RESUMEN
Intracytoplasmic sperm injection (ICSI) in horses is currently employed for clinical and commercial uses, but the protocol could be optimized to improve its efficiency. We have hypothesized that destabilization of plasma and acrosomal membranes prior to injection would positively impact the developmental potential of equine zygotes generated by ICSI. This study evaluated effects of the sperm treatment with lysolecithin on plasma and acrosomal membranes and on oocyte activation ability, initially following heterologous ICSI on bovine oocytes and subsequently employing equine oocytes. The effects of the lysolecithin -treatment on the efficiency of conventional and piezo-assisted equine ICSI were evaluated. To do this, the equine sperm were treated with different concentrations of lysolecithin and the sperm plasma membrane, acrosome and DNA integrity were evaluated by flow cytometry. The results showed that a lysolecithin concentration of 0.08 % destabilized the membranes of all sperm and affected DNA integrity within the range described for the species (8-30 %). In addition, the heterologous ICSI assay showed that lysolecithin treatment was detrimental to the sperm's ability to activate the oocyte, therefore, chemical oocyte activation was used after equine ICSI after injection with lysolecithin -treated sperm. This group showed similar developmental rate to the control group with and without exogenous activation. In conclusion, lysolecithin pre-treatment is not necessary when using ICSI to produce equine embryos in vitro. The results from the current study provide additional insight regarding the factors impacting ICSI in horses.
Asunto(s)
Lisofosfatidilcolinas , Inyecciones de Esperma Intracitoplasmáticas , Espermatozoides , Animales , Caballos , Inyecciones de Esperma Intracitoplasmáticas/veterinaria , Inyecciones de Esperma Intracitoplasmáticas/métodos , Masculino , Lisofosfatidilcolinas/farmacología , Espermatozoides/efectos de los fármacos , Femenino , Oocitos/efectos de los fármacosRESUMEN
In assisted reproductive techniques, it is essential to perform a sperm selection to obtain spermatozoa with high motility and membrane integrity for in vitro fertilisation (IVF) and high-DNA integrity for intracytoplasmic sperm injection (ICSI). In this study, we evaluated whether Isolate® was a suitable substitute for Percoll® for assisted reproductive techniques. Commercial cryopreserved bovine semen was used after selection in both gradients, and plasma and acrosome membrane integrity, reactive oxygen species (ROS) levels, DNA integrity and mitochondrial membrane potential (ΔΨm) were assessed by flow cytometry. Motility parameters were also evaluated by CASA system. A similar percentage of spermatozoa with intact plasma membrane, acrosome integrity and high ΔΨm was observed in both sperm selection methods, but only Percoll® showed higher percentage of spermatozoa with intact plasma and acrosome membrane compared to the post-thawing group. No differences were observed in the motility, ROS, DNA fragmentation and on the in vitro embryo production in all experimental groups. In conclusion, the selection of bovine spermatozoa with Isolate® generates spermatozoa with similar quality parameters and embryonic development compared to Percoll® providing a suitable alternative sperm selection method for assisted reproductive techniques in this species.
