Behavioral Analysis and Ethogram of Mating in the Wasp Sphex latreillei (Lepeletier) (Hymenoptera: Crabronidae).

The present study reevaluates mating in Sphex latreillei (Lepeletier) based on the analysis of 69 filmed reproductive interactions from a population in central Chile. Behaviors recorded before, during, and after copulation were analyzed through Markov chains, identifying statistically significant behavioral transitions that are summarized in a mating ethogram. The results suggest that females exercise choice either during copulation by the means of an internal courtship, or via a post-copulation selection. Both types of inter-sexual selection proposed would explain, in both female and male, the dynamics of a sexual behavior crucial for a reproductive success.

Pseudo-obstrucción intestinal por miopatía visceral esporádica / Intestinal pseudo-obstruction due to sporadic visceral myopathy

We report an unusual case of a patient with sporadic visceral myopathy and involvement of the entire gastrointestinal and urinary tract. Visceral myopathy is a form of chronic idiophatic intestinal pseudo-obstruction characterized by vacuolar degeneration, atrophy and fibrosis of the intestinal propia muscle layer without inflammatory cells. It can be found in childhood and adolescence affecting the gastrointestinal and urinary visceral muscle. The familial occurrence can be found in about 30% of cases and the mode of transmission is autosomal recessive in most families. It is crucial to exclude secondary forms of chronic intestinal pseudo-obstruction and to obtain full thickness intestinal biopsy for the diagnosis. Surgical treatment is only beneficial in cases with isolated segmental involvement of the gastrointestinal tract.

Se presenta el caso infrecuente de un paciente con miopatía visceral esporádica y afectación de la totalidad del tracto gastrointestinal y de la vía urinaria. La miopatía visceral es una forma de pseudo-obstrucción intestinal crónica idiopática caracterizada por degeneración vacuolar, atrofia y fibrosis de la capa muscular propia de la pared intestinal, sin células inflamatorias. Se puede presentar en niños y adolescentesafectando la musculatura visceral digestiva y urinaria. La manifestación familiar se encuentra en aproximadamente el 30% de los casos y se transmite de forma autosómica recesiva en la mayoría de las familias. Esfundamental descartar causas secundarias de pseudo-obstrucción intestinal crónica y la realización de biopsia de todo el espesor de la pared gastrointestinal para poder arribar al diagnóstico. El tratamiento quirúrgico sólo es eficaz en los que tienen afectación de porciones aisladas del tubo digestivo.

Anomalies of the fetal venous system: a report of 26 cases and review of the literature.

OBJECTIVE: To evaluate sonographic appearance, natural history, and neonatal outcome of fetal venous anomalies. METHODS: We performed an observational study, including all fetuses affected by abnormalities of the venous system diagnosed by ultrasound during the prenatal period. RESULTS: 26 fetuses were identified. Other malformations were present in 5 cases (19.2%), 1 fetus had trisomy 21, and 1 fetus had intrauterine growth retardation (IUGR). Twenty-five pregnancies ended in liveborn infants, and there was 1 case of unexplained intrauterine death in the fetus with IUGR affected by varix of the umbilical vein. CONCLUSIONS: Fetal venous anomalies are very rare and may be associated with fetal malformations or IUGR. Conservative management appears to be an adequate medical practice in the absence of other fetal problems, but in the presence of a varix of the umbilical vein, serial follow-up scans are needed to exclude the onset of hydrops or thrombosis of the varix.

Pseudo-obstrucción intestinal por miopatía visceral esporádica / Intestinal pseudo-obstruction due to sporadic visceral myopathy

We report an unusual case of a patient with sporadic visceral myopathy and involvement of the entire gastrointestinal and urinary tract. Visceral myopathy is a form of chronic idiophatic intestinal pseudo-obstruction characterized by vacuolar degeneration, atrophy and fibrosis of the intestinal propia muscle layer without inflammatory cells. It can be found in childhood and adolescence affecting the gastrointestinal and urinary visceral muscle. The familial occurrence can be found in about 30% of cases and the mode of transmission is autosomal recessive in most families. It is crucial to exclude secondary forms of chronic intestinal pseudo-obstruction and to obtain full thickness intestinal biopsy for the diagnosis. Surgical treatment is only beneficial in cases with isolated segmental involvement of the gastrointestinal tract.(AU)

Se presenta el caso infrecuente de un paciente con miopatía visceral esporádica y afectación de la totalidad del tracto gastrointestinal y de la vía urinaria. La miopatía visceral es una forma de pseudo-obstrucción intestinal crónica idiopática caracterizada por degeneración vacuolar, atrofia y fibrosis de la capa muscular propia de la pared intestinal, sin células inflamatorias. Se puede presentar en niños y adolescentesafectando la musculatura visceral digestiva y urinaria. La manifestación familiar se encuentra en aproximadamente el 30% de los casos y se transmite de forma autosómica recesiva en la mayoría de las familias. Esfundamental descartar causas secundarias de pseudo-obstrucción intestinal crónica y la realización de biopsia de todo el espesor de la pared gastrointestinal para poder arribar al diagnóstico. El tratamiento quirúrgico sólo es eficaz en los que tienen afectación de porciones aisladas del tubo digestivo.(AU)

Pulmonary stenosis and atresia with intact ventricular septum during prenatal life.

