary hypertension crises, in the first 15 post-operative days. The mean ventilation time was of 36.5+/-93 hours (medium 7 h) and the average ICU stay was of 4.3+/-4.8 days (medium 3 days). The minimum follow-up period is 1 month and the maximum is 84 months (medium 29.5 months), during which time 4 re-operations (8%) took place: two for residual VSD's and two for mitral regurgitation. There was no mortality at re-do surgery. At follow up there was residual mitral regurgitation, mild in 17 patients and moderate in two. Four other patients presented with minor residual defects., Conclusions: The complete correction of AVSD can be carried out with acceptable results, in a varied spectrum of anatomic forms and of clinical severity. Despite the age of correction, for the complete forms, predominantly below 12 months, pulmonary hypertension was the constant cause for post operative mortality. Earlier timing of surgery and stricter peri-operative control might still improve results.

In order to study Zn and Cd accumulation and depuration, a set of oysters, Crassostrea rhizophorae, were transplanted to a metal contaminated coastal lagoon and another one was harvested there and transplanted to a non-polluted site. C. rhizophorae oysters and Perna perna mussels native from both sites were collected in order to monitor variability of metal concentration in resident populations. After three months exposure, oysters transplanted to the polluted site accumulated fourfold Zn (307-1319 microgg(-1)) without reaching the concentration level of resident oysters (9770 microgg(-1)). Cadmium concentrations had a slight but significant decrease during the same period (1.25-0.54 microgg(-1)). Oysters transplanted to the non-polluted site, showed threefold Zn depuration (6727-2404 microgg(-1)), while Cd had no significant variation (0.90-1.45 microgg(-1)). Results showed that transplanted oysters do not reach heavy metal concentrations in indigenous populations suggesting transplanted organisms would be better used to evaluate bioavailability instead of environmental concentrations.

The condition index (CI) of oysters represents an ecophysiological approach to estimate meat quality and yield in cultured bivalve mollusks. In the present study, the CI of oysters from a heavy-metal polluted bay was analyzed with respect to Zn and Cd contamination in soft tissues, spawning, and polychaete infestation. The CI was calculated through a new technique based on molds made to measure the volume of oyster-shell internal cavities. The higher CI values (over 9 in the dry season) were probably related availability of suspended particles rich in organic matter in the bay, while the rapid reduction in the CI from one season to the next at some stations suggests the effect of spawning. Polychaete infestation was considered low (18.7%) and produced no clear CI effects. The Cd in the oyster tissue collected during the rainy season was weak, although still significantly correlated with the CI (r = -0.36; p < 0.05). All other comparisons of CI and metal concentrations demonstrated a non-significant correlation. The CI variations observed on the temporal and spatial scale were likely to have been caused by availability of organic matter and spawning, rather than spionid infestation or metal body burdens.

Expression of the IL-2 receptor alpha chain (CD25) by peripheral CD4 T cells follows cellular activation. However, CD25 expression by CD4 cells is widely used as a marker to identify regulatory T cells (T(R)), although cells with regulatory properties are also found in the CD4+CD25- subset. By using in vivo functional assays and Foxp3 expression as a faithful marker of T(R) differentiation, we have evaluated the requirements for CD25 expression by peripheral T(R). We first show that in vivo depletion of CD25+ cells prevents the development of spontaneous encephalomyelitis in recombination-activating gene (RAG)-deficient anti-myelin basic protein T cell antigen receptor (TCR) transgenic mice, and allows disease induction in otherwise healthy RAG-competent transgenic mice. Similar treatment in normal thymectomized animals is followed by the fast recovery of a normal number of CD25+ T(R). Consistently, Foxp3-expressing T(R) encompassed in the CD25- cell population convert to CD25+ after homeostatic expansion and are selectable by IL-2 in vitro. Surface expression of CD25 on T(R) is controlled by the activity of conventional CD4 cells and is fully labile because it can be lost and regained without affecting the functional potential of the cells. These findings reveal that Foxp3-expressing CD25- cells constitute a peripheral reservoir of differentiated T(R), recruited to the CD25+ pool upon homeostatic expansion and/or activation. This analysis, together with the notion that physiological commitment of T(R) takes place exclusively in the thymus should help for the interpretation of experiments assessing peripheral T(R) differentiation from naive CD4 T cells, defined as CD25-.

