Successful pregnancy after uterine artery embolization for uterine arterovenous malformation: a rare case report.

OBJECTIVE: This paper reports on a rare case of pregnancy after uterine artery embolization (UAE) for uterine arteriovenous malformation (AVM). Debate exists about persistence of fertility in women after UAE. Adverse effects of this technique can modify both uterine echostructure, inducing necrosis and infarction, endometrial atrophy and uterine artery rupture, and ovarian reserve, causing persistent amenorrhea. Ovarian reserve appears to be affected by UAE in pre-menopausal women. However, younger ovaries (according to biological ovarian age) exhibit a greater capacity for recovery after ovarian damage. Therefore, larger studies are needed for more conclusive results. CASE REPORT: A 28-year-old woman was admitted to our department due to life-threatening uterine bleeding, resulting in tachycardia, pallor, and sweating. The patient came with a history of two spontaneous miscarriages. After sonography and computed tomography, AVMs were identified at uterine fundus and anterior wall. CONCLUSION: The pathogenesis of infertility after UAE is not yet known. The peculiarity of this case was that, only few months later, the patient became pregnant and gave birth to a live fetus at 37 weeks with cesarean delivery.

Evidence for the presence of a type III secretion system in diffusely adhering Escherichia coli (DAEC).

Diffusely adhering Escherichia coli (E. coli) strains (DAEC) represent a potential cause of diarrhoea in infants, and the detection of type three secretion system (TTSS) genes in DAEC would substantiate their pathogenic nature. In this work, four isolates of DAEC, recovered from stools of diarrhoeic children, were analysed by PCR, in order to detect the presence of TTSS genes. Primers targeted to the escC, escJ, escN and escV, some of the most conserved TTSS genes in enteropathogenic and enterohaemorrhagic Escherichia coli (EPEC and EHEC), were used in order to verify the occurrence of homologous genes in our DAEC isolates. By this approach, we were able to characterise DNA fragments corresponding to putative escJ and escN genes in all DAEC isolates. Furthermore, DNA fragments homologous to the escC and escV genes were also amplified from all isolates. Besides the similarity found among the DAEC esc homologues with EPEC and EHEC esc genes, the nucleotide sequence analysis of the flanking regions of the amplified DNA fragments suggests that the putative DAEC esc genes are organised in the same manner as observed in EPEC and in EHEC strains. The results described here provide strong evidence for the presence of a TTSS in the DAEC strains analysed, implicating a pathogenic nature of these isolates.

Ultrastructure of spermatozoa of the lizard Ameiva ameiva, with considerations on polymorphism within the family Teiidae (Squamata).

A detailed description of sperm ultrastructure of the lizard Ameiva ameiva (Teiidae) is provided. Mature spermatozoa are characterized by: a depressed acrosome at the anterior portion; a unilateral ridge at the anterolateral portion; an acrosome vesicle divided into cortex and medulla; medulla divided into two regions with different electron-densities; paracrystalline subacrosomal material with radial organization in transverse section; a pointed prenuclear perforatorium; a stopper-like perforatorium base plate that appears embedded in the subacrosomal material; the presence of an epinuclear lucent zone surrounded by its own membrane; a large nuclear rostrum; round nuclear shoulders; a nuclear space at the nucleus tip; a bilateral stratified laminar structure; a central dense body within the proximal centriole; a short midpiece; an axonemal midpiece axial component; peripheral fibers 3 and 8 grossly enlarged at the anterior portion of axoneme; columnar mitochondria with linear cristae; solid dense bodies arranged as rings or spirals; a triangular-shaped annulus in transverse section; a fibrous sheath into the midpiece; a thin zone of cytoplasm at the anterior portion of the principal piece; and a slight decrease in diameter of the principal piece immediately after the annulus. Comparisons with Cnemidophorus sexlineatus and Micrablepharus maximiliani failed to identify unique sperm ultrastructure traits of Teiidae or Teiioidea (Teiidae + Gymnophthalmidae). High levels of polymorphism between Ameiva and Cnemidophorus, two closely related genera of the family Teiidae, were detected, suggesting that extensive sampling within squamate families is essential if sperm ultrastructure data are to be used in phylogenetic analyses at this taxonomic level.

Lactoferrin and free secretory component of human milk inhibit the adhesion of enteropathogenic Escherichia coli to HeLa cells.

