RESUMEN
BACKGROUND: Uterine cervical secretory cells receive a sympathetic cholinergic secretomotor innervation. Glandular nitric oxide (NO) production has been proposed to be a prerequisite for muscarine-induced carbohydrate secretion from endometrial glands and cervical glands at ovulation time and from the seminal vesicle glands. Nitric oxide has also been suggested to have a significant role in the process of implantation and early pregnancy in the mouse, a process, which has also been compared with an inflammatory response. METHODS: The carbohydrate secretion from everted guinea pig uterine horns placed in organ baths was estimated. Polymerase chain reaction was performed in order to identify the isoforms of nitric oxide synthase (NOS). results. Carbamylcholine chloride (Carbachol) induced carbohydrate secretion of the endometrium, whereas L-NNA and L-NAME inhibited the Carbachol-induced secretion. The isomer D-NAME had no effect on Carbachol-induced secretion. The NO donor GTN induced carbohydrate secretion of the endometrium. The addition of the nitrergic inhibitor of soluble guanylyl cyclase (sGC) ODQ to Carbachol and to the NO donor GTN gave a reduced response. No synergism was seen when the sGC stimulator YC-1 was applied together with Carbachol. Three isoforms of NOS - endothelial NOS (eNOS), cytokine-inducible NOS (iNOS), and neuronal (nNOS) - were identified at implantation time and may take place in the endometrial cell. CONCLUSIONS: The results of this study suggest that glandular NO production is a prerequisite for the autonomic nervous modulation of endometrial secretion in the guinea pig and that NO may play a role in the implantation time.
Asunto(s)
Metabolismo de los Hidratos de Carbono , Implantación del Embrión/fisiología , Endometrio/metabolismo , Óxido Nítrico/fisiología , Sistemas de Mensajero Secundario/fisiología , Animales , Arginina/farmacología , Carbacol/farmacología , Agonistas Colinérgicos/farmacología , Endometrio/efectos de los fármacos , Endometrio/enzimología , Inhibidores Enzimáticos/farmacología , Femenino , Cobayas , Técnicas In Vitro , NG-Nitroarginina Metil Éster/farmacología , Óxido Nítrico Sintasa/antagonistas & inhibidores , Óxido Nítrico Sintasa/genética , Óxido Nítrico Sintasa/metabolismo , Nitroarginina/farmacología , Reacción en Cadena de la Polimerasa , ARN/análisis , Receptores Muscarínicos/fisiología , Factores de TiempoRESUMEN
Uterine secretory cells receive a sympathetic cholinergic secremotor innervation. Nitric oxide (NO) has been suggested to be a second messenger of neurogenic modulated glandular secretion of the seminal vesicle. Thus a similar pattern for nervous induced carbohydrate secretion of the endometrium was assumed. The nitric oxide synthase (NOS) activity was estimated via formation of L-citrulline from L-arginine and histochemically with the nicotinamide-adenine dinucleotide phosphate diaphorase (NADPH-d) nitro blue technique. The carbohydrate secretion from everted uterine horns placed in organ baths was estimated. A calcium dependent formation of citrulline was found in the uterine horn suggesting an NOS activity. Strong NADPH staining cells were found in the glandular ducts of the endometrium and in the epithelial linings of the oviduct. Carbachol induced carbohydrate secretion of the endometrium while N-nitro L-arginin (L-NNA) and N-nitro L-arginin methyl ester (L-NAME) inhibited the carbachol induced secretion. The isomer D-NAME had no effect on carbachol induced secretion. When L-arginine was administered together with L-NNA no inhibitory effect on carbachol induced secretion was seen. L-arginine only had no effect on carbohydrate secretion. The NO donor glyceryl tritrate increased carbohydrate secretion but no synergistic effect was seen in combination with carbachol. The results suggest that glandular NO production is a prerequisite for muscarinic carbohydrate secretion of the endometrium.
Asunto(s)
Endometrio/metabolismo , Cobayas/fisiología , Óxido Nítrico/fisiología , Receptores Muscarínicos/fisiología , Sistemas de Mensajero Secundario/fisiología , Animales , Arginina/metabolismo , Carbacol/farmacología , Endometrio/química , Endometrio/efectos de los fármacos , Inhibidores Enzimáticos/farmacología , Femenino , Técnicas In Vitro , NADP/análisis , NADP/metabolismo , NG-Nitroarginina Metil Éster/farmacología , Óxido Nítrico Sintasa/biosíntesis , Nitroarginina/farmacologíaRESUMEN
In a study of the practical efficacy of quality criteria for obstetric care, it was found that fetal growth disorders are difficult to detect, even when growth retardation is suspected. Examination of the quality indicator, unrecognised SGA (small for gestational age), showed barely half the cases of subnormal gestational age-related birthweight.
Asunto(s)
Retardo del Crecimiento Fetal/diagnóstico , Recién Nacido Pequeño para la Edad Gestacional , Neonatología/normas , Obstetricia/normas , Indicadores de Calidad de la Atención de Salud , Femenino , Humanos , Recién Nacido , Embarazo , SueciaRESUMEN
The aim of this study was to compare the new vasodilator felodipine with nifedipine in 18 patients with poorly controlled hypertension. The design was a double-blind, cross-over study using a double-dummy technique. Felodipine 5mg was given 3 times daily and nifedipine 10mg 3 times daily. In case of an unsatisfactory blood pressure reduction, the drug dose was doubled. 14 patients had the higher dose of felodipine and 16 the higher dose of nifedipine. Both agents had good antihypertensive effect. After 1 week's therapy, felodipine reduced the blood pressure by 18/12 mm Hg (supine) and 18/13 mm Hg (upright), and nifedipine by 19/11 and 24/14 mm Hg, respectively. After 4 weeks' therapy, 12 hours after drug intake, felodipine reduced the blood pressure by 11/8 mm Hg (supine) and 16/8mm Hg (upright), and nifedipine by 3/2 and 6/4 mm Hg, respectively. Two patients on nifedipine withdrew from the study due to adverse reactions. In general, however, there were few side effects, with no significant difference between the drugs.