The Pregnane X Receptor (PXR) is a nuclear receptor involved in the transcriptional regulation of drug-metabolizing enzymes and transporters. In mammals, many xenobiotics induce the expression of cytochrome P4503A (CYP3A) and the multiple drug resistance 1 (MDR1) genes via the PXR pathway. Little attention has been given to studies about the identification and biological function of PXR homologues in non-mammalian species. Zebrafish is being widely used and accepted as model for toxicological and pharmacological studies to understand the mechanisms of human diseases and identify conserved signaling pathways. The aim of this study was to evaluate the in vivo expression of PXR, CYP3A and MDR1 genes in liver of zebrafish treated with the synthetic steroid pregnenolone 16alpha-carboninitrile (PCN), the antimycotic clotrimazole (CTZ) and the antianginal drug nifedipine (NIF). The liver of fish treated with PCN showed a 1.9-fold induction in the PXR followed by 1.8-fold induction in the CYP3A and 1.6-fold induction in the MDR1 mRNA. CTZ and NIF did not affect statistically the expression of PXR, CYP3A and MDR1. The similar pattern of mRNA expression of PXR, CYP3A and MDR1 genes found in fish treated with different PXR inducers suggests that the intrinsic association between these three genes is conserved in zebrafish.

The mRNA levels of two components of the mussel (Mytilus galloprovincialis) metallothionein (MT) gene families, MT10 and MT20, were evaluated using real-time quantitative-PCR and Sybr Green I chemistry in animals exposed to heavy metals in vivo and in primary cell cultures. This method was highly specific in detecting the expression of the two genes over a widely dynamic range of starting DNA amounts, showing that the basal level of MT expression is mostly due to MT10 mRNA. Basal MT expression reflected the intracellular concentration of heavy metal as indicated by the use of the heavy metal chelator TPEN on primary cells. MT10 was observed to be inducible by Cd, Zn, and Cu ions, and to a lesser extent by Hg. By contrast, the MT20 expression level was very low under basal conditions, while its mRNA increased dramatically in response to Cd exposure, and to a lesser extend to Hg, leading to levels of expression similar to those of the MT10 gene. The essential metals Cu and Zn had a very small effect on the MT20 gene, whereas the concomitant exposure to Cu and H(2)O(2) produced a rapid rise of expression. In summary, data indicate that the MT isogenes are differentially regulated by heavy metals, while hydroxyl radicals may have a role in MT20 gene activation. Also, protein expression showed metal inducibility only after Cd exposure, suggesting the occurrence of posttranscriptional control mechanisms.

In the present work, a biosensor was developed with Laccase Coriolus Versicolor as the biological reconnaissance element immobilized on derivatized polyethersulphone membranes and applied to a Pt-Ag, AgCl US electrode base. Its application to several polyphenols usually found in red wine (caffeic acid, gallic acid, catechin, rutin, trans-resveratrol, quercetin and malvidin) was tested. It was observed that an amperometric response was obtained for catechin at +100 mV (versus Ag, AgCl) and caffeic acid at -50 mV in acetate buffer solutions (pH 4.5) having 12% ethanol. At pH 3.5 and +100 mV the biosensor was sensitive to both substrates and their response was additive. A limit of detection of 1.0 x 10(-6) M, linearity ranging from 2.0 to 14.0 x 10(-6) M, high sensitivity (0.0566 mAM(-1)) and reproducibility (R.S.D. <10%) were achieved for equimolar mixed solutions of catechin and caffeic acid. Under the same experimental conditions the other polyphenols tested individually did not yield any biosensor response. The application of the biosensor to red wine samples required a previous solid phase extraction for polyphenols enrichment. In fact, attempts to apply the biosensor in red wine using the "standard addition" methodology showed that large interferences occurred, as was to be expected. Reduction currents of -0.33 +/- 0.03 nA were obtained when the biosensor was used with the wine extract at +100 mV. This current could be ascribed to catechin and caffeic acid, although some interference by other polyphenols at the matrix level seemed to persist. The present biosensor showed promising applications for the wine analysis in future.