AIM: To identify fetal echocardiographic characteristics predictive of perinatal outcome in cases with a prenatal diagnosis of pulmonary stenosis or pulmonary atresia. PATIENTS AND METHODS: We retrospectively reviewed the records and the videotapes of all the cases of pulmonary stenosis and pulmonary atresia diagnosed at our institutions between 1990 and 1999. The following measurements were obtained: diameters of right and left atria and ventricles and ventricular wall thickness; main pulmonary artery and aortic root diameter; direction of flow through the atrioventricular, aortic and pulmonary valves and through the ductus arteriosus. Perinatal outcome and follow-up of the survivors were available in each case. RESULTS: There were 21 cases of pulmonary atresia. Eleven were diagnosed before 24 weeks and nine of them (82%) underwent termination of pregnancy. The survival rate was 50% among the 12 fetuses born at term. None of the fetuses that survived had a large right ventricle, while this was a finding in 50% of those that died. Among the fetuses that died, 83% had a hypertrophic right ventricular wall compared to 33% of the survivors. There were 12 cases of pulmonary stenosis. Three cases were diagnosed before 24 weeks but none underwent termination of pregnancy. All the fetuses with pulmonary stenosis were born at term and four died in the perinatal period. The survival rate was thus 66.6% (8/12). Three (75%) of the fetuses that died had reversed flow in the ductus arteriosus compared with one of the fetuses that survived. CONCLUSION: Our data suggest that a grossly enlarged right ventricle and/or a hypertrophied right ventricular wall in cases of pulmonary atresia and reversed flow in the arterial duct in cases of pulmonary stenosis are likely indicators of a poor prognosis.

Surgical retrieval of an embolized central venous catheter in a premature baby.

Embolization of central venous catheter fragments is usually treated with percutaneous interventional techniques, which are difficult to apply in infants with very low birth weight. We surgically removed a catheter fragment in a preterm neonate, to avoid the impending thrombosis of the right pulmonary artery. The operation was performed with a nerve hook introduced through a tiny incision in the vessel's wall. The procedure was well tolerated, and no stricture remains at the site of incision.

Arteriovenous fistulas of the placenta in a singleton fetus with large atrial septal defect and anomalous connection of the umbilical veins.

Arteriovenous fistulas of the placenta rarely occur in singleton pregnancies. This report describes the fetal and neonatal hemodynamic pattern in a singleton gestation in which multiple placental artery-to-vein anastomoses were associated with a large atrial septal defect and a single umbilical artery with an anomalous connection of the persistent right and left umbilical veins. Possible links between the extracardiac vascular malformation and the congenital heart defect are discussed.

Berry syndrome, a complex aortopulmonary malformation: one-stage repair in a neonate.

Successful one-stage repair of a Berry syndrome (interrupted aortic arch, distal aortopulmonary septal defect, right pulmonary artery branch originating from the ascending aorta, and intact ventricular septum) in the neonatal period has been reported in only 2 cases. We report the case of a newborn operated on with deep hypothermic arrest and isolated myocardial perfusion in whom the interrupted aortic arch was corrected by direct anastomosis between the ascending and descending aorta and the aortopulmonary septal defect was treated with reconstruction of the pulmonary trunk and right pulmonary artery, using a flap of aortic tissue. A native pericardial patch was used to reconstruct the ascending aorta.

Accuracy of routine ultrasonography in screening heart disease prenatally. Gruppo Piemontese for Prenatal Screening of Congenital Heart Disease.

The aim of the present study was to assess the accuracy of the four-chamber view as a screening test for detection of congenital heart disease (CHD) prenatally in a low-risk population. A prospective observational study was conducted in 17 ultrasound units of the Piemonte Region, Italy, in pregnancies with no risk factors for CHD. At each routine scan, from 18 weeks of gestational age, the four-chamber view of the heart was looked for. When an anomaly was suspected, the patients were referred to a specialized unit. Follow-up of the babies until discharge from the hospital was obtained. 11,232 sonograms were performed on 8299 pregnancies. Cardiac malformations were diagnosed in 40 newborns (4.8/1000). Six of them (15 per cent) had been recognized in utero. The sensitivity, specificity, and positive and negative predictive values were 15, 99.9, 50, and 99.6 per cent, respectively. When malformations that are not associated with an abnormal four-chamber view were excluded from the analysis, the sensitivity increased to 35.3 per cent. The sensitivity found in this study is low, but it is probably realistic since it is comparable to that reported in other multicentric studies. This type of study should reflect the state of the art of the method applied in the field. Although the sensitivity is low, it would be nil if the test were not performed. Moreover, it will probably increase with better training of the operators and by extending the examination to the ventriculo-arterial connections.

