The influence of the type of intracranial lesion on the final outcome in a consecutive series of 277 severely head-injured patients was analyzed. Patients were studied with computerized tomography (CT) and underwent continuous measurement of intracranial pressure. They received identical treatment according to a standardized protocol. Outcome of patients with either epidural hematoma (38 cases), subdural hematoma (56 cases), brain contusion (87 cases), or diffuse brain damage (96 cases) was rather heterogeneous, and serial CT scanning allowed the authors to outline eight consistent anatomical patterns in the whole series which have stronger prognostic significance than the four major lesion categories mentioned above. Patients with pure extracerebral hematoma (19 cases), single brain contusion (45 cases), general brain swelling (41 cases), and normal CT scans (28 cases) had a significantly better outcome than patients developing acute hemispheric swelling after operation for a large extracerebral hematoma (27 cases), patients with multiple brain contusion, either unilateral or bilateral (74 cases), and patients with diffuse axonal injury (43 cases). These anatomical patterns are interesting because, in addition to having clinical and physiopathological significance, they provide useful prognostic information and facilitate improved therapeutic decision-making in severely head-injured patients.

In patients with an acute epidural hematoma, reducing the anisocoria-surgery interval below 90 minutes is significantly associated with a better outcome (p = 0.0238, Fisher's exact test).

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Trichosporon species are emerging pathogens capable of causing severe infections in immunocompromised patients. In this paper, we report a case of systemic infection in a liver transplant patient caused by Trichosporon asahii to show the etiologic agent's aggressiveness and poor therapeutic results with the different antifungals employed.

Wnt ligands are important regulators of skeletal homeostasis. Wnt10B tends to stimulate the differentiation of common mesenchymal precursors toward the osteoblastic lineage, while inhibiting adipocytic differentiation. Hence, we decided to explore the association of WNT10B allelic variants with bone mineral density and osteoporotic fractures. A set of tag SNPs capturing most common variations of the WNT10B gene was genotyped in 1438 Caucasian postmenopausal women, including 146 with vertebral fractures and 432 with hip fractures. We found no association between single SNPs and spine or hip bone mineral density (BMD). In the multilocus analysis, some haplotypes showed a slight association with spine BMD (P = 0.03), but it was not significant after multiple-test correction. There was no association between genotype and vertebral or hip fractures. Transcripts of WNT10B and other Wnt ligands were detected in human bone samples by real-time PCR. However, there was no relationship between genotype and RNA abundance. Thus, WNT10B is expressed in the bone microenvironment and may be an important regulator of osteoblastogenesis, but we have not found evidence for a robust association of common WNT10B gene allelic variants with either BMD or fractures in postmenopausal women.Keywords Wnt Á Gene expression Á Association study Á Polymorphisms Bone mass has a strong genetic component [1,2]. At the tissue level, the maintenance of bone mass depends on the proper balance between bone formation and bone resorption, which are modulated by a number of endocrine and paracrine factors. Following the seminal studies revealing marked skeletal abnormalities in patients with mutations of the lipoprotein receptor-related protein (LRP) 5 gene [3], the Wnt pathway has emerged as an important regulator of bone homeostasis [4,5]. It includes different ligands, receptors, coreceptors, and inhibitors. Apart from possible variants due to alternative splicing and posttranslational modifications, at least 19 Wnt ligands have been described. They bind a membrane receptor complex formed by a frizzled protein and LRP. Ten different frizzled genes exist, whereas LRP5 and LRP6 are the most extensively studied LRP forms [6]. Binding of Wnt ligands initiates a cascade of events which mediate their cellular effects. The bestknown intracellular mechanisms constitute the so-called canonical pathway, which leads to the accumulation of bcatenin [7]. Several Wnts are produced in the bone tissue and exert an influence on bone remodeling, particularly on cells of the osteoblastic lineage. However, the true physiological role of the various Wnt ligands and their relative importance have not been elucidated.A number of Wnt ligands have been shown to modulate osteoblast differentiation and activity in vitro. FABP4-

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