The authors present a case report of a 12-year-old boy with diagnosis of transposition of the great arteries and ventricular septal defect, who underwent an arterial switch operation plus closure of the septal defect. On follow-up, left ventricular outflow tract obstruction was detected, initially mild. Last year, he started complaining of fatigue on exercise. Severe subaortic stenosis was diagnosed and surgical repair was performed with good results. Subaortic stenosis is a rare complication on follow-up of patients who have undergone an arterial switch operation, particularly those with transposition of the great arteries and ventricular septal defect.

Unlabelled: A predictive equation of osmolarity that correlates closely with the measured osmolality was determined. Taking into account that an osmometer is not available in most clinical settings, the proposed equation appears to provide a quick and simple osmolarity calculation of neonatal parenteral nutrition solutions., Objective: We measured the osmolalities of neonatal parenteral nutrition (PN) solutions to determine if these values may be predicted by a simple equation for calculation of their osmolarity values., Methods: The osmolalities of 101 consecutive different final PN admixtures, prepared for 36 neonates, were measured by the freezing point depression method. The respective intra-assay and interassay coefficients of variation were always <2.1%. Linear multivariate regression analysis was used to determine a predictive equation of osmolarity that correlates closely with the value of measured osmolality., Results: The mean (SD) osmolality of the final PN admixtures was 749.7 (165.4) mOsm/kg. The best-fitted equation, with a coefficient of discrimination R2 = .95 (R2 = .90 for samples between 500 and 1000 mOsm/L) is osmolarity (mOsm/L) = (nitrogen x 0.8) + (glucose x 1.235) + (sodium x 2.25) + (phosphorus x 5.43)-50, with the concentration of components in mmol/L. Adapting the equation in our daily practice, using g/L for glucose and amino acids, mg/L for phosphorus, and mEq/L for sodium, the equation is osmolarity (mOsm/L) = (amino acid x 8) + (glucose x 7) + (sodium x 2) + (phosphorus x 0.2) - 50, with a similar R2., Conclusions: Taking into account that an osmometer is not available in most clinical settings, the proposed equation appears to provide a quick and simple osmolarity calculation of neonatal PN solutions, thus allowing more accurate decisions to be taken regarding the choice of route and rate of administration of PN solutions.

Objective: The aim of this study was to determine the incidence and evolution of the atypical glandular cells of undetermined significance (AGUS) without associated lesions identified on cervical Pap smear., Material and Methods: Retrospective study concerning 33.923 cervicovaginal smears performed in the Cytopathology Department of the Coimbra University Hospital (H.U.C.) between January 1995 an December 1997. AGUS diagnosis, isolated or associated with other lesions, was made in 716 cases. Four hundred fourty-four of them were refered to patiens of the H.U.C. Ginecology Department. One hundred seventy-seven cases were classified as AGUS alone; 62 related to the Ginecology Department where follow-up was performed within a period from 3 to 36 months. This study concerns exclusively AGUS patients without associated lesions (N=62)., Results: Sixty two cases of isolated AGUS were studied; the incidence was 0,52% and the average age 44,7 ±11,7 [19-75] years old. Follow-up, performed between 3 and 36 months, revealed: isolated cervical smears (N=9), cervical smears and endocervical curettage (N=15), cervical smears with colposcopy and directed biopsy and/or endocervical curettage (N=11), cervical smears and colposcopy (N=19). Total histerectomy was performed in 8 cases by other reasons. Cervical smears were normal in 91,2 % of the cases (N=62). Histologic examination of surgical samples refering to total histerectomy, cervix biopsies was normal in 14 cases (38,9%), revealed cronic cervicitis in 14 cases, LSIL in 7 cases and endocervical polyps in one case., Conclusion: In spite of the reduced data of the study, the results point to no need to an agressive therapeutical approach at AGUS diagnosis in Pap smears.

