HIV and syphilis affect similar patient groups and co-infection is common. All patients presenting with syphilis should be offered HIV testing and all HIV-positive patients should be regularly screened for syphilis. Syphilis agent may enhance the transmission of the other, probably through increased incidence of genital ulcers. Detection and treatment of syphilis can, therefore, help to reduce HIV transmission. Syphilis may present with non-typical features in the HIV-positive patient: there is a higher rate of symptomless primary syphilis and proportionately more HIV-positive patients present with secondary disease. Secondary infection may be more aggressive and there is an increased rate of early neurological and ophthalmic involvement. Diagnosis is generally made with serology but the clinician should be aware of the potential for false-negative serology in both primary and, less commonly, in secondary syphilis. All HIV-positive patients should be treated with a penicillin-based regimen that is adequate for the treatment of neurosyphilis. Relapse of infection is more likely in the HIV-positive patient and careful follow-up is required.

Here we present two clinical cases of solitary naso-sinusal fibrous tumour. This tumour has a mesenchymal origin and has an evident pleural location, with well defined immunohistochemical and ultrastructural characteristics. The clinical manifestation is an apparent benign tumour with an inclination to local aggressiveness. The most effective treatment seems to be surgical removal, but given the low number of cases mentioned (there are only eight cases reported in international literature), and the tendency to eventual recurrence, called for cobalt therapy after surgery. The evolution of clinical cases is irregular.

The paper deals with the retrospective review done by the AA. about the treatments used for squamous carcinomata of the pyriform sinus at Santa Creu i Sant Pau Hospital, Barcelona, between the years 1984-1990. In this term 76 sinus pyriform carcinomata were diagnosed, 12 of which (16%) were managed palliatively. In the other 64 cases radical treatment was advised and followed: 5 cases underwent radical cobalt-therapy; polychemotherapy followed by radiotherapy in 27; surgery plus radiotherapy in 7; and polychemotherapy completed with surgery and radiotherapy in the remaining 25 cases. Considerations on the realized pharyngectomies and their reconstructive steps and complications are commented. Inventory and end results in each group are reported. The beneficial local influence was evident when surgery was employed (100% with surgery plus radiotherapy and 92% with polychemotherapy, surgery and radiotherapy). Local control was inferior if surgery was discarded (20% in radiotherapy and 37% by polychemotherapy followed by radiotherapy). Actuarial survival for the lump sum amounted for the 40 percent after 5 years follow-up. It must be emphasized that these groups are not comparable because the choice treatment in each case was indicated in view of the initial stage.

A case of laryngopharyngoesophageal foreing body is presented. The management, general diagnosis and therapy of these disorders are commented.

The complications of the pectoralis major myocutaneous flap (PMMF) placed at cervical level, carried out in oncologic patients during the period 1984-1992 are reviewed. A total of 33 PMMF for reconstruction at the cervical level were carried out in 30 patients. Data referred to the age, sex, indication, technics, complications and evolution of the patients were analysed. The global rate of patients affected by complications was 67%, with a 17% of failures. Considering the 33 PPMF carried out, in 15 occasions there appeared fistulas (45%) and in other 8 cases dehiscence or partial necrosis (24%). In only one case a total necrosis of the flap appeared (3%). The appearance of complications significatively increased the hospital stay.

