Mesotelioma peritoneal multiquístico benigno: reporte de un caso y revisión de la literatura / Benign multicystic peritoneal mesothelioma: case report and literature review

INTRODUCCIÓN: El mesotelioma peritoneal multiquístico benigno (MPMB) es una entidad con muy baja incidencia que se presentan con mayor frecuencia en mujeres jóvenes. CASO CLÍNICO: Paciente de 17 años que consulta por amenorrea secundaria. Además, refería pérdida de peso, estreñimiento y molestias abdominales. La exploración fue normal y en las pruebas de imagen se objetivó una pelvis ocupada por una masa multiquística, de unos 20 cm de diámetro máximo, de paredes finas y contenido anecoico. Se solicitaron marcadores tumorales de los cuales sólo se encontró elevado el CA 19.9 (35,2 U/mL). Se decidió realizar una laparoscopia exploradora para establecer un diagnóstico y ante los hallazgos y al considerarse la masa fácilmente resecable, en el mismo acto quirúrgico se extirpó por completo para su estudio anatomopatológico, que confirmó un MPMB. Se desestimaron tratamientos adicionales y actualmente se encuentra en seguimiento y asintomática. CONCLUSIÓN: La patogénesis del MPMB no está clara. Algunos autores defienden que se trata de una reacción peritoneal a un daño inflamatorio, otros apoyan que se trata de una neoplasia benigna. Esta naturaleza incierta, junto con la escasa experiencia, hacen que el manejo resulte complejo. Es necesario individualizar cada caso e intentar ser conservadores especialmente en pacientes jóvenes. Si se opta por un manejo activo, lo más acertado es la citorreducción completa seguida de quimioterapia hipertérmica peritoneal. El seguimiento, en cualquier caso, debe ser exhaustivo y multidisciplinar principalmente con pruebas de imagen.

BACKGROUND: Benign Multicystic Peritoneal Mesothelioma (BMPM) is an entity with a very low incidence that occurs more frequently in young women. CASE REPORT: A 17-year-old woman attended for secondary amenorrhea. She also referred to weight loss, constipation and abdominal discomfort. The examination was normal and echography revealed a pelvis occupied by a 20 centimeters multicystic mass, with thin walls and anechoic content. A preoperative study with tumor markers was requested in which only a CA 19.9 elevation was observed (35.2 U/ml 0-27). It was decided to perform an exploratory laparoscopy to establish a diagnosis. Due to the findings and because of the fact that the mass was considered easy to remove, it was completely removed in the same surgical act. The pathological result confirmed a BMPM. Additional treatments have been dismissed and are the patient is currently being followed up without symptoms. CONCLUSION: The pathogenesis of BMPM is unclear. Some authors argue that it is a peritoneal reaction to inflammatory damage, others support that it is a benign neoplasm. This uncertain nature coupled with limited experience make management complex. It is necessary to evaluate each case and try to be conservative especially in young patients. If surgery management is chosen, complete cytoreduction followed by hyperthermic peritoneal chemotherapy is the most successful option. The follow-up in any case must be exhaustive and multidisciplinary, mainly with imaging tests.

Manejo expectante de gestación ectópica abdominal tras fecundación in vitro en paciente con salpinguectomía bilateral: reporte de un caso / Expectant management of abdominal ectopic pregnancy following in vitro fertilization in a patient with previous bilateral salpinguectomy: a case report

ANTECEDENTES El embarazo ectópico abdominal es el menos habitual de los embarazos ectópicos, con una prevalencia situada entre el 0.9 - 1.4%. La mortalidad materna es elevada, alcanzando un 20% y la viabilidad fetal mínima. El manejo médico en estas situaciones es complicado ya que no está bien establecido debido a su baja frecuencia. CASO CLÍNICO Mujer de 35 años, con antecedente de esterilidad por endometriosis y salpinguectomía bilateral. Tras 5 fecundaciones in vitro (FIV) consigue una primera gestación, con finalización mediante cesárea por no progresión de parto. Acude a urgencias en su segundo embarazo, logrado tras 3 (FIV), con edad gestacional de 7 semanas. Presenta sangrado vaginal escaso y la ecografía demuestra a nivel de Douglas y hacia fosa iliaca izquierda un saco gestacional de 3 cm con embrión sin latido cardiaco de 5 mm. El nivel de β-hcg es de 1477 mUI/ml. Se diagnostica de gestación ectópica abdominal y se opta por actitud expectante dada la estabilidad clínica de la paciente. En un control a las 48h la β-Hcg es de 464 mUI/ml y la paciente se mantiene estable. En controles posteriores se observan niveles descendentes de β-Hcg y tras un mes la resolución es completa. CONCLUSIÓN El embarazo ectópico abdominal es una entidad poco frecuente pero con una alta tasa de mortalidad. Aunque lo más común es optar por un abordaje quirúrgico es necesario individualizar cada caso y basarse en la clínica y las diferentes pruebas diagnósticas para seleccionar aquellos casos que se pueden beneficiar de un manejo conservador.

