Conventional Ultrafiltration During Elective Cardiac Surgery and Postoperative Acute Kidney Injury

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Fluorimetric determination of activity and isoenzyme composition of N-acetyl-beta-D-hexosaminidase in seminal plasma of fertile men and infertile patients with secretory azoospermia.

BACKGROUND: The activity and isoenzyme composition of N-acetyl-beta-D-hexosaminidase (EC.3.2.1.52) in seminal plasma of fertile and infertile men have been evaluated. However, no data are available on the isoenzyme content in seminal plasma from patients with secretory azoospermia. METHODS: The activity and isoenzyme composition of seminal plasma from 15 normozoospermic controls and 18 patients with secretory azoospermia were determined by fluorimetric methods. 4-Methylumbelliferil-2-acetamido-2-deoxy-beta-D-glucopyranoside and 4-methylumbelliferil-2-acetamido-2-deoxy-beta-D-glucopyranoside-6-sulfate were used as fluorigenic substrates. Receiver-operating characteristic (ROC) curve analysis was performed to evaluate the diagnostic efficiency of the assays. RESULTS: No significant difference was found in total enzyme activity between the two groups, while isoenzyme A activity was significantly lower (p=0.004) and the ratio between total enzyme activity and isoenzyme A activity was significantly higher (p=0.04) in azoospermic patients compared to controls. The diagnostic efficiency of these evaluations was low (< or =75.7%). CONCLUSIONS: Our findings show that the isoenzyme composition of N-acetyl-beta-D-hexosaminidase in seminal plasma from patients with secretory azoospermia is significantly different from controls, but this difference does not represent a useful marker of secretory azoospermia. The fluorimetric assays are simple and rapid methods for evaluating the isoenzyme composition.     

Examination of the effects of hemodynamic and pharmacologic interventions on coronary collateral flow in a patient during cardiac catheterization

The vasomotor response of native human collateral vessels to pharmacologic or hemodynamic vasodilatory stimuli is not well known. We describe a case where retrograde collateral flow velocity was measured both at baseline and following selected hemodynamic and pharmacologic interventions. This index case represents the first in a series of potential human physiologic studies designed to address questions pertaining to control of collateral blood supply in humans. © 1993 Wiley-Liss, Inc.     

Inherited rod-cone dysplasia: abnormal distribution of cyclic GMP in visual cells of affected Irish setters

Light-adapted retinas from Irish setters affected with inherited rod-cone dysplasia accumulate high concentrations of cyclic GMP in the outer plexiform layer (OPL). A 29-fold difference in OPL cGMP levels between affected and normal occurs at 19-20 days. However, the highest concentration, 550 mumol kg-1 (dry) wt, is reached at about 4 weeks of age, at which time OPL cyclic GMP is 20-fold higher than cGMP in the OPL of normal control retinas. Levels remain high in affected OPL until about 7 weeks of age; after this, the cyclic GMP level falls and the peak shifts to the outer nuclear layer (ONL). In the normal retina on the other hand, the highest cyclic GMP levels are in the outer segments (OS). The result is that cyclic GMP is highest at opposite ends of the photoreceptor neuron in normal and affected retinas during the first 7 weeks of development. These differing distributions are established as early as postnatal day 10, before signs of degeneration become evident, as determined by either ERG or morphological examination. Moreover, a 38-fold rise in cyclic GMP occurs in the ONL of affected retinas between 1 and 3 weeks of age significantly before the degeneration of nuclei begins at 4 to 5 weeks. The early differences in cyclic GMP distribution are probably not due to differences in guanylate cyclase activity since enzyme levels in normal and affected photoreceptor cells are virtually identical until about 4 weeks of age. Since cGMP has been observed to reach high levels in normal dark-adapted rabbit and frog OPL, the extraordinary OPL levels seen in affected setters may indicate the importance of cGMP in both normal synaptic function and in the disease process.     

Bilateral ectopic pregnancy

Bilateral simultaneous ectopic pregnancy is a very rare clinical condition. Two different subsets of patients can be distinguished: women presenting with the disease as a result of spontaneous conception and those with the condition after undergoing assisted reproduction procedures. This article reviews and analyzes 42 cases of bilateral ectopic pregnancies reported in the last 10 years, proposes a new classification of the disease, and presents some data that should be useful for the clinician who confronts this difficult entity.