Asunto(s)
Técnicas Reproductivas Asistidas/veterinaria , Preservación de Semen/veterinaria , Inyecciones de Esperma Intracitoplasmáticas/veterinaria , Espermatozoides/citología , Acrosoma/metabolismo , Animales , Bovinos , Criopreservación , Fragmentación del ADN , Citometría de Flujo , Masculino , Povidona , Dióxido de Silicio , Motilidad EspermáticaRESUMEN
Intracytoplasmic sperm injection (ICSI) is an assisted reproduction tool with several applications. Its effectiveness in bovines is lower than that in other species, mainly because of difficulties in the decondensation of the sperm nucleus after injection, and the presence of the acrosome and the plasma membrane which remain intact in this procedure. In this study, we assessed the effect of lysolecithin (LL) and Triton X-100 (TX), in combination with glutathione (GSH) as sperm pretreatments prior to ICSI. The GSH-LL and GSH-TX groups showed 0% of spermatozoa with intact membrane (SYBR 14+/PI), in comparison with the control (63.3%) and GSH (65.7%) groups. The proportions of spermatozoa with damaged acrosome membrane in the GSH-LL, GSH-TX, GSH and control groups were 46%, 35.9%, 10.5% and 7.5%, respectively. Sperm chromatin decondensation analysis showed that the groups incubated for 3 hr with GSH presented greater decondensation (p < .05). Although fertilization was improved in all treatment groups evaluated, no differences were observed in the cleavage rate 72 hr after activation in the GSH (73.7%), GSH-LL (80.2%) and GSH-TX (77.8%) groups compared to the control (66.3%), neither in the blastocyst rate on day 8 (24.0%, 26.2%, 27.1% and 28.4% for the control, GSH, GSH-LL and GSH-TX groups, respectively). No differences were also observed in the total number of cells in all groups. In conclusion, although these sperm treatments promoted nuclear decondensation and induced plasma membrane disruption, these effects were not sufficient to improve bovine embryonic development after ICSI.
Asunto(s)
Bovinos , Glutatión/farmacología , Lisofosfatidilcolinas/farmacología , Octoxinol/farmacología , Inyecciones de Esperma Intracitoplasmáticas/veterinaria , Espermatozoides/efectos de los fármacos , Animales , Membrana Celular/efectos de los fármacos , Membrana Celular/fisiología , Masculino , Espermatozoides/fisiologíaRESUMEN
Mammalian sperm undergo a series of biochemical transformations in the female reproductive tract that are collectively known as capacitation. Cyclodextrins added to the sperm culture medium have been described to induce in vitro sperm capacitation, enabling its use in protein-free media. However, the additive capacitating effect of methyl-ß-cyclodextrin (MßCD) in the medium containing bovine serum albumin (BSA) is unknown in the bovine species. In this study, we evaluated the effects of incubating frozen-thawed bovine spermatozoa in a BSA-containing medium supplemented with MßCD on different sperm quality and functional parameters. Sperm viability decreased with the addition of MßCD in a dose-dependent manner (p < 0.05), and DNA damage could be observed but only with the highest concentration of MßCD. However, pre-incubation of spermatozoa in MßCD-supplemented medium improved the capacitation status as assessed by the increase in plasma membrane fluidity, intracellular calcium concentration, induced acrosome reactivity and zona pellucida (ZP)-binding ability (p < 0.05). Thus, we conclude that MßCD supplementation is able to enhance the capacitation status of frozen-thawed bovine spermatozoa cultured in capacitation medium containing BSA and could result in a valid strategy for its application on artificial reproductive technologies such as in vitro fertilization or intracytoplasmic sperm injection.
Asunto(s)
Acrosoma/efectos de los fármacos , Bovinos , Daño del ADN , Capacitación Espermática/efectos de los fármacos , Zona Pelúcida/fisiología , beta-Ciclodextrinas/química , Animales , Relación Dosis-Respuesta a Droga , Femenino , Citometría de Flujo , Masculino , Interacciones Espermatozoide-Óvulo/efectos de los fármacosRESUMEN
Although the effects of exercise on insulin sensitivity are generally positive, eccentric exercise presents a paradox because it induces a transient state of insulin resistance that persists for up to 48 h after the exercise bout. Excessive eccentric contractions, such as prolonged downhill running, or marathon running, causes muscle damage and disruption of the integrity of the cell. Down-regulation of insulin receptor tyrosine phosphorylation and subsequent steps in the insulin signalling pathway, including insulin receptor substrate-1 (IRS-1)-associated phosphoinositide 3-kinase (PI3K), Akt kinase serine phosphorylation and activity and glucose transporter (GLUT-4) protein content, are evident in skeletal muscle after eccentric exercise. Furthermore, increased tumour necrosis factor alpha (TNF-alpha) secretion from monocytes is associated with the decrease in PI3K activity after this type of exercise. Recent studies have shown that TNF-alpha can increase IRS-1 serine/threonine phosphorylation, which impairs IRS-1 docking to the insulin receptor, and this inhibits insulin signalling. Thus a unifying hypothesis to explain insulin resistance after eccentric exercise may include inflammation arising from the disruption of muscle-cell integrity, leading to an acute-phase response that includes TNF-alpha, with the latter inhibiting insulin signalling and subsequent metabolic events. In contrast, exercise training increases insulin signalling and GLUT-4 expression, decreases TNF-alpha expression in skeletal muscle, and is associated with enhanced insulin sensitivity. These observations highlight the complexity of the cellular and molecular adaptations to exercise. Understanding these adaptations is essential in order to establish a sound theoretical basis for recommending exercise as a therapeutic intervention for insulin resistance and type 2 diabetes.