BACKGROUND Abdominal ectopic pregnancy accounts for only 0.9-1.4% of all ectopic pregnancies. The maternal mortality rate is high (up to 20%) and fetal viability mínimum. The managment, specially the conservatory management of these cases is difficult because of our limited experiencie due to its low frecuency. CASE PRESENTATION 35-year-old woman, with history of sterility due to endometriosis that required bilateral laparoscopic salpinguectomy. Her first pregnancy (after 5 in vitro fertilization cicles (IVF)) finalized with a caesarean section because of to the lack of labour progresion. She was admitted to our emergency department during her second pregnancy (after 3 IVF cicles), with 7 weeks of gestational age. She had a little vaginal bleeding. Ultrasound scan showed a 5mm gestational sac with a 3mm embryo without cardiac activity in the pouch of Douglas. The β-Hcg level was 1477mUI/ml. The final diagnosis was ectopic abdominal pregnancy and it was decided to undertake an expectant management because she was clinically stable. The β-Hcg level after 48 hours was 464 mUI/ml. In subsequent examinations β-Hcg showed descending levels and after one month the resolution was completed. CONCLUSION Abdominal ectopic pregnancy is very infrequent but it has a high mortality rate. The most common approach is surgical but it is necessary to study all signs and diagnostic tests to select patients that could get profit from a conservatory management.

Posoperatorio del donante vivo de riñón: diferencia con pacientes sometidos a nefroctomías laparoscópicas por otras causas / No disponible

Debido al incremento de la nefrectomía laparoscópica para trasplante renal de donantes vivos en nuestro hospital en los últimos años (en 2017, 332 trasplantes renales de donante vivo, de los que 47 se hicieron en Andalucía y 17 de ellos en nuestro centro), se ha realizado un estudio prospectivo en el cual se analizaron, con 6 variables, el impacto que tiene el posoperatorio de la nefrectomía laparoscópica en los donantes vivos con respecto al resto de pacientes que se someten al mismo procedimiento por otras causas en nuestra unidad. El objetivo principal del estudio es analizar las implicaciones y el impacto que tiene el posoperatorio de la nefrectomía laparoscópica en los diferentes procesos. Se parte de la hipótesis de que las implicaciones que tiene el donante vivo afectarán al desarrollo de su posoperatorio (mayor dolor, mayor estancia hospitalaria...), comparado con el resto de pacientes que se someten a la misma intervención por otros motivos. Se identificó en este estudio que este tipo de cirugía implica mayor estancia hospitalaria, con respecto a la misma cirugía por otros motivos, pero no existe un resultado en el número de pacientes estudiados de mayor dolor en estos pacientes con respecto a los otros citados. Mostraremos los cuidados enfermeros que seguimos en nuestra unidad con estos pacientes. Para ello tomaremos como referencia los patrones funcionales de Gordon, determinando los diagnósticos enfermeros, así como los criterios de resultados (NOC) y las intervenciones de enfermería (NIC)

Due to the increase of laparoscopic nephrectomy in live donors for renal transplantation during the last years in our hospital (in 2017, 332 live donor renal transplants, of these 47 were done in Andalusia, and 17 in our hospital). A prospective study was conducted to analyse 6 variables, the Impact of postoperative laparoscopic nephrectomy in live donors compared to those patients who underwent the same procedure for different reasons in our unit. The primary aim of the study is to examine the implications and impact of postoperative laparoscopic nephrectomy in different processes. It is assumed that the live donor's implications will affect the postoperative period (pain, length of hospital stay...), compared to the rest of the patients who undergo the same procedure for different reasons. A study identified that this type of surgery involves unnecessarily prolonged stay in hospital, with regards to the same surgery but for different reasons. However, there is no evidence of difference between the number of patients studied with severe pain and the aboye mentioned. We will show the nursing care that we follow with these patients in our unit. We will take as reference Gordon's functional health patterns, identifying nursing diagnosis as well as the nursing outcomes classification (NOC) and nursing interventions

Plan de cuidados en la ablación percutánea por radiofrecuencia de tumores renales / No disponible

