ResumenLa frecuencia con la que se diagnostica la paracoccidioidomicosis en nuestro país sigue apoyando la consideración de que esta entidad constituye la micosis sistémica más importante en nuestro medio. En el presente trabajo se informan 333 casos de pacientes con paracoccidioidomicosis, diagnosticados por los cuatro laboratorios del programa de micosis pulmonares del lnstituto Nacional de Salud y por el laboratorio de rnicología médica del Grupo de Microbiología del mismo instituto, durante un período de 12 años (1981-1 992). El diagnóstico fue establecido con la sospecha clínica y una combinación de pruebas de laboratorio con diferentes sensibilidades y especificidades. De los 333 pacientesestudiados, 31 6 (95%) eran hombres y 17 (5%) mujeres; relación hombre:mujer 18,5:1. El 55,5% de los pacientes se encontraba en el grupo de edad de 41 a 60 años. La forma clínica predominante fue la forma crónica del adulto (99%) con 50,7% de presentación unifocal. La distribución geográfica fue muy amplia y señaló la importancia de los centros de diagnóstico. Las sensibilidades del 97% para la inmunodifusión y del 90% para la fijación del complemento confirmaron su importante valor diagnóstico. SummaryParacoccidioidomycosis is the most important systemic mycosis in our country, as demonstrated by the high frequency of diagnosed cases. In this report, 333 paracoccidioidomycosis cases diagnosed at the four laboratories of the Pulmonary Mycoses Program of the Instituto Nacional de Salud and at the Mycology Laboratory of the same institute during a twelve year period are presented. In relation to the age and sex distribution, 316 patients (95%) were male, and 17 (5%) female (male:female ratio 18.5:l) and 55.5% of the patients were in the age group 41-60. Regarding the clinical presentation, the chronic adult form was the predominant one (99%) with unifocal oresentation in 50.7% of the cases. The amole aeoaraohic distribution of the disease .-.~ ~ demonstrates the irnportance of the diagnostic centers. The sensitivities of 97% for immunodiffusion and 90% for complement fixation validate them as important diagnostic tests ' Grupo de Microbiología, Instituto Nacional de Salud.
La conidiobolomicosis es una micosis subcutánea que se localiza generalmente en la línea media facial; es causada por un hongo saprófito de suelos y vegetales secos, propio de regiones intertropicales, que afecta principalmente a hombres adultos. El agente etiológico Conidiobolus coronatus pertenece a la clase de los Zigomicetos, orden Entomoftorales; se caracteriza por hifas cortas y gruesas, generalmente aseptadas, que crece entre 30°C y 37°C y produce granulomas nasales. Se informan a continuación los hallazgos histológicos de un caso de conidiobolomicosis en un paciente de 31 años de raza negra, natural y procedente de la región de Urabá, quien presentaba deformidad mediofacial con edema de nariz, labio superior e imágenes polipoides en senos maxilares con destrucción del tabique nasal. La biopsia demostró inflamación granulomatosa necrosante difusa en la dermis profunda e hipodermis asociada con eosinófilos y fenómeno de Splendore-Hoeppli, en cuya zona central se ubicaban espacios aparentemente vacíos que contenían el hongo que no se tiñó con HE, pero que sí lo hizo con las coloraciones de PAS y Grocott lo cual permitió la observación de hifas de paredes gruesas y rígidas, con torsión central y extremos cónicos.Palabras clave: conidiobolomicosis, Conidiobolus coronatus, micosis subcutáneas, entomoftoromicosis, rinoentomoftoromicosis, cigomicosis. Conidiobolomycosis: a case report with histophathologic findingsConidiobolomycosis is a subcutaneous mycosis of the facial midline affecting primarily adult males. It is caused by the saprophytic fungus, Conodiobolus coronatus, present in soils and dried vegetables, characteristic of intertropical regions. C. coronatus belongs to the class Zygomycetes, order Entomophthorales; it is a fungus composed of thick, short hyphae that grows at temperatures between 30°C and 37°C and causes nasal granulomas. The histologic findings are described of a case of conidiobolomycosis in a 31-year-old male, born and resident in the Urabá region of Colombia. He presented with a mid-facial deformity of the nose and upper lip edema, and polypoid images in the maxillary sinuses with destruction of the nasal septum. The biopsy revealed a diffuse inflammatory lesion located in the deep dermis and in the hypodermis corresponding to a necrotizing granuloma. Associated eosinophils and the presence of the Splendore-Hoeppli phenomenon were noted in the vacant central zone which apparently corresponded to location of the fungal hyphae. They did not stain with HE stain, but reacted to the PAS and Grocott staining techniques and appeared as rigid, thick-walled hyphae, centrally twisted and with cone-shaped endings.
We consider the existence of positive solutions of the nonlinear two pointas the parameter λ varies through positive values. Every solution u(x) is an even function, and when it exists, it is uniquely identified by α = u(0). We study how the number of solutions changes when the parameter varies, i.e. we will be focusing on the locations of bifurcation points.The authors P. Korman, Y. Li and T. Ouyang ( "Computing the location and the direction of bifurcation", Mathematical Research Letters, accepted ), prove that a necessary and sufficient condition for α to be a bifurcation point iswhere F (α) = α 0 f (u) du. We will prove that G(α) has vertical asymptotes at α = b, α = 1 and at any point α ∈ (0, 1) for which α 0 f (u) du = 0. We will use the asymptotic behavior of G to estimate intervals where G(α) = 0, that is, intervals where there is no bifurcation point. Abstract Approved:Thesis Supervisor
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