Asunto(s)
Ejercicio Físico , Insulina/metabolismo , Transducción de Señal , Humanos , Resistencia a la Insulina , Fosfatidilinositol 3-Quinasas/metabolismoRESUMEN
Changes in tumor necrosis factor-alpha (TNF-alpha) may provide a mechanism to explain impaired glucose metabolism with advancing age. Hyperglycemic clamps (180 min, 10 mM) were performed on seven older [67 +/- 2 yr; body mass index (BMI) 24.7 +/- 1.0 kg/m(2)] and seven younger (22 +/- 1 yr; BMI 21.8 +/- 1.3 kg/m(2)) healthy sedentary males with normal glucose tolerance. TNF-alpha production at basal and at the end of 180 min of hyperglycemia and hyperinsulinemia was measured ex vivo from lipopolysaccharide-stimulated (1 ng/ml) peripheral blood mononuclear cells. Plasma glucose, insulin, and C-peptide levels were similar in both groups at basal and during the last 30 min of the hyperglycemic clamp. Glucose infusion rates were lower (P < 0.004) in the older group compared with the young, indicating decreased insulin action among the older subjects. Basal TNF-alpha secretion was similar in older and younger subjects. TNF-alpha was suppressed (P < 0.02) in the younger group (230 +/- 46 vs. 126 +/- 49 pg/ml; basal vs. clamp) but not in the older group (153 +/- 37 vs. 182 +/- 42 pg/ml), with significant group differences in response (P < 0.05). A significant correlation was observed between the level of suppression in TNF-alpha production and insulin action (Kendall's rank, tau = 0.40, P < 0.05). Furthermore, the TNF-alpha response during the clamp was related to fat mass (r = 0.88, P < 0.001) and abdominal fat (r = 0.81, P < 0.003). In conclusion, these findings suggest a possible mechanism by which TNF-alpha may modulate glucose metabolism in younger people. Aging and modest increases in adiposity prevent the "normal" suppression of TNF-alpha production after a sustained postprandial-like hyperglycemic-hyperinsulinemic stimulus, which may contribute in part to the decline in insulin sensitivity in older men.
