Six Cases of Prenatal and Neonatal Torsion of the Spermatic Cord

Torsions of the spermatic cord occurring from the intrauterine period to the end of the first year of life are termed perinatal. These are divided into prenatal and postnatal torsions, depending on their occurrence in the intrauterine or postuterine period. From January 1984 to January 1996, 6 cases were identified at our institution, involving 4 prenatal and 2 postnatal extravaginal torsions of the spermatic cord. These cases are reviewed with regard to optimal therapeutic approaches for the treatment of both the affected gonad as well as the contralateral one, and whether the event occurred prenatally or postnatally. The authors also propose several clinical indications useful for obstetricians, pediatricians, urologists and nurses.     

A morphometric study of bone marrow angiogenesis in hairy cell leukaemia with clinicopathological correlations

Bone marrow angiogenesis has recently been implicated in the pathophysiology and course of various haematological malignancies. Little is known, however, about the significance of this phenomenon in hairy cell leukaemia (HCL). We evaluated various morphometric characteristics of microvessels, highlighted by means of anti-CD34 immunohistochemistry, in the bone marrow of 44 patients with typical HCL, before and after treatment with interferon-alpha (IFN-alpha). Overall, bone marrow from 103 HCL patients and 20 controls was examined. Microvessel density (MVD) and several size- and shape-related parameters were quantified in the region of most intense vascularization using image analysis. MVD, size-related parameters and the percentage of branching microvessels were higher in HCL than in controls. Likewise, perimeter counts were higher in partial/non-responders than in complete responders. Achievement of complete response was accompanied by smaller calibre microvessels. IFN-alpha induced a decrease in MVD and branching values in cases with diffuse marrow involvement. In univariate analysis, progression-free survival was adversely affected by MVD, branching and major axis length. Multivariate analysis indicated that MVD/branching independently affected progression-free survival and the likelihood of complete response. Our data suggest that the generation of bone marrow microvessels indicated an increased risk of progression and IFN-alpha treatment failure in HCL. Furthermore, the prognostic significance of angiogenesis requires the concomitant assessment of MVD and the complexity of the microvascular network.     

Incidental thyroid cancer in patients undergoing total thyroidectomy for benign disease

Aim

To determine the frequency of incidental thyroid carcinoma (ITC) in patients undergoing surgery for presumably benign thyroid diseases.

Methods

A total of 267 patients submitted to total thyroidectomy were included in the study.

Results

Histology revealed ITC in 31 (11.6%) patients. Papillary carcinoma was the commonest ITC at a percentage of 71% (22/31 patients), while follicular variant accounted for 29%. ITC was more common in patients with toxic goitre and toxic solitary nodule.

Conclusions

The result of this study show a high incidence of ITC (11.6 %). The frequency differs among patients presenting a different thyroid pathology. This is because of the small sample used in the study. Papillary carcinoma was the commonest ITC.

     

An Intermediate Complex in the Dissociation of Aspartate Transcarbamylase

The multisubunit enzyme aspartate transcarbamylase consists of six copies of two types of polypeptide chains, catalytic (C) and regulatory (R). A complex formed by the partial dissociation of this enzyme has been isolated. This species, which has the structure C(6)R(4), is a likely intermediate in the stepwise dissociation of aspartate transcarbamylase induced by mercurials. The formation of the complex is the result of the release of a single regulatory dimer (R(2)) from the parent molecule.The specific activity of the intermediate is essentially the same as that of aspartate transcarbamylase. By contrast, both homotropic and heterotropic interactions are reduced, but not abolished. These observations suggest that the allosteric transitions involved in the control mechanisms do not require the intact structure C(6)R(6).     

Exercise training improves hemodynamic recovery to isometric exercise in obese men with type 2 diabetes but not in obese women

ObjectivesWomen with type 2 diabetes (T2D) show greater rates of mortality due to ischemic heart disease than men with T2D. We aimed to examine cardiovascular and autonomic function responses to isometric handgrip (IHG) exercise between men and women with T2D, before and after an exercise training program.Materials/MethodsHemodynamic responses were measured in 22 men and women with T2D during and following a 3-min IHG test, and before and after 16 wks of aerobic exercise training.ResultsWomen had a smaller decrease in mean arterial pressure (MAP) and systolic blood pressure (BP) during recovery from IHG (ΔMAP_REC) than men pre- and post-training (P < 0.05). Men showed a greater reduction in diastolic BP during recovery from IHG (P < 0.05), and exercise training improved this response in men but not in women (men, pre-training: ? 13.9 ± 1.8, post-training: ? 20.5 ± 5.3 mmHg vs. women, pre-training: ? 10.7 ± 1.7, post-training: ? 4.1 ± 4.9 mmHg; P < 0.05). Men had a greater reduction in sympathetic modulation of vasomotor tone (P < 0.05), as estimated by blood pressure variability, following IHG. This response was accentuated after training, while this training effect was not seen in women. Post-training ΔMAP_REC was correlated with recovery of low frequency component of the BP spectrum (ΔLF_SBPrec, r = 0.52, P < 0.05).ConclusionsDifferences in BP recovery immediately following IHG may be attributed to gender differences in cardiovascular autonomic modulation. An improvement in these responses occurs following aerobic exercise training in obese men, but not in obese women with T2D which reflects a better adaptive autonomic response to exercise training.