Conotruncal anomalies in prenatal life.

This retrospective multicenter study represents an analysis of the intrauterine determinants of the prognosis for conotruncal anomalies. Data regarding reason for referral, presence of chromosomal or extracardiac anomalies, pregnancy and surgical outcome were recorded in 67 cases of conotruncal anomalies from three Italian referral units. Chromosomal aberrations effected 11 of the 60 (18.3%) fetuses in which a karyotype was available. Extra-cardiac malformations were present in 25/67 cases (37.3%). No chromosomal anomalies were present in fetuses with complete or corrected transposition of the great arteries. However, tetralogy of Fallot and double-outlet right ventricle were associated with chromosomal anomalies in 22% and 38% of cases, respectively, and with extracardiac anomalies in 45% and 46% of cases, respectively. Only 20 of the 67 (31%) cardiac malformations were associated with an abnormal four-chamber view. There were 28 (41.7%) terminations of pregnancy, six (8.9%) intrauterine deaths and 16 (23.8%) neonatal deaths. Seventeen neonates (25.3%) are currently alive, and 15 of these have undergone reparative surgery. The prognosis of conotruncal anomalies is poorer when the conditions is diagnosed in utero. This is mainly due to the frequent association with chromosomal and/or extracardiac anomalies, often leading to intrauterine or early neonatal death.

Rudimentary pulmonary valve and ventricular septal defect associated with patent ductus arteriosus.

This report describes a rare case of patency of the ductus arteriosus in the setting of ventricular septal defect and rudimentary pulmonary valve. We comment on the fetal, neonatal, and postmortem findings and speculate about the role of the ductus arteriosus in the development of dilatation of the pulmonary arteries in this malformation.

[Sudden death during a game of soccer in a young adolescent with a myocardial muscle bridge]. / Morte improvvisa durante una partita di calcio in un giovane adolescente portatore di ponte muscolare coronarico.

The case of a young adolescent who suffered a sudden death while playing soccer is described. At necropsy a long intramyocardial segment of the obtuse marginal branch of the left coronary artery was found, with fresh ischemic damage in the surrounding myocardium. We comment about negativity of the tests the boy had undertaken because of a single syncopal episode he suffered in similar circumstances. Those tests included two 24-hour Holter monitorings, a maximal electrocardiographic stress-test and an electrophysiologic study. In no occasion did he complain of angina pectoris.

[Influence of sleep, wakefulness and some daily activities on ventricular ectopic activity in recent myocardial infarction (author's transl)]. / Influenza del ciclo sonno-veglia e di alcune attivita' giornaliere sull'attivita' ectopica ventricolare nell'infarto miocardico recente.

87 24-hour electrocardiographic monitoring sessions were conducted in 71 ambulatory patients (pts) in the early post-hospital phase after acute myocardial infarction. 29 (41%) had anterior, 42 (59%) inferoposterior myocardial infarction, 44 (62%) had angina or asymptomatic ischemia, 7 (10%) were in cardiac failure (II-III class NYHA). The occurrence of ventricular ectopic activity (VEA) during sleep hours was compared to the awake state; VEA during sexual and other activities of the awake state was studied. Excluding pts free of VEA during 24-hour monitoring the number of ventricular mature beats was lowered in 71% of sessions and augmented in 12% during sleep hours (p less than 0.001). Maximal grade of VEA was observed during wakefulness in 62% of session and in 9% during sleep (p less than 0.001); in 9% there was no difference, in 20% no VEA occurred. Total VEA, bi-tri-quadrigeminism and repetitive extrasystoles were significantly reduced during sleep: p less than 0.001, p less than 0.05 and p less than 0.01 respectively. This pattern was independent from site of infarction, presence of ischemia, cardiac failure (II-III class NYHA). A discrete correlation was observed between total VEA and heart rate; a poor correlation was seen between total VEA, multiform and repetitive extrasystoles. During wakefulness VEA was mainly related to physical exertion and emotional stress. Sleep and relax periods of the day showed VEA similar to sleeping hours of the night. Sexual activity did not significantly elicit more VEA than other activities of the awake state. Repetitive forms, observed in 8% of the population, were probably related to the rapid increase of sympathetic tone. The absence of repetitive VEA, potentially dangerous, during sleep hours (except the first) not due to antiarrhythmic drugs suggests to increase the dosage of these medications during the awake state in the majority of these pts.