Asunto(s)
Envejecimiento/fisiología , Hiperglucemia/metabolismo , Hiperinsulinismo/metabolismo , Factor de Necrosis Tumoral alfa/biosíntesis , Adulto , Anciano , Glucemia/fisiología , Composición Corporal , Índice de Masa Corporal , Péptido C/sangre , Femenino , Técnica de Clampeo de la Glucosa , Humanos , Insulina/sangre , Islotes Pancreáticos/metabolismo , Masculino , Monocitos/metabolismoRESUMEN
The purpose of this study was to determine the separate and combined effects of exercise and insulin on the activation of phosphatidylinositol 3-kinase (PI3-kinase) and glycogen synthase in human skeletal muscle in vivo. Seven healthy men performed three trials in random order. The trials included 1) ingestion of 2 g/kg body wt carbohydrate in a 10% solution (CHO); 2) 75 min of semirecumbent cycling exercise at 75% of peak O(2) consumption; followed by 5 x 1-min maximal sprints (Ex); and 3) Ex, immediately followed by ingestion of the carbohydrate solution (ExCHO). Plasma glucose and insulin were increased (P < 0.05) at 15 and 30 (Post-15 and Post-30) min after the trial during CHO and ExCHO, although insulin was lower for ExCHO. Hyperinsulinemia during recovery in CHO and ExCHO led to an increase (P < 0.001) in PI3-kinase activity at Post-30 compared with basal, although the increase was lower (P < 0. 004) for ExCHO. Furthermore, PI3-kinase activity was suppressed (P < 0.02) immediately after exercise (Post-0) during Ex and ExCHO. Area under the insulin response curve for all trials was positively associated with PI3-kinase activity (r = 0.66, P < 0.001). Glycogen synthase activity did not increase during CHO but was increased (P < 0.05) at Post-0 and Post-30 during Ex and ExCHO. Ingestion of the drink increased (P < 0.05) carbohydrate oxidation during CHO and ExCHO, although the increase after ExCHO was lower (P < 0.05) than CHO. Carbohydrate oxidation was directly correlated with PI3-kinase activity for all trials (r = 0.63, P < 0.001). In conclusion, under resting conditions, ingestion of a carbohydrate solution led to activation of the PI3-kinase pathway and oxidation of the carbohydrate. However, when carbohydrate was ingested after intense exercise, the PI3-kinase response was attenuated and glycogen synthase activity was augmented, thus facilitating nonoxidative metabolism or storage of the carbohydrate. Activation of glycogen synthase was independent of PI3-kinase.
Asunto(s)
Carbohidratos de la Dieta , Ejercicio Físico/fisiología , Glucógeno Sintasa/metabolismo , Insulina/metabolismo , Músculo Esquelético/enzimología , Fosfatidilinositol 3-Quinasas/metabolismo , Esfuerzo Físico/fisiología , Adulto , Biopsia , Glucemia/metabolismo , Índice de Masa Corporal , Calorimetría Indirecta , Ingestión de Energía , Ayuno , Humanos , Hiperinsulinismo , Insulina/sangre , Proteínas Sustrato del Receptor de Insulina , Secreción de Insulina , Masculino , Músculo Esquelético/citología , Consumo de Oxígeno , Fosfoproteínas/metabolismo , Postura , CarreraRESUMEN
Physiological stress associated with muscle damage results in systemic insulin resistance. However, the mechanisms responsible for the insulin resistance are not known; therefore, the present study was conducted to elucidate the molecular mechanisms associated with insulin resistance after muscle damage. Muscle biopsies were obtained before (base) and at 1 h during a hyperinsulinemic-euglycemic clamp (40 mU x kg(-1) x min(-1)) in eight young (age 24+/-1 yr) healthy sedentary (maximal O(2) consumption, 49.7+/-2.4 ml x kg(-1) x min(-1)) males before and 24 h after eccentric exercise (ECC)-induced muscle damage. To determine the role of cytokines in ECC-induced insulin resistance, venous blood samples were obtained before (control) and 24 h after ECC to evaluate ex vivo endotoxin-induced mononuclear cell secretion of tumor necrosis factor (TNF)-alpha, interleukin (IL)-6, and IL-1beta. Glucose disposal was 19% lower after ECC (P<0.05). Insulin-stimulated insulin receptor substrate (IRS)-1 tyrosine phosphorylation was 45% lower after ECC (P<0.05). Insulin-stimulated phosphatidylinositol (PI) 3-kinase, Akt (protein kinase B) serine phosphorylation, and Akt activity were reduced 34, 65, and 20%, respectively, after ECC (P < 0.05). TNF-alpha, but not IL-6 or IL-1beta production, increased 2.4-fold 24 h after ECC (P<0.05). TNF-alpha production was positively correlated with reduced insulin action on PI 3-kinase (r = 0.77, P = 0.04). In summary, the physiological stress associated with muscle damage impairs insulin stimulation of IRS-1, PI 3-kinase, and Akt-kinase, presumably leading to decreased insulin-mediated glucose uptake. Although more research is needed on the potential role for TNF-alpha inhibition of insulin action, elevated TNF-alpha production after muscle damage may impair insulin signal transduction.