This paper describes an investigation on the electric permittivity of concentrated suspensions of non-spherical particles, specifically prolate spheroids. It is first discussed how the determination of the frequency (omega) dependence of the electric permittivity (a phenomenon traditionally known as LFDD or low-frequency dielectric dispersion) can provide ample information on the properties of the dispersed material (shape, size, state of aggregation, conductivity) and of its interface with the (typically aqueous) medium. The basic quantities are the strength and frequency dependence of the dipole moment induced by the applied field, and its dimensionless counterpart, the dipole coefficient, C(*)(omega). It is explicitly shown how the (complex) relative permittivity of the suspension, epsilon(r)(*)(omega), can be calculated from it. Two theoretical models on the polarizability of spheroidal colloidal particles will be used as theoretical starting point; one of them (Model I) explicitly considers two relaxations of the permittivity, each associated to one of the particle axes. The other (Model II) is a semi-analytical theory that yields an LFDD practically independent of the axial ratio of the particles. Both models are aimed to be used if the suspensions are dilute (low volume fraction of solids, varphi), and here they are generalized to concentrated systems by means of a previously published approximate evaluation of the permittivity of concentrated suspensions. Experiments are performed in the 1kHz-1MHz frequency range on suspensions of elongated goethite particles; the effects of ionic strength, pH, and volume fraction are investigated, and the two models are fitted to the data. In reality, taking into account that the particles are non-uniformly charged (a fact that contributes to their instability), two zeta potentials (roughly representing the lateral surface and the tip of the spheroid) are used as parameters. The results indicate that, when experimental conditions are optimal (high ionic strength and low zeta potential), the suspensions do indeed display two relaxations, that we ascribe to the long axis (and to flocs likely present in suspension) and to the short one. The permittivity increases with ionic strength, a result found with other systems, and compatible with a zeta potential that, on the average, decreases with ionic strength, an equally well known result, consequence of electric double layer compression. Another reasonable finding is the increase of estimated average dimensions and the decrease of electrokinetic potentials when the pH is close to the isoelectric point of goethite (around pH 9). The increase in volume fraction, finally, produces an overall increase in the permittivity, and the approximate model used for the evaluation of volume fraction variations can describe properly these effects, with basically constant zeta potentials and dimensions.

OBJECTIVE: To identify the variables that influenced brain-dead donor family groups to refuse donation. METHODS: The Tissue and Organ Procurement System in Venezuela designed a tool to register some phases of a family interview performed by transplant coordinators. This tool analyzed three phases. The first phase of the interview allowed the coordinator to evaluate the communication quality with the family group during a brain-death notification. The second phase assessed how families understood this notification, and the third phase identified the family grief sequence. Among the 186 interviews during 2007 to procure tissues and organs for transplantation, 37.63%(n = 70) concluded as family refusals. A retrospective study sought to analyze these results. RESULTS: The average time between notification of brain death and the first approach to the family was 8.78 hours. Setting a place for interviews was done in 91.10% of cases. Previous knowledge about donation was seen in only 53.33% of cases. The main phase of family grief identified was denial (80%). The five reasons for family denial were: absolute denial, family disagreement, uncertainty about the destination of the donated organs and tissues, fear about deformation of the donor's body, and lack of acceptance of brain death. CONCLUSIONS: Brain-death notification produced a deep sadness among family groups. There was a lack of knowledge regarding donation of tissues and organs. It was impossible to quantify the time needed by families to understand and accept brain death and to identify the grief sequence in order to avoid family refusals.

BACKGROUND AND AIMS: To evaluate if the antidiabetic properties of Salacia oblonga extract are mediated not only by inhibiting intestinal alpha-glycosidases but also by enhancing glucose transport in muscle and adipose cells. METHODS: S. oblonga extract effects on 2-deoxy-d-glucose uptake were assayed in muscle L6-myotubes and 3T3-adipocytes. In L6-myotubes, the amount and translocation of glucose transporters were assayed. A fractionation of the extract was carried out to identify the active compounds. Furthermore, we analyzed the phosphorylation status of key components of signaling pathways that are involved in the molecular mechanisms regulating glucose uptake. RESULTS: S. oblonga extract increased 2-deoxy-d-glucose uptake by 50% in L6-myotubes and 3T3-adipocytes. In L6-myotubes, the extract increased up to a 100% the GLUT4 content, activating GLUT4 promoter transcription and its translocation to the plasma membrane. Mangiferin was identified as the bioactive compound. Furthermore, mangiferin effects were concomitant with the phosphorylation of 5'-AMP-activated protein kinase without the activation of PKB/Akt. The effect of mangiferin on 2-deoxy-d-glucose uptake was blocked by GW9662, an irreversible PPAR-gamma antagonist. CONCLUSIONS: S. oblonga extract and mangiferin may exert their antidiabetic effect by increasing GLUT4 expression and translocation in muscle cells. These effects are probably mediated through two independent pathways that are related to 5'-AMP-activated protein kinase and PPAR-gamma.