BACKGROUND: Diarrhoea caused by Escherichia coli is an important cause of infant morbidity and mortality in developing countries. Enteropathogenic Escherichia coli (EPEC) is considered one of the major causes of diarrhoea in children living in developing countries. The ability of diarrhoeagenic strains of E. coli to adhere to and colonize the intestine is the first step towards developing the disease. EPEC strains adhere to enterocytes and HeLa cells in a characteristic pattern known as localized adherence. Many epidemiological studies of diarrhoea have shown that breast-feeding protects infants from intestinal infections. Both immunoglobulin and non-immunoglobulin elements of human milk are thought to contribute to the protection from diarrhoeal agents. RESULTS: The effects of human milk and its protein components on the localized adherence of EPEC were investigated. Non-immunoglobulin components of human milk responsible for the inhibition of EPEC adhesion to HeLa cells were isolated by chromatographic fractionation of human whey proteins. Besides secretory immunoglobulin A, which has been previously reported to affect the adhesion of EPEC, free secretory component (fSC) and lactoferrin (Lf) were isolated. Even in concentrations lower than those usually found in whole milk, fSC and Lf were able to inhibit the adhesion of EPEC. alpha-lactalbumin was also isolated, but showed no activity on EPEC adhesion. CONCLUSIONS: This study demonstrated that the immunoglobulin fraction, the free secretory component and lactoferrin of human milk inhibit EPEC adhesion to HeLa cells. These results indicate that fSC and Lf may be important non-specific defence factors against EPEC infections.

Binding of lactoferrin and free secretory component to enterotoxigenic Escherichia coli.

The ability of two glycoproteins of human milk, lactoferrin and free secretory component, to bind to Escherichia coli colonization factors (CFAs) was investigated using immunocytochemistry assays of enriched fimbrial extracts. The results revealed that lactoferrin binds to fimbrial CFA I adhesin but not to CFA II adhesin (CS1 and CS3), while free secretory component interacts with both CFA I and CFA II adhesins. Our data indicate that lactoferrin and free secretory component, which are very abundant proteins of human milk, could play an important role against infant enteric disease by blocking bacterial adhesion.

Human milk fractions inhibit the adherence of diffusely adherent Escherichia coli (DAEC) and enteroaggregative E. coli (EAEC) to HeLa cells.

Binding to a specific receptor is an essential step for most enteropathogens to initiate an intestinal infection. We analyzed the inhibitory effect of human milk and its protein components on adhesion of two diarrheagenic Escherichia coli strains, diffusely adherent E. coli (DAEC) and enteroaggregative E. coli (EAEC), to HeLa cells. Defatted milk, whey proteins, immunoglobulin and non-immunoglobulin fractions, in concentrations lower than usually found in whole milk, inhibited both DAEC and EAEC adhesion, indicating that human milk components may contribute to the defense of the infants against enteropathogens.

Free secretory component and lactoferrin of human milk inhibit the adhesion of enterotoxigenic Escherichia coli.

The non-immunoglobulin component of human milk responsible for the inhibition of Escherichia coli cell adhesion (haemagglutination) mediated by colonisation factor antigen 1 (CFA1) was determined by chromatographic fractionation of human whey proteins with Sephadex G-200, DEAE cellulose and heparin-sepharose. Pure free secretory component (fSC) and pure lactoferrin (Lf) were isolated and both compounds inhibited the haemagglutination induced by E. coli CFA1+. The lowest concentrations of purified fSC and Lf able to inhibit the haemagglutination induced by E. coli strain TR50/3 CFA1+ were 0.06 mg/ml and 0.1 mg/ml respectively. Commercially available lactoferrin from human milk and transferrin from human serum, which has a great structural analogy to lactoferrin, also inhibited the haemagglutination. The lowest concentrations of the commercial lactoferrin and transferrin able to inhibit the haemagglutination induced by E. coli TR50/3 CFA1+ were 0.03 mg/ml and 0.4 mg/ml, respectively. These results indicate that fSC and Lf may be important non-specific defence factors against enterotoxigenic E. coli infections.

Mannose-resistant haemagglutination (MRHA) and haemolysin (Hly) production of strains of Escherichia coli isolated from children with diarrhoea: effect of breastfeeding.