Asunto(s)
Insulina/fisiología , Músculo Esquelético/fisiopatología , Fosfatidilinositol 3-Quinasas/metabolismo , Fosfoproteínas/metabolismo , Proteínas Serina-Treonina Quinasas , Proteínas Proto-Oncogénicas/metabolismo , Adulto , Glucemia/análisis , Citocinas/biosíntesis , Ejercicio Físico , Ayuno/sangre , Humanos , Insulina/sangre , Proteínas Sustrato del Receptor de Insulina , Masculino , Músculo Esquelético/metabolismo , Dolor/fisiopatología , Proteínas Proto-Oncogénicas c-akt , Transducción de Señal/fisiologíaRESUMEN
Insulin action in skeletal muscle is enhanced by regular exercise. Whether insulin signaling in human skeletal muscle is affected by habitual exercise is not well understood. Phosphatidylinositol 3-kinase (PI3-kinase) activation is an important step in the insulin-signaling pathway and appears to regulate glucose metabolism via GLUT-4 translocation in skeletal muscle. To examine the effects of regular exercise on PI3-kinase activation, 2-h hyperinsulinemic (40 mU. m(-2). min(-1))-euglycemic (5.0 mM) clamps were performed on eight healthy exercise-trained [24 +/- 1 yr, 71.8 +/- 2.0 kg, maximal O(2) uptake (VO(2 max)) of 56.1 +/- 2.5 ml. kg(-1). min(-1)] and eight healthy sedentary men and women (24 +/- 1 yr, 64.7 +/- 4.4 kg, VO(2 max) of 44.4 +/- 2.7 ml. kg(-1). min(-1)). A [6, 6-(2)H]glucose tracer was used to measure hepatic glucose output. A muscle biopsy was obtained from the vastus lateralis muscle at basal and at 2 h of hyperinsulinemia to measure insulin receptor substrate-1(IRS-1)-associated PI3-kinase activation. Insulin concentrations during hyperinsulinemia were similar for both groups (293 +/- 22 and 311 +/- 22 pM for trained and sedentary, respectively). Insulin-mediated glucose disposal rates (GDR) were greater (P < 0.05) in the exercise-trained compared with the sedentary control group (9.22 +/- 0.95 vs. 6.36 +/- 0.57 mg. kg fat-free mass(-1). min(-1)). Insulin-stimulated PI3-kinase activation was also greater (P < 0.004) in the trained compared with the sedentary group (3.8 +/- 0.5- vs. 1.8 +/- 0.2-fold increase from basal). Endurance capacity (VO(2 max)) was positively correlated with PI3-kinase activation (r = 0.53, P < 0.04). There was no correlation between PI3-kinase and muscle morphology. However, increases in GDR were positively related to PI3-kinase activation (r = 0.60, P < 0.02). We conclude that regular exercise leads to greater insulin-stimulated IRS-1-associated PI3-kinase activation in human skeletal muscle, thus facilitating enhanced insulin-mediated glucose uptake.