Cassava flour is the main dietary carbohydrate source in the Amazonian region. The cariogenic potentials of the two main kinds of cassava flour - 'seca' and 'd'água' - were evaluated in vivo and in vitro. A sweet made from a regional fruit (cupuaçú) and a species of local fish (tambaqui) were used as positive and negative controls, respectively. For in vivo evaluation of dental plaque acidogenicity, the study had a crossover design, in four legs, with 19 volunteers in four treatment groups. Dental plaque pH was determined by the microtouch method before and for 60 min after food consumption. For in vitro evaluation, stimulated saliva of each volunteer was incubated with the food and pH variation was determined over 4 h. Carbohydrates were chemically determined in the flours and the majority was found to be water-insoluble. In vivo, plaque pH decreased significantly after the consumption of the sweet (p < 0.05), increased after the fish (p < 0.05), but did not change after intake of the flours (p > 0.05). In vitro, the flours were slowly fermented by bacteria present in saliva. The in vivo and in vitro findings suggest that, in the form that the main cassava flours from the Amazonian region of Brazil are customarily eaten, they may be considered to have no or very low cariogenicity., (Copyright 2002 S. Karger AG, Basel)

Traditional paper-based Medical Records, and even most of their digital counterparts, represent historical patient information. On the other hand new generations of Point-of-Care devices can be connected to standard networks and deliver streams of real time data through an Intranet, or even the Internet. Vital signs provided by IP-based devices can then be viewed at remote stations. Merging both worlds, real time and historical, in the pursuit of a comprehensive EPR is the main challenge of the present project. The basic infra-structure is composed of three main components: an existing Web-based EPR viewing station1 (Web-EPR); a fully integrated HIS/PACS system1; and a monitoring network (Siemens Infinity Network 2). Communication between the components was obtained by developing interfaces based on both HL7 and Siemens protocols the later only for waveforms. For the graphical display a web-browser-based application of the streamed signals was developed and integrated into the existing Web-EPR. This addition expanded the Web-EPR capabilities providing means to include real time signals and calculated parameters on the set of information already available. Some extra features of this project include: one-way SMS messaging of the parameters, interactive WAP access and a DICOM compliant storage of signal waveforms.

We evaluated the bactericidal antibody response to Neisseria meningitidis serogroup B in convalescent patients (n=65) from bacterial meningitis. Patients infected with B meningococci were stratified according to their vaccination status (Cuban BC vaccine) into group 1 (immunized) (n=12) and group 2 (non-immunized) (n=15). The results suggested that antibody titers > or =2 (log(2)) indicate a specific immune response to N. meningitidis. In group 1, 64% of patients had a significant antibody titer (> or =2) in their acute sera against a B:4:P1.15 strain, compared to only 21% of group 2 patients. All patients from group 1 without bactericidal antibodies in their acute sera had a significant increase (at least 2-fold increase in log(2) titers) in antibody titers in their convalescent sera, in contrast, to only 27% of patients from group 2 (P=0.06). Using mutant strains lacking OMP1 or OMP5, it was shown that OMP1 was an important antigen recognized by immunized patients but not by non-immunized patients.

Hypocitraturia (HCit) is one of the most remarkable features of renal tubular acidosis, but an acidification defect is not seen in the majority of hypocitraturic patients, whose disease is denoted idiopathic hypocitraturia. In order to assess the integrity of urinary acidification mechanisms in hypocitraturic idiopathic calcium stone formers, we studied two groups of patients, hypocitraturic (HCit, N = 21, 39.5 +/- 11.5 years, 11 females and 10 males) and normocitraturic (NCit, N = 23, 40.2 +/- 11.7 years, 16 females and 7 males) subjects, during a short ammonium chloride loading test lasting 8 h. During the baseline period HCit patients showed significantly higher levels of titratable acid (TA). After the administration of ammonium chloride, mean urinary pH (3rd to 8th hour) and TA and ammonium excretion did not differ significantly between groups. Conversely, during the first hour mean urinary pH was lower and TA and ammonium excretion was higher in HCit. The enhanced TA excretion by HCit during the baseline period and during the first hour suggests that the phosphate buffer mechanism is activated. The earlier response in ammonium excretion by HCit further supports other evidence that acidification mechanisms react promptly. The present results suggest that in the course of lithiasic disease, hypocitraturia coexists with subtle changes in the excretion of hydrogen ions in basal situations.