In the Silene latifolia-Hadena bicruris nursery pollination system, the Hadena moth is both pollinator and seed predator of its host plant. Floral scent, which differs among S. latifolia individuals and populations, is important for adult Hadena to locate its host. However, the success of moth larvae is strongly reduced if hosts are infected by the anther smut fungus Microbotryum violaceum, a pathogen that is transmitted by flower visitors. There were no qualitative differences between the scent of flowers from healthy and diseased plants. In addition, electroantennographic measurements showed that Hadena responded to the same subset of 19 compounds in samples collected from healthy and diseased plants. However, there were significant quantitative differences in scent profiles. Flowers from diseased plants emitted both a lower absolute amount of floral scent and had a different scent pattern, mainly due to their lower absolute amount of lilac aldehyde, whereas their amount of (E)-beta-ocimene was similar to that in healthy flowers. Dual choice behavioral wind tunnel tests using differently scented flowers confirmed that moths respond to both qualitative and quantitative aspects of floral scent, suggesting that they could use differences in floral scent between healthy and infected plants to discriminate against diseased plants. Population mean fruit predation rates significantly increased with population mean levels of the emission rates of lilac aldehyde per flower, indicating that selection on floral scent compounds may not only be driven by effects on pollinator attraction but also by effects on fruit predation. However, variation in mean emission rates of scent compounds per flower generally could not explain the higher fruit predation in populations originating from the introduced North American range compared to populations native to Europe.

We performed simultaneous recordings of Bispectral Index (BIS) and middle latency auditory evoked potentials. We also recorded two clinical scales, the Modified Ramsay scale and the COMFORT scale. Heart rate and blood pressure were measured once a day, for a maximum of 5 days, in 81 critically ill children. Changes with tactile, auditory, and painful stimuli were analysed. All the stimuli significantly increased the BIS value, the painful stimulus having the greatest effect. The painful stimulus was the only one that altered the middle latency auditory evoked potentials. Although the responses of the clinical scales to stimuli were statistically significant, they were of little clinical relevance. None of the stimuli used significantly altered the heart rate or blood pressure. We conclude that tactile, auditory and painful stimuli produced changes of little relevance in the clinical scales, BIS or middle latency auditory evoked potentials. We found the BIS was the most sensitive method and the painful stimulus had the greatest effect.

The flowers of Canada thistle, Cirsium arvense (L.), attract a wide range of insects, including pollinators and herbivorous species. This attraction is primarily mediated by floral odor, which offers potential for developing generic insect attractants based on odor. In this study, we have analyzed the chemical composition of the volatiles produced by Canada thistle flowers. Nineteen floral compounds were identified in the headspace, including phenylacetaldehyde (55%), methyl salicylate (14%), dimethyl salicylate (8%), pyranoid linalool oxide (4.5%), and benzaldehyde (3.5%). Other minor compounds include benzyl alcohol, methylbenzoate, linalool, phenylethyl alcohol, furanoid linalool oxide, p-anisaldehyde, 2,6-dimethyl-1,3,5,7-octatetraene, benzylacetate, benzyl tiglate,(E,E)-alpha-farnesene, benzyl benzoate, isopropyl myristate, and 2-phenylethyl ester benzoic acid. The relative attractiveness of various doses of the main floral volatile compound phenylacetaldehyde (i.e., 10, 100, 200, and 400 mg) was tested for insect attraction. Both the total catch and the biodiversity of insect species trapped increased as the loading of phenylacetaldehyde increased. Volatiles were chosen from the odors from the flowers of Canada thistle and formulated and tested in the field. An 11-component blend was the most attractive of several floral blends tested. These findings indicate that chemical components of flower odors of Canada thistle can serve as a generic insect attractant for monitoring of invasive pest species.

