<Emphasis Type="Bold">Reproductive Endocrinology:</Emphasis> Uterine Perfusion and Hormonal Pattern in Patients with Polycystic Ovary Syndrome

Purpose: To evaluate whether polycystic ovary syndrome (PCOS) patients with different pulsatility index (PI) of uterine artery showed differences in their hormonal pattern. Methods: Eighty-eight PCOS-affected patients and 15 controls were submitted to Doppler flow measurement of uterine artery; LH, FSH PRL, estradiol, and androgens concentration determination; and BMI evaluation during early follicular phase. Results: The mean PI of uterine artery of PCOS patients was significantly higher than control group (2.97 ± 0.9 vs. 1.89 ± 0.2 respectively). The distribution of the PI'values was significantly different in the PCOS-affected patients and in control group. The plasma levels of DHEAS and BMI were significantly higher in PCOS patients with PI 3 than in PCOS patients with PI < 3. Conclusion: High resistance in the uterine artery is present in PCOS patients, but a wide range PI values of uterine artery is present. BMI and DHEAS seem to be factors interfering with uterine perfusion.     

Frequency and extent of contraction band necrosis in orthotopically transplanted human hearts. A morphometric study

BACKGROUND: The aims of the present study are to quantify forms of myocardial and coronary changes found at postmortem and to discuss their significance in relation to causes of death and cardiac arrest in orthotopic transplanted human hearts. METHODS: The examined material included (1) 46 orthotopic transplanted human hearts and, as "controls", hearts from (2) 25 sudden/unexpected coronary death cases, 38 patients with acquired immunodeficiency syndrome, 34 subjects with "silent" Chagas' disease who died suddenly, 27 non cardiac patients who died from intracranial hemorrhage due to a ruptured cerebral aneurysm and 45 healthy subjects dead from head trauma. RESULTS: Contraction band necrosis was observed in 85% of transplanted hearts, 66% of AIDS cases and in 100% Chagas' disease, 89% intracranial hemorrhage, 71% sudden coronary death, and 18% normal head trauma cases. Foci of lymphocytic infiltrate were present in 89% of transplanted heart, 50% AIDS, 100% Chagas' disease, 37% intracranial hemorrage and 64% head trauma groups. An allograft coronary vasculopathy was observed in four transplanted hearts with a survival greater than 202 days. In another 12 cases, who survived more than one year, atherosclerosis was the only coronary lesion found. No relation was observed between coronary lesions of any degree of stenosis and myocardial injuries. CONCLUSIONS: In the group studied acute rejection was the least frequent cause (2%) of graft failure at any time following transplantation and coronary vasculopathy a questionable cause of it in four cases. Rather, contraction band necrosis as an expression of catecholamine myotoxicity seemed to play a role in graft failure related to increased myocardial catecholamine sensitivity after global denervation.     

Atropine-facilitated electrical cardioversion of persistent atrial fibrillation

Conventional electrical cardioversion failed to restore normal sinus rhythm (NSR) in 49 of 364 patients (13.5%) with persistent atrial fibrillation. After receiving up to 2 mg of atropine, 40 (81%) of these 49 "electrical-refractory" patients were successfully cardioverted to NSR by subsequent attempts of electrical cardioversion.     

Incidence and characteristics of myelodysplastic syndromes in Ourense (Spain) between 1994-1998

The very few reference epidemiological studies on myelodysplastic syndromes (MDS) have been carried out in Europe: Germany, France, UK and Sweden. We present the first Spanish study on the incidence and characteristics of MDS. The incidence rates, distribution by FAB subtypes, sex and age groups are within the ranges established by the reference studies with minimal differences which we point out and attempt to explain.     

Acute normovolemic hemodilution: physiology, limitations, and clinical use

Acute normovolemic hemodilution before major surgery is a relatively simple, cheap, and effective tool to avoid or reduce allogeneic blood transfusions. The anesthesiologist, however, must be familiar with the practical aspects of ANH. In addition, knowledge of the physiologic compensatory mechanisms that occur during ANH and their limits are mandatory for the safe use of this blood-saving technique.The decision whether or not to perform ANH and to what level and the concomitant use of other blood-saving techniques must be made on an individual basis, based on the locally present knowledge and training of the involved anesthesia personnel and tailored to the patient’s needs to suit and serve him best.     

Integrins in Mammary Gland Development and Differentiation of Mammary Epithelium

Integrins are major extracellular matrix (ECM) receptors that can also serve for some cell-cell interactions. They have been identified as important regulators of mammary epithelial cell growth and differentiation. Their ability to promote cell anchorage, proliferation, survival, migration, and the induction of active ECM-degrading enzymes suggests that they play an essential role in normal mammary morphogenesis, but, on the other hand, reveals their potential to promote tumor progression.     

The effectiveness and safety of spinal anaesthesia in the pyloromyotomy procedure

BACKGROUND: Hypertrophic pyloric stenosis is a relatively common disorder of the gastrointestinal tract in infancy, causing projectile vomiting and metabolic abnormalities. Surgical management in the form of pyloromyotomy under general anaesthesia has been reported as safe for relieving the obstructed bowel. A number of studies have demonstrated the advantages of spinal anaesthesia over general anaesthesia in high risk infants undergoing minor infraumbilical surgery. The purpose of this study was to evaluate spinal anaesthesia as an alternative option to general anaesthesia in infants undergoing pyloromyotomy. METHODS: Twenty-five infants undergoing pyloromyotomy under spinal anaesthesia were studied. Haemodynamic and respiratory parameters were noted before performing the spinal block, 5 min after the spinal block, and every 10 min after performing the spinal block; for a total period of 30 min. The spinal block was performed using spinal isobaric bupivacaine 0.5%, 0.8 mg.kg-1. Blood pressure, heart rate, respiratory rate and oxygen saturation values were recorded. RESULTS: The sensory levels achieved ranged between T3-T5 thoracic segments within 6-8 min and were sufficient to perform surgery in 23 cases. There were no statistically significant differences in the oxygen saturation, systolic blood pressure and respiratory rate compared with before the spinal block and after 5, 10, 20 and 30 min. CONCLUSIONS: This study proposes that spinal anaesthesia is an alternative option to general anaesthesia in infants undergoing pyloromyotomy, and should be considered in infants undergoing pyloromyotomy.