Percutaneous puncture of venous bypass grafts for transluminal angioplasty

Percutaneous transluminal angioplasty was performed on 45 patients with vascular stenoses after vein bypass surgery. In 25 cases, the angioplasty catheter was introduced by direct puncture of the vein graft. The procedure was successful and reoperation was avoided in all but one of these cases. There were no complications. The experience has shown that in selected postoperative patients, direct puncture of the graft is safe and greatly facilitates performance of the angioplasty.     

Late follicular phase administration of levonorgestrel as an emergency contraceptive changes the secretory pattern of glycodelin in serum and endometrium during the luteal phase of the menstrual cycle

This study examined serum glycodelin concentrations and endometrial expression during the luteal phase following oral administration of levonorgestrel (LNG) at different stages of the ovarian cycle. Thirty women were recruited and allocated into three groups. All groups were studied during two consecutive cycles, a control cycle and the treatment cycle. In the treatment cycle, each woman received two doses of 0.75 mg LNG taken 12 h apart on days 3–4 before the luteinizing hormone (LH) surge (Group 1), at the time of LH rise (Group 2) and 48 h after the rise in LH was detected (Group 3). Serum progesterone (P) and glycodelin were measured daily during the luteal phase, and an endometrial biopsy was taken at day LH +9 for immunohistochemical glycodelin-A staining. In Group 1, serum P levels were significantly lower, serum glycodelin levels rose earlier and endometrial glycodelin-A expression was weaker than in Groups 2 and 3, in which no differences were found between control and treatment cycles. Levonorgestrel taken for emergency contraception (EC) prior to the LH surge alters the luteal phase secretory pattern of glycodelin in serum and endometrium. Based on the potent gamete adhesion inhibitory activity of glycodelin-A, the results may account for the action of LNG in EC in those women who take LNG before the LH surge.     

Amelioration of the cerebrovascular amyloidosis in a transgenic model of Alzheimer’s disease with the neurotrophic compound Cerebrolysin™

Summary. Increased production and reduced clearance of amyloid (A) plays a central role in the pathogenesis of Alzheimers disease (AD). We have recently shown that the neurotrophic peptide mixture Cerebrolysin (Cbl) has the ability of improving synaptic functioning and reducing amyloid deposition in a transgenic (tg) animal model of Alzheimers disease (AD). Since in AD, potentially toxic A aggregates accumulate not only around neurons but also in the blood vessels, then it is important to investigate whether bioactive compounds such as Cbl might have the capacity to ameliorate the age-related cerebral amyloid angiopathy (CAA) in tg models. To this end, tg mice expressing mutant human amyloid precursor protein (APP) under the Thy1 promoter were treated with Cbl or saline alone starting at 7 or 12 months of age for a total of three months. Neuropathological analysis with an antibody against A showed that Cbl decreased amyloid deposition around the blood vessels in a time dependant manner. These effects were accompanied by a reduction in perivascular microgliosis and astrogliosis and increased expression of markers of vascular fitness such as CD31 and ZO-1. No lymphocytic infiltration was observed associated with A in the vessels. Consistent with these findings, ultrastructural analysis showed that while in tg mice treated with saline alone there was an abundant accumulation of amyloid fibers in the vascular wall accompanied by thickening of the basal membrane and endothelial cell damage, in Cbl-treated mice there was considerable reduction in the subcellular alterations of endothelial and smooth muscle cells with preservation of basal membranes and intercellular junctions. Taken together, these results suggest that Cbl treatment might have beneficial effects in patients with cognitive impairment due to cerebrovascular amyloidosis by reducing A accumulation and promoting the preservation of the cerebrovasculature.     

Intracranial artifact un magnetic resonance caused by embolization of microscopic metallic fragment

Magnetic resonance imaging (MRI) artifacts have been described in many articles published in the literature. We present the case of a 72 year old man who was admitted due to left inferior limb weakness. MRI imaging demonstrated an acute right infarction of the right posterior cerebral artery. In the right frontal lobe a metallic artifact was demonstrated as well. The artifact showed a central signal void and it was surrounded by a high signal intensity rim. His aortic valve had been replaced 12 years earlier. This indicates that the artifact is in fact due to a small metallic fragment embolization during cardiac surgery.     