INTRODUCTION: Acoustic neuroma usually presents as an unilateral tumor, seldom - bilateral and rarely in coexistence with other central nervous system neoplasms. The following paper reports such a case of a 21-year-old male patient presented with sudden deafness in left ear accompanied with tinnitus and vertigo. Symptoms started 4 weeks prior hospitalization. Their aggravation has been observed 7 days before admission to the hospital. Audiometry revealed moderate sensorineural hearing loss in left ear (for low and middle frequencies), brainstem auditory evoked potentials were absent on the left side and ENG examination showed left peripheral vestibular impairment. Initially patient received i.v. vasodilatators showing 20-25 dB improvement in low frequencies after 3 days of treatment. MRI study revealed in the left internal acoustic meatus mass (7 x 7 x 14 mm) suggesting acoustic neuroma and an oval mass (7 x 9 x 14 mm) in the pineal gland presenting radiological features of pinealoma. Patient has been qualified for neurosurgical treatment. Acoustic neuroma has been removed by suboccipital approach and pinealoma has been left for further observation as it was found incidentally. Histopathological examination confirmed diagnosis of left VIII nerve schwannoma. The left facial palsy (House-Brackmann III/IV grade) and profound hearing loss appeared after surgery. The postoperative course shows no evidence of acoustic neuroma recurrence.

Human immunodeficiency virus (HIV) seroconversion illness occurs in up to 80% of patients who newly acquire the virus. It is hoped that the new fourth generation HIV assay will have improved sensitivity for diagnosis. This article describes the case of a patient who presented with typical symptoms of HIV seroconversion illness but who had a negative initial test with the new assay. Current management of HIV seroconversion illness is also outlined.

This study presents two cases of Arnold-Chiari malformation type I. In a 26-year old man, right side deafness and left side sensorineural hearing loss at high frequencies occurred. Another patient, a 48-year old man also complained of sensorineural hearing loss and dizziness, that appeared a year and half ago. In addition, this patient had episodes of vertigo with nausea and vomit that occurred about one year before main symptoms. In both patients ENT examinations were performed as well as an audiological diagnostic battery including tonal- and impedance-audiometry, auditory brainstem responses, distortion product otoacoustic emissions and electroencephalography. Magnetic resonance imaging (MRI) showed pathological changes in the cerebello-pontine angle region that allowed diagnosing Arnold-Chiari malformation in both cases. Additionally, angio-MRI performed in patient with right side deafness revealed cochleovestibular nerve compression syndrome on the same side. Presumably, both anomalies occurring simultaneously in this patient might be responsible for deafness in the right ear, instead of mild or moderate hearing loss and tinnitus usually expected according to the literature. The paper presented two cases of Arnold-Chiari malformation with co-existing cochleovestibular nerve compression syndrome in one case. The importance of both audiological diagnostic battery and MRI in diagnostic procedures of this malformation has been demonstrated.

HIV and syphilis affect similar patient groups and co-infection is common. All patients presenting with syphilis should be offered HIV testing and all HIV-positive patients should be regularly screened for syphilis. Syphilis agent may enhance the transmission of the other, probably through increased incidence of genital ulcers. Detection and treatment of syphilis can, therefore, help to reduce HIV transmission. Syphilis may present with non-typical features in the HIV-positive patient: there is a higher rate of symptomless primary syphilis and proportionately more HIV-positive patients present with secondary disease. Secondary infection may be more aggressive and there is an increased rate of early neurological and ophthalmic involvement. Diagnosis is generally made with serology but the clinician should be aware of the potential for false-negative serology in both primary and, less commonly, in secondary syphilis. All HIV-positive patients should be treated with a penicillin-based regimen that is adequate for the treatment of neurosyphilis. Relapse of infection is more likely in the HIV-positive patient and careful follow-up is required.

We report the case of a 61-year old man who, already for a month, had infiltrated plaques on the chest, back, neck and face as well as axilar lymphadenopathy, bearing a striking resemblance to lymphoma. During his stay in the hospital he had fever, sore throat, macules on the palms and soles and a depapilated plaque on the tongue and alopecia. A test for syphilis confirmed the diagnosis. The HIV serology was also positive. The nodular secondary syphilis is an unusual form that was first documented more than 20 years ago. Since then, only a few cases have been reported in which the first diagnosis included lymphoreticular malignancy. This form of secondary syphilis was found in the HIV-infected as well as non-infected patients. We discuss the atypical clinical course, the inappropriate serological reactions and the therapy in HIV infected patients with secondary syphilis.