Aneurisma de aorta abdominal infrarrenal en asociación con riñón en herradura: aportación de un caso

We review the association between surgically resolvable aortic disease and horseshoe kidney with a discussion of diagnostic problems and therapeutic options.Male patient 81 years of age with horseshoe kidney and an abdominal aortic aneurysm that was discovered by chance in an abdominal ultrasound during a check-up for his prostate condition.A retroperitoneal approach was used in order to resect the aneurysm and perform an aorto-aortic bypass with no complications occurring. Two years after the diagnosis, the patient is still asymptomatic from a vascular point of view.The co-presence of horseshoe kidney and aortic disease needing surgical correction is infrequent, but it significantly increases the technical complexity of aortic reconstruction. A literature review is included.     

Effect of the aromatase inhibitor 4-hydroxyandrostene-3,17-dione progesterone synthesis by human luteal cells

The authors studied the effects of 4-hydroxyandrostene-3,17-dione (4-OHA) on progesterone (P), 17 beta-estradiol (E2), and 20 alpha-hydroxy-4-pregnen-3-one synthesis and pregnenolone accumulation in cultured human midluteal cells. A dose-dependent inhibition with and without human chorionic gonadotropin (hCG) of E2 and P production was observed. The accumulation of pregnenolone was significantly enhanced three to fourfold by 4-OHA in this culture system, as compared with control value. In addition, a sevenfold increase on pregnenolone accumulation was observed in the presence of 4-OHA plus 10 IU of hCG as compared with control values and 2.2-fold as compared with the 4-OHA treatments. These in vitro findings indicate a direct effect of 4-OHA on luteal steroidogenesis. Nevertheless, the suppressive effect of 4-OHA on P and E2 production is located at different sites of the steroidogenic pathway. In addition, the results demonstrate that hCG in the presence of 4-OHA stimulated pregnenolone accumulation, suggesting that the inhibition of P synthesis is in some steps after the formation of pregnenolone. These data indicate that the actions of 4-OHA on P or E2 formation have different inhibitory mechanisms.