Histopathological effects of ammonia on the gills of the estuarine crab Chasmagnathus granulata (Dana, 1851) were evaluated after acute exposure to ammonia concentrations around LC(50) value (17.85 Mm). Disruption of pilaster cells and a subsequent collapse of gill lamellae were the main effects observed. Epithelial necrosis and hyperplasia were also detected. Significant (P<0.05) increases in pCO(2) and lactate, and significant decreases of pO(2) were detected in the haemolymph of ammonia-exposed crabs. These changes suggest that the observed histopathological damage affected gas exchange, possibly leading to death.

The authors describe a case of abdominal angiostrongyliasis in an adult patient presenting acute abdominal pain caused by jejunal perforation. The case was unusual, as this affliction habitually involves the terminal ileum, appendix, cecum or ascending colon. The disease is caused by the nematode Angiostrongylus costaricensis, whose definitive hosts are forest rodents while snails and slugs are its intermediate hosts. Infection in humans is accidental and occurs via the ingestion of snail or slug mucoid secretions found on vegetables, or by direct contact with the mucus. Abdominal angiostrongyliasis is clinically characterized by prolonged fever, anorexia, abdominal pain in the right-lower quadrant, and peripheral blood eosinophilia. Although usually of a benign nature, its course may evolve to more complicated forms such as intestinal obstruction or perforation likely to require a surgical approach. Currently, no efficient medication for the treatment of abdominal angiostrongyliasis is known to be available. In this study, the authors provide a review on the subject, considering its etiopathogeny, clinical picture, diagnosis and treatment.

Purpose: To divulge information on the chemical composition and physical-chemical features of some mineral waters from Brazilian natural sources that will be of useful protocol investigation and patient advice., Methods: The survey was based on bottle labels of non-gaseous mineral waters commercially available in the city of Rio de Janeiro. The íon concentration of each mineral was calculated from the salt content., Results: 36 springs were enralled from different states of the country. The pH (25 degrees C), 4.1 to 9.3, varied on dependence of the source and it was linearey correlated with the cations calcium, magnesium and sodium and the anion bicarbonate. It was atributed to high alkalinity (about 70% of bicarbonate in the molecula-gram) of these salts. The calcium (0.3 to 42 mg/l), magnesium (0.0 to 18 mg/l) and bicarbonate (4 to 228 mg/l) contents are relatively low., Conclusion: The mineral content of the Brazilian springs enrolled in this survey is low; about 70% of the sources having calcium and magnesium less than 10 mg/l and 1.0 mg/l, respectively, similar to local tap water.

There has been increasing interest in the storage and retrieval of medical images in hospitals and clinics here in Brazil and elsewhere. At the Heart Institute of São Paulo, with thousands of image-based procedures performed each month, the pursuit of optimal transmission and storage methods for digital images is a major concern. The use of data-compression techniques can reduce the enormous amount of imaging data to be stored or transmitted across a computer network, so that the efficiency of the computing system is preserved. The techniques for image compression can be categorized as "lossless" or "lossy," with "lossy" techniques being those in which some, supposedly irrelevant information is lost. Lossy techniques are much more efficient than lossless ones, achieving data-compression ratios as high as 100:1.

The goal of image compression is to reduce the amount of data needed to represent images. In medical applications, it is not desirable to lose any information and thus lossless compression methods are often used. However, medical imaging systems have intrinsic noise associated to it. The application of a lossy technique, which acts as a low pass filter, reduces the amount of data at a higher rate without any noticeable loss in the information contained in the images. We have compressed images of nuclear medicine using the discrete cosine transform algorithm. The decompressed images were considered reliable for visual inspection. Furthermore, a parameter was computed from these images and no discernible change was found from the results obtained using the original uncompressed images.