Asunto(s)
Ejercicio Físico/fisiología , Insulina/farmacología , Músculo Esquelético/efectos de los fármacos , Fosfatidilinositol 3-Quinasas/metabolismo , Fosfoproteínas/metabolismo , Adulto , Glucemia/efectos de los fármacos , Glucemia/metabolismo , Activación Enzimática/efectos de los fármacos , Femenino , Glucosa/farmacología , Humanos , Infusiones Intravenosas , Insulina/sangre , Proteínas Sustrato del Receptor de Insulina , Masculino , Músculo Esquelético/metabolismoRESUMEN
Physiological stressors such as sepsis and tissue damage initiate an acute immune response and cause transient systemic insulin resistance. This study was conducted to determine whether tumor necrosis factor-alpha (TNF-alpha), a cytokine produced by immune cells during skeletal muscle damage, decreases insulin responsiveness at the cellular level. To examine the molecular mechanisms associated with TNF-alpha and insulin action, we measured insulin receptor substrate (IRS)-1- and IRS-2-mediated phosphatidylinositol 3-kinase (PI 3-kinase) activation, IRS-1-PI 3-kinase binding, IRS-1 tyrosine phosphorylation, and the phosphorylation of two mitogen-activated protein kinases (MAPK, known as p42(MAPK) and p44(MAPK)) in cultured C2C12 myotubes. Furthermore, we determined the effects of TNF-alpha on insulin-stimulated 2-deoxyglucose (2-DG) uptake. We observed that TNF-alpha impaired insulin stimulation of IRS-1- and IRS-2-mediated PI 3-kinase activation by 54 and 55% (P < 0.05), respectively. In addition, TNF-alpha decreased insulin-stimulated IRS-1 tyrosine phosphorylation by 40% (P < 0.05). Furthermore, TNF-alpha repressed insulin-induced p42(MAPK) and p44(MAPK) tyrosine phosphorylation by 81% (P < 0.01). TNF-alpha impairment of insulin signaling activation was accompanied by a decrease (P < 0.05) in 2-DG uptake in the muscle cells (60 +/- 4 vs. 44 +/- 6 pmol. min-1. mg-1). These data suggest that increases in TNF-alpha may cause insulin resistance in skeletal muscle by inhibiting IRS-1- and IRS-2-mediated PI 3-kinase activation as well as p42(MAPK) and p44(MAPK) tyrosine phosphorylation, leading to impaired insulin-stimulated glucose uptake.
Asunto(s)
Glucosa/metabolismo , Insulina/farmacología , Proteínas Quinasas Activadas por Mitógenos , Músculos/efectos de los fármacos , Músculos/metabolismo , Transducción de Señal , Factor de Necrosis Tumoral alfa/farmacología , Proteínas Quinasas Dependientes de Calcio-Calmodulina/metabolismo , Línea Celular , Desoxiglucosa/metabolismo , Activación Enzimática , Proteínas Sustrato del Receptor de Insulina , Péptidos y Proteínas de Señalización Intracelular , Proteína Quinasa 1 Activada por Mitógenos/metabolismo , Proteína Quinasa 3 Activada por Mitógenos , Fosfatidilinositol 3-Quinasas/metabolismo , Fosfoproteínas/metabolismo , Fosfoproteínas/farmacología , Fosforilación , Fosfotirosina/metabolismoRESUMEN
Vascular permeability factor (VPF)/vascular endothelial growth factor (VEGF) is an angiogenic cytokine expressed by many human and animal tumors. Hypoxia often up-regulates VPF/VEGF expression further. To better define the role of VPF/VEGF in tumor biology, we screened tumorigenic lines for those expressing minimal constitutive and hypoxia-inducible VPF/VEGF. Human melanoma SK-MEL-2 cells best fit these criteria and formed small, poorly vascularized tumors in immunodeficient mice. We transfected SK-MEL-2 cells stably with sense or antisense mouse VPF/VEGF cDNA or with vector alone. Cells transfected with sense VPF/VEGF (V+) expressed and secreted large amounts of mouse VPF/VEGF and formed well-vascularized tumors with hyperpermeable blood vessels and minimal necrosis in nude/SCID mice. Antisense-transfected VPF/VEGF (V-) cells expressed reduced constitutive VPF/VEGF and no detectable mouse VPF/VEGF, and formed small, minimally vascularized tumors exhibiting extensive necrosis. Vector-alone transfectants (N1 cells) behaved like parental cells. V+ cells formed numerous lung tumor colonies in SCID mice, approximately 50-fold more than N1 cells, whereas V- cells formed few or none. These experiments demonstrate that VPF/VEGF promotes melanoma growth by stimulating angiogenesis and that constitutive VPF/VEGF expression dramatically promotes tumor colonization in the lung.
