RESUMEN
Thirty-seven days after successful embryo transfer, a chorionic vesicle was recovered from the upper abdominal retroperitoneal space in a patient presenting with an acute life-threatening hemorrhage. This is the first case report of a retroperitoneal ectopic pregnancy which, although uncommon, is a potentially fatal complication of in vitro fertilization-embryo transfer.
Asunto(s)
Transferencia de Embrión , Fertilización In Vitro , Embarazo Abdominal/diagnóstico , Adulto , Femenino , Hemorragia/etiología , Hemorragia/cirugía , Hemostasis Quirúrgica , Humanos , Embarazo , Embarazo Abdominal/complicaciones , Embarazo Abdominal/cirugía , Espacio RetroperitonealRESUMEN
This report discusses our experience with two patients who had unilateral adrenalectomy during pregnancy as treatment for Cushing's syndrome secondary to an adrenal adenoma. Previously only five patients with this clinical problem who underwent unilateral adrenalectomy during pregnancy had been reported. We have reviewed the world literature on Cushing's syndrome in pregnancy secondary to an adrenal adenoma. A total of 19 patients who had unilateral adrenalectomy for this problem after the completion of pregnancy were identified. The review of world literature and the two patients who are the subject of this report were the basis of our analysis of fetal death, neonatal complications, and maternal complications in seven pregnancies during which unilateral adrenalectomy was performed (group 1) compared to the 19 pregnancies that were associated with unilateral adrenalectomy at the completion of pregnancy (group 2). Of the seven pregnancies in group 1, one fetal death and no neonatal complications occurred, but fetal death and neonatal complications occurred in 12 of the 19 pregnancies in group 2. Four of the seven mothers in group 1 had complications; 16 of the 19 mothers in group 2 had complications. This study suggests that adrenalectomy during pregnancy should be considered as a therapeutic option in the management of Cushing's syndrome secondary to an adrenal cortical adenoma.
Asunto(s)
Adenoma/complicaciones , Adrenalectomía , Síndrome de Cushing/etiología , Neoplasias Hipofisarias/complicaciones , Complicaciones Neoplásicas del Embarazo , Adulto , Síndrome de Cushing/cirugía , Femenino , Humanos , Periodo Posparto , Embarazo , Resultado del EmbarazoRESUMEN
Levels of airborne asbestos for six Colorado public school facilities with sprayed-on asbestos materials were documented using three analytical techniques. Phase contrast microscopy showed levels up to the thousandths of a fiber per cubic centimeter (f/cc), scanning electron microscopy (SEM) up to the hundredths of a f/cc, and transmission electron microscopy coupled to selected area electron diffraction and energy dispersive X-ray analysis (TEM-SAED-EDXA) up to the tenths of an asbestos f/cc. Phase contrast microscopy was found to be an inadequate analytical technique for documenting the levels of airborne asbestos fibers in the schools: only large fibers which were not embedded in the filter were counted, and asbestos fibers were not distinguished from nonasbestos.
Asunto(s)
Contaminantes Atmosféricos/análisis , Amianto/análisis , Instituciones Académicas , Colorado , Microscopía Electrónica de Rastreo , Microscopía de Contraste de FaseRESUMEN
Preincubation for 10-30 min with trypsin, pronase, chymotrypsin, or papain primed macrophages to undergo a twofold to sixfold increase in oxidative metabolism, measured as release of superoxide anion or hydrogen peroxide, during stimulation by phorbol myristate acetate or ingestion of Candida parapsilosis. Preincubation of macrophages with inactivated proteases, nonenzyme proteins, or neuraminidase did not affect their oxidase response. Exposure of macrophages to proteases generated at sites of inflammation could prime these cells for a more effective oxidase response to phagocytosis or for greater tissue damage from release of toxic oxygen metabolites.