La atención sanitaria basada en la evidencia y su aplicación a través de herramientas para la disminución de la variabilidad de la práctica clínica es fundamental en la práctica diaria. Con esta comunicación mostramos el uso de la técnica de la ablación percutánea por radiofrecuencia de tumores renales. Mostraremos los cuidados enfermeros seguidos en la unidad para mejorar la calidad de los cuidados. Tomamos como muestra tres casos clínicos de nuestro servicio. Describiremos todos los cuidados que se realizan para la atención integral de enfermería, realizando un seguimiento de los mismos. Para ello tomaremos como referencia los patrones funcionales de Gordon, determinando los diagnósticos enfermeros, así como los criterios de resultados (NOC) y las intervenciones de enfermería (NIC)

Evidence base-health care and its application through tools to decrease the variability of the clinical practice is of pivotal importance in the daily practice. The aim is to show percutaneous ablation technique by means of radiofrequency of renal tumours. Nursing care plan followed in the unit is shown. As an example, three clinical cases are presented. Comprehensive nursing care is described with a close monitoring of the situation. Gordon is the method used in the nursing process to provide a more comprehensible nursing assessment of the patient (diagnosis, nursing outcomes classification and Nursing Interventions Classification)

Tapones de desinfección pasiva con alcohol. Implantación en la unidad de Urología / No disponible

Debido al incesante aumento de las infecciones asociadas a los catéteres de acceso venosos periféricos y centrales que enfermería utiliza, añadiendo la importancia de la prevención de las mismas como línea de actuación dentro de las guías FASE (Fáciles y Seguras basadas en la Evidencia), vemos importante la introducción de cambios en el hacer de nuestra profesión. Por ello se implantó en nuestra unidad el uso de tapones protectores impregnados en alcohol que, colocándolos en los puertos denominados bioconectores, los dejaban no solo aislados del medio, sino que se consideran desinfectados. Durante 21 días hicimos un seguimiento de quiénes de los pacientes candidatos de usarlo lo tenían y quiénes no. Y finalmente pasamos unas encuestas de valoración para evaluar el rendimiento global del producto en comparación con el sistema anterior de desinfección. Para observar si nuevas medidas de asepsia en el uso de dispositivos venosos eran aceptadas y valoradas. Observando un gran nivel de adhesión

Because of the ever-increasing infections associated with peripheral and central venous catheters, added the importance of prevention which constitutes a line of action of the simple and safety guides based on Evidence (FASE guides), used by nursing staff it is important to introduce changes in this profession. Therefore, a policy of port protectors which are alcohol-impregnated caps is also necessary since they are a physical barrier to contamination and guarantee disinfection compliance. For 21 days we conducted a study to determine the appropriate candidates. Finally, we conducted an assessment survey to evaluate the overall performance of the product in comparison with the previous method of disinfection to be able to check is new measures of asepsis with regards to the use of venous access devices were well accepted and valued. Noting great level of satisfaction

Plan de cuidados en la cistitis actínica: a propósito de un caso / No disponible

Dada la importancia de una adecuada atención de enfermería, así como del uso de planes de cuidados estandarizados para la mejora de dichos cuidados, presentamos esta comunicación donde mostramos un caso clínico concreto. Se trata de una mujer de 48 años que ingresa en nuestra planta con el diagnóstico de cistitis actínica o rádica. Para ello tomamos como referencia los patrones funcionales de Gordon, determinando los diagnósticos enfermeros así como los criterios de resultados (NOC) y las intervenciones de enfermería (NIC). Por otro lado, hemos usado la escala tipo Likert con la que hemos evaluado los indicadores propuestos para conseguir nuestros resultados

Given the importance of an adequate nursing work and the development of standardized care plans to improve care practice, we bring forward this communication to present this particular clinical case: a 48-year-old female patient who developed actinic cystitis. To treat this female patient, we use Gordon's functional health patterns. This allows us to provide a comprehensive nursing assessment of the patient to determine nursing outcomes classification (NOC) and to evaluate the effects of interventions (NIC). On the other hand, we have used Likert scale to assess the proposed indicators which will allow us to reach the main goals

Hypothyroidism and oxidative stress: differential effect on the heart of virgin and pregnant rats.