Asunto(s)
ADN Complementario/genética , Factores de Crecimiento Endotelial/biosíntesis , Linfocinas/biosíntesis , Melanoma/metabolismo , Neovascularización Patológica/metabolismo , Animales , División Celular , Factores de Crecimiento Endotelial/genética , Humanos , Linfocinas/genética , Melanoma/genética , Melanoma/fisiopatología , Ratones , Ratones Desnudos , Ratones SCID , Metástasis de la Neoplasia , Oligonucleótidos Antisentido/genética , Transfección , Células Tumorales Cultivadas , Factor A de Crecimiento Endotelial Vascular , Factores de Crecimiento Endotelial VascularRESUMEN
The purpose of the study was to evaluate the "lato sensu" graduate programs of study of the Department of Nursing in the UFRN, and to know the perspectives of its students and faculty. A total of 67 questionnaires were applied to 14 professors and 53 ex-students. The sources of data were: a survey of the scientific knowledge produced by the faculty; specialization program final reports; partial 1989-1991 program evaluations; and, the final report of the first Graduate Program Evaluation Seminar (1992). Eventhough the results of the evaluation were positive, some aspects of the program were found to need further analysis so that future graduate studies might be improved. These aspects were: revision of the curriculum content, improvement of the space environment, and improvement of the bibliographic resources.
Asunto(s)
Curriculum , Educación de Postgrado en Enfermería/normas , Brasil , Docentes de Enfermería , Humanos , Investigación en Educación de Enfermería , Evaluación de Programas y Proyectos de Salud , Estudiantes de Enfermería , Encuestas y CuestionariosRESUMEN
La enfermedad venosa de los miembros inferiores es una patología bastante frecuente en nuestra población, la cual eleva significativamente la tasa de morbilidad de als enfermedades cardiovasculares; debido a su cronicidad, induce a serios problemas y a un entorno patológico amplio incluyendo costo sociales, familiares y económicos altos. Han sido ensayados múltiples farmacos en el tratamiento de esta enfermedad, con resultados variables. Ultimas investigaciones señalan que la "Diosmina" es un medicamento con notables efectos benéficos sobre las flebopatias; debido a ello se realizó este estudio prospectivo Clínicoterapéutico a doble ciego, en el Hospital Nacional Edgardo Rebagliati Martins (IPSS) Consultorio No. 55, de enero a mayo de 1992. De 100 pacientes incluidos en el estudio, 50 recibieron Diosmina y otros tantos- Diosmina placebo, la dosis administrada a los pacientes fue 1 capsula cada 12 horas (600mg por día). La mayoria de pacientes fueron mujeres (81 por ciento) con edad promedio de 45 años. Los hallazgos clínicos más importantes fueron: dilataciones venosas, edema, dolor, ardor y pesadez de miembros inferiores. Ambas drogas fueron muy bien toleradas. Con la droga "A" se obtuvo una mejoria de los síntomas en un 78 por ciento, a los 30 días, 95 por ciento, a los 60 días y 97 por ciento a los 90. Con la droga "B" solo se obtuvo una mejoria de los sintomas de un 25 por ciento a los 30 días(p menor de 0.001), no modificandose dicha respuesta a los 60 y 90 días. Nuestros resultados corroboran la eficacia de la Diosmina (Droga "A") en el tratamiento de la Insuficiencia Periférica Vascular Venosa
Asunto(s)
Humanos , Masculino , Femenino , Adulto , Persona de Mediana Edad , Diosmina/uso terapéutico , Insuficiencia Venosa/tratamiento farmacológico , Enfermedad Crónica , Diosmina/administración & dosificación , Método Doble Ciego , Estudios Prospectivos , Factores de TiempoRESUMEN