Localization of species conserved zona pellucida antigens in mammalian ovaries

The mammalian zona pellucida (ZP) consists of three glycoproteins (ZP1, ZP2 and ZP3), which are variably conserved among species at the genomic and amino acid levels. In order to evaluate the expression of ZP during ovarian development, a population of antibodies was selected that recognize species conserved antigenic domains of the three ZP proteins. Domain specific antibodies were selected from sera of rabbits immunized with all three native pig ZP proteins by elution of antibodies bound to each of the three human ZP recombinant proteins expressed from cDNAs, using the baculovirus expression system in insect cells. Immunoblot analysis was used to characterize the specificity of the antibodies and immunohistochemistry was used to evaluate the stage specific expression of ZP proteins during ovarian follicular development of the mouse, baboon and human. This study demonstrates that the conserved domains of all three ZP proteins are localized in the oocyte extracellular ZP matrix as well as in a subset of granulosa cells. However, this expression does vary among species with respect to the stage and cell type during early stages of ovarian follicular development. These antibodies should serve as excellent markers for evaluating early stages of human ovarian follicular development and in the development of contraceptive agents.     

Inhalation techniques in the treatment of asthma

In the pharmacological treatment of asthma, the most suitable way is by inhalation, since this enables us to achieve a greater concentration of medicine in the affected organ than systemic medication, and besides the latter's secondary effects are minimized. The suitable use of inhalers and hence their efficacy depends on very different factors. Some of those of a merely technical kind are as follows: A suitable volume of inhalation. The rhythm of inhalation. The length of the inspiratory apnea following administration of the medicine. The coordination between the inspiration of the aerosol and activation of the device, in the case of the metered dose inhaler (MDI). One of the reasons for the incorrect use of MDI aerosols is the lack of coordination between activation of the device and inspiration. This has led to the design of different devices that avoid the need for this coordination, such as: inhalation chambers and devices for inhaling dry dust. It has also been suggested in the literature that the causes of these mistakes are to be found in the health professionals not knowing, or not suitably teaching the patients how to handle the devices. In spite of being designed to facilitate correct administration, suitable knowledge of the technique of their use by the patient is required.     

Epicutaneous test with inhalers in the study of atopic dermatitis

In some 80% of patients with atopic dermatitis, the presence of specific IgE is found when facing food or environmental allergens. It has also been demonstrated in a sub-group of patients with atopic dermatitis that the dermatitis lesions are exacerbated following the ingestion or inhalation of allergens, and that they improve with reduction of exposure to allergens. Although the prick method and the determination of specific IgE in serum are highly sensitive techniques, epicutaneous tests, applying the allergen directly to the skin, might be the ideal diagnostic method since they reproduce the characteristic inflammatory response of the disease on the affected organ itself, the skin. However, there is great variability in the results obtained through epicutaneous tests with aeroallergens, basically due to methodological differences, which are reviewed in this paper. Finally, we present the results of carrying out epicutaneous tests with inhalant allergens on our patients with atopic dermatitis and controls, where some 27% of positive patches were obtained, basically with acari, and in those patients with more severe dermatitis, without there being complete concordance with the prick technique. For this reason, the epicutaneous test appears to be a method of allergological diagnosis that might be useful and complementary to the routine techniques of the prick method and the determination of specific IgE in serum, but it is in need of suitable standardization.     

Childhood diarrhea and observed hygiene behavior in Salvador,Brazil

Brief biweekly home visits, made as part of a cohort study of diarrhea in young children under age 5 years that was carried out in Salvador, Brazil, in 1998-1999, were used as a low-cost way to collect structured observation data on domestic hygiene behavior. Field-workers were trained to check a list of 23 forms of hygienic or unhygienic behavior by the child or the child's caretaker, if any behaviors were seen during the visit. Children were grouped according to whether mainly unhygienic behavior or mainly hygienic behavior had been recorded. This permitted study of the determinants of hygiene behavior and of its role in the transmission or prevention of diarrheal disease. Observations were recorded on roughly one visit in 20. Households with adequate excreta disposal were significantly more likely to be in the "mainly hygienic" group. The prevalence of diarrhea among children for whom mainly unhygienic behavior was recorded was 2.2 times that among children in the "mainly hygienic" group. The relative risk for prevalence was 2.2 (95% confidence interval: 1.7, 2.8). The relative risk fell to 1.9 (95% confidence interval: 1.5, 2.5) after data were controlled for confounding, but the difference was still highly significant.