ABSTRACT
Myocardial damages due to ischemia-reperfusion (I/R) are recognized to be the result of a complex interplay between genetic and environmental factors. Epidemiological studies suggested that, among environmental factors, carbon monoxide (CO) urban pollution can be linked to cardiac diseases and mortality. The aim of this work was to evaluate the impact of exposure to CO pollution on cardiac sensitivity to I/R. Regional myocardial I/R was performed on isolated perfused hearts from rats exposed for 4 wk to air enriched with CO (30-100 ppm). Functional variables, reperfusion ventricular arrhythmias (VA) and cellular damages (infarct size, lactate dehydrogenase release) were assessed. Sarcomere length shortening and Ca(2+) handling were evaluated in intact isolated cardiomyocytes during a cellular anoxia-reoxygenation protocol. The major results show that prolonged CO exposure worsens myocardial I/R injuries, resulting in increased severity of postischemic VA, impaired recovery of myocardial function, and increased infarct size (60 +/- 5 vs. 33 +/- 2% of ischemic zone). The aggravating effects of CO exposure on I/R could be explained by a reduced myocardial enzymatic antioxidant status (superoxide dismutase -45%; glutathione peroxidase -49%) associated with impaired intracellular Ca(2+) handling. In conclusion, our results are consistent with the idea that chronic CO pollution dramatically increases the severity of myocardial I/R injuries.
Subject(s)
Air Pollutants/toxicity , Air Pollution/adverse effects , Carbon Monoxide/toxicity , Myocardial Reperfusion Injury/pathology , Air Pollutants/analysis , Animals , Antioxidants/metabolism , Arrhythmias, Cardiac/physiopathology , Calcium/physiology , Carbon Monoxide/analysis , Coronary Vessels/physiology , Glutathione Peroxidase/metabolism , Heart Ventricles , L-Lactate Dehydrogenase/metabolism , Male , Myocardium/enzymology , Myocardium/metabolism , Myocytes, Cardiac/drug effects , Oxidative Stress/physiology , Rats , Rats, Wistar , Sarcomeres/drug effects , Sarcomeres/ultrastructure , Superoxide Dismutase/metabolismABSTRACT
The aim of this retrospective study was to compare stage, disease-free survival and overall survival in patients suffering from endometrial cancer who underwent hysteroscopy and those who did not. Between January 1, 1990 and June 30, 2001, 181 patients were referred to our Gynaecologic Department for primary endometrial carcinoma; from clinical charts we reviewed the personal and pathological data of all patients. Patients were divided into two groups: those with hysteroscopy (69 patients) and those without (112 patients). Endometrial biopsy was performed at the end of hysteroscopy. We compared symptoms at diagnosis, stage and survival. Hysteroscopy demonstrates a high diagnostic accuracy for endometrial cancer. In our case series we obtained a sensitivity of 93.10%, specificity of 99.96%, positive predictive value of 98.18% and negative predictive value of 99.85%; when hysteroscopy was associated with endometrial biopsy the sensitivity was 96.55% and specificity 100%. In this study we had a significant difference in stage Ia; in the group with hysteroscopy, stage Ia cases were 23.2% while in the group without, stage Ia cases were 15.2%. Survival in stage Ia only was 100% and 91.7%, respectively, at three and five years. In conclusion hysteroscopy was found to have a very important role in the early diagnosis of endometrial cancer, especially when it is limited to the mucosal surface.
Subject(s)
Endometrial Neoplasms/diagnosis , Hysteroscopy , Adult , Aged , Aged, 80 and over , Biopsy , Disease-Free Survival , Endometrial Neoplasms/pathology , Female , Humans , Middle Aged , Retrospective Studies , Sensitivity and Specificity , Survival RateABSTRACT
A case of vaginal bleeding occurring in a patient with a cervico-isthmic pregnancy located in a previous caesarean section scar was treated with curettage and systemic methotrexate. Metrorrhagia and uterine rupture are severe complications of this kind of ectopic pregnancy and sometimes require demolitive surgery, still today. Early ultrasonographic diagnosis is necessary to allow conservative treatment.
Subject(s)
Pregnancy, Ectopic/diagnostic imaging , Adult , Cesarean Section , Cicatrix , Curettage , Female , Humans , Methotrexate/therapeutic use , Pregnancy , Pregnancy, Ectopic/drug therapy , Pregnancy, Ectopic/surgery , UltrasonographyABSTRACT
PURPOSE OF INVESTIGATION: To analyze aggressive angiomyxoma hormone-dependency. METHOD: Estroprogestinic receptor expression was studied by immunohistochemistry in 5 patients with aggressive angiomyxoma of the vulva. RESULTS: The immunohistochemical results confirm the positivity of angiomyxoma for estrogen and progesterone receptors. CONCLUSIONS: We hypothesized that the concomitant factor favoring neoplastic growth is a different genetic substrate specific in the female sex. Analysis of the data regarding the distribution of angiomyxomas in different age groups has strengthened this hypothesis suggesting that this tumor is correlated with complete maturity, in all probability hormonal. However it cannot be excluded that the tumor begins to develop at an early age, but since it has a slow growth rate, the phenomenon is delayed and is related to hormonal stimulation.