Haemolysin production (Hly) and mannose-resistant haemagglutination induction (MRHA) of human (H), bovine (B), and both (HB) erythrocytes was investigated in strains of E. coli isolated from 142 cases of children with diarrhoea aged 0-36 months. Haemolysin production was more frequent in strains isolated from children under 1 year and this characteristic was strongly associated with HB+ haemagglutination (P < 0.005). Isolation frequency of MRHA strains was compared in 53 breastfed and 50 non-breastfed children under 1 year of age. HB+ strains were significantly more frequent in non-breastfed infants (P < 0.025). Severity of diarrhoea evaluated by the number of watery stools per day, was significantly reduced in the breastfed group (P < 0.05). The results suggests that breastfeeding may protect infants against the establishment of HB+ strains which might be acting either as a main pathogen or as an opportunistic strain.

Stable isotope metabolic studies of zinc nutrition in slum-dwelling lactating women in the Amazon valley.

1. Zinc metabolism has been studied in a group of undernourished, slum-dwelling, lactating women in Manaus, Brazil, by means of modified metabolic balance techniques and the stable isotope 67Zn. 2. The subjects were found to be consuming a diet which provided an average of 34% of the recommended dietary allowance for lactating women, but six of the seven appeared to achieve Zn balance. In five of the subjects use of 67Zn in a stable isotope dilution manner demonstrated that they were absorbing a high proportion of the dietary Zn (proportional absorption ranged from 0.59 to 0.84), suggesting an adaptation to the chronically low intake. 3. Two subjects had marginally low plasma Zn concentrations, although hair, urine and milk Zn contents were all within accepted normal values. 4. Preliminary findings on the rate of plasma Zn turnover and the size of the exchangeable body Zn pool obtained using 67Zn suggest that these subjects may have a reduction in both.

Longitudinal study of diarrhoeal disease in a peri-urban community in Manaus (Amazon-Brazil).

A 20-month longitudinal study of diarrhoeal disease was carried out in a poor peri-urban community of Manaus (Amazon-Brazil), and the attack rate of this disease ranged from 0.2 to 4.8 episodes of diarrhoea per person per year. The age group most affected was 0 to 35 months old. A probable aetiological agent was identified in 68 of the 110 faecal samples collected. The most frequent enteropathogens isolated were enterotoxigenic Escherichia coli and Giardia lamblia. Enterotoxigenic Escherichia coli was also isolated from stream-water and from flies collected inside a household.

The influence of drugs on the response of a cell culture preparation to bacterial toxins.

The influence was studied of lanthanum chloride, chlorpromazine hydrochloride, indomethacin and sodium cromoglycate on the morphological changes induced in Vero cells by the action of the cholera toxin, the thermolabile enterotoxin (LT) and the Vero cell cytotoxin (VT) of Escherichia coli, the enterotoxin of Clostridium perfringens, and the cytotoxin of Clostridium difficile. These drugs were able to inhibit the effects produced by C. difficile cytotoxin but not by the other toxins examined.

Detection of Clostridium perfringens enterotoxin by tissue culture and double-gel diffusion methods.

Culture filtrates of four enterotoxin-producing strains of Clostridium perfringens type A produced morphological changes in cells of 10 of 12 established mammalian cell lines tested, and particularly Vero (African green-monkey kidney) and MDCK (dog kidney) cells. Double-gel diffusion and Vero-cell tests detected enterotoxin in culture filtrates of, respectively, 29 (28%) and 56 (54%) of 103 strains of C. perfringens tested. The feasibility of cell-culture assays for the routine detection of C. perfringens enterotoxin is indicated.

Clostridium difficile toxin-induced intestinal secretion in rabbit ileum in vitro.

In rabbit ileum in vitro Clostridium difficile toxin (200 microliter crude extract) almost abolished net Na absorption, by decreasing mucosa to serosa flux, and induced net Cl secretion by increasing the serosa to mucosa flux. These flux changes were induced when there was no visible histological damage to the mucosa. The toxin did not influence adenylate or guanylate cyclase activity in a plasma membrane fraction of isolated rabbit enterocytes nor did it affect cAMP concentrations in intact rabbit ileum pre-incubated with toxin. The flux responses to the toxin were prevented by removing calcium from the serosal medium, suggesting that the secretory process may be calcium dependent. These results indicate a possible mechanism by which this toxin could induce diarrhoea.