Three cadaver spines, 40 patients who were symptomatic for lumbar disk disease, and ten healthy subjects were examined by MR. T2 weighted spin echo images were used to evaluate the character of an intranuclear cleft. This cleft appears identical to annular tissue both on T2 weighted images and histologically. A 120 msec TE, 3 sec TR image was used to delimit the normal nucleus pulposus from the annulus. The incidence and age distribution of the cleft were calculated. An intranuclear cleft was present in all normal disks in both control and symptomatic subjects who were 30 years of age and older. If present in one disk, it was also present in 94% of the other disks in the same subject. This cleft represents a normal anatomic structure and appears to be a constant feature in subjects 30 years of age or older. Its absence, in the presence of an increased signal intensity within the disk, suggests a pathological process with a long T2 value, such as inflammation.
Asunto(s)
Desplazamiento del Disco Intervertebral/diagnóstico , Disco Intervertebral/patología , Espectroscopía de Resonancia Magnética , Adolescente , Adulto , Factores de Edad , Anciano , Cadáver , Femenino , Humanos , Desplazamiento del Disco Intervertebral/patología , Vértebras Lumbares/patología , Masculino , Persona de Mediana Edad , Factores de TiempoRESUMEN
Se trata de un estudio retrospectivo de 916 pacientes con el diagnóstico presuntivo de apendicitis aguda que fueron sometidos a tratamiento quirúrgico. Se analizaron los datos de la anamnesis, examen clínico, exámenes auxiliares y hallazgos anatomopatológicos
Asunto(s)
Niño , Adolescente , Adulto , Persona de Mediana Edad , Humanos , Masculino , Femenino , Apendicectomía , Apendicitis/diagnóstico , Antibacterianos/uso terapéutico , Apendicitis/cirugía , Perú , Infección de la Herida QuirúrgicaRESUMEN
Primary intracranial germinomas are classically known as midline lesions, occurring most commonly in the pineal and suprasellar regions, and will usually present with symptoms related to increased intracranial pressure or hypothalmic dysfunction. Involvement of both the pineal and the suprasellar region in the same patient (double midline lesions) is relatively rare (7%). Dissemination of germinoma to both cerebellopontine angles, in addition to the double midline lesions, with the initial clinical presentation of lower cranial nerve involvement has not been previously reported. We encountered such an unusual case, which prompted this report and review of the literature.
Asunto(s)
Neoplasias Encefálicas/complicaciones , Neoplasias Cerebelosas/complicaciones , Disgerminoma/complicaciones , Enfermedades del Nervio Vestibulococlear/etiología , Adulto , Neoplasias Encefálicas/diagnóstico , Neoplasias Cerebelosas/diagnóstico , Ángulo Pontocerebeloso , Gonadotropina Coriónica/análisis , Disgerminoma/diagnóstico , Humanos , Masculino , Neoplasias Primarias Múltiples , Glándula Pineal , Tomografía Computarizada por Rayos X , alfa-Fetoproteínas/análisisRESUMEN
The authors present a case of a patient with recurring stones suffering from disectasia of the vesical neck. Two of the stones situated in the navicular cavity were easily removed by means of Zeiss' loop without any complications and therefore the authors think that this simple method may be used when attempts to remove the stone by means of forceps or other techniques have failed and before proceeding to an external meatotomy which in always more traumatic and this system may even be applied as the initial and best method in these patients. After having made a review of the bibliography at their disposal, the authors have found no descriptions of any case in which this method was used, as in the cases of ureteral lithiasis.