The present study investigates the effects of hypothyroidism on both the redox state and the thyroid hormone receptors expression in the heart ventricle of virgin and pregnant rats.Hypothyroid state was induced by 6-n-propyl-2-thiouracil in drinking water given to Wistar rats starting 8 days before mating until day 21 of pregnancy or for 30 days in virgin rats. Serum paraoxonase-1 (PON-1) activity, serum and heart nitrites, and thiobarbituric acid-reactive substances (TBARS) were analyzed. Heart protein oxidation, as carbonyls, and copper-zinc superoxide dismutase (CuZnSOD), glutathione peroxidase (GPx), and catalase (CAT) activities, were determined. In addition, heart expressions of NADPH oxidase (NOX-2), CAT, SOD, GPx, and thyroid receptors (TRα and TRß) mRNA were assessed by RT-PCR. Inducible and endothelial Nitric Oxide Synthase (iNOS and eNOS) were determined by Western blot. Hypothyroidism in the heart of virgin rats decreased TRα and TRß expressions, and induced oxidative stress, leading to a decrease of nitrites and an increase of carbonyls, NOX-2 mRNA, and GPx activity. A decreased PON-1 activity suggested low protection against oxidative stress in blood circulation. Pregnancy reduced TRα and TRß mRNA expressions and induced oxidative stress by increasing nitrite and TBARS levels, SOD and CAT activities and NOX-2, eNOS and iNOS expressions, while hypothyroidism, emphasized the decreases of TRα mRNA levels and did not alter the redox state in the heart. TR expressions and redox balance of rat hearts depend on the physiological state. Pregnancy per se seems to protect the heart against oxidative stress induced by hypothyroidism. Supporting Information for this article is available online at http://www.thieme-connect.de/ejournals/toc/hmr.

Trastorno de la imagen corporal en pacientesportadores de derivaciones urinarias / No disponible

A pesar de los avances en cirugía urológica que mejoran la salud física y psicológica de los pacientes, sigue habiendo pacientes con derivacionesurinarias heterotópicas no continentes que, además del problema físico que les reporta la intervención quirúrgica, tienen quereajustar su imagen mental que tienen de sí mismos.Se plantea como objetivo exponer los cuidados que presta el personal de enfermería para potenciar la imagen corporal del paciente.Se realizó estudio descriptivo transversal sobre la percepción de la imagen corporal de un total de 43 pacientes. Para estudio se utilizóla escala de Goldberg ansiedad-depresión relacionándolo con la imagen corporal.Con este estudio se pretende concienciar al personal de enfermería sobre la importancia del abordaje de la imagen corporal (AU)

In spite of the progress in urological surgery that improve both physical and psychological patients health, there keeps being patients withnon continent heterotopic urinary derivations that besides the physical problem that brings their the operation, they have to readjust theirmental self-image that they have about themselves.Exposing cares that nursing staff lends to promote the body image of the patient is suggested as goal.Transversal descriptive study on the perception of body image of a total of 43 patients was carried out. For the study, Goldberg scale ofanxiety was used - depression relating with body image. With this study it is intended to make nursing staff aware on the importance ofthe dealing with body image (AU)

A 66-kDa protein of bovine hypophyseal Pars tuberalis induces luteinizing hormone release from rat Pars distalis

In this study, evidence for a factor secreted by bovine hypophyseal pars tuberalis that stimulates luteinizing hormone (LH) release from rat pars distalis cells is shown. The secretion products of bovine pars tuberalis cells into the culture medium were assayed on dispersed rat pars distalis cells in 30 min incubations and superfusion experiments. The culture medium from pars tuberalis total cell populations, added at a dose of 6 microg per tube, induced the greater LH release from pars distalis cells, without effect on follicle stimulating hormone (FSH) release. After pars tuberalis cells separation on a discontinuos Percoll gradient, only the culture medium of cells from 50 and 60% strength Percoll were able to release LH from rat pars distalis cells. Therefore, cell fractions from 50 and 60% strenght Percoll were cultured together. To elicit maximal LH release (6 times the basal output), with the addition of 2 microg of pars tuberalis protein was required, suggesting that these cells produce the factor or factors which affect pars distalis gonadotrope cells. After applying the pars tuberalis culture medium on 12% SDS-PAGE, the band with biological activity was that of 66-kDal. Fifty ng protein of its eluate released almost 9 times the basal output of LH from pars distalis cells. Results suggest a modulating effect of a protein from the bovine pars tuberalis on rat cultured gonadotrope cells from the pars distalis.

A 66-kDa protein of bovine hypophyseal Pars tuberalis induces luteinizing hormone release from rat Pars distalis

In this study, evidence for a factor secreted by bovine hypophyseal pars tuberalis that stimulates luteinizing hormone (LH) release from rat pars distalis cells is shown. The secretion products of bovine pars tuberalis cells into the culture medium were assayed on dispersed rat pars distalis cells in 30 min incubations and superfusion experiments. The culture medium from pars tuberalis total cell populations, added at a dose of 6 microg per tube, induced the greater LH release from pars distalis cells, without effect on follicle stimulating hormone (FSH) release. After pars tuberalis cells separation on a discontinuos Percoll gradient, only the culture medium of cells from 50 and 60% strength Percoll were able to release LH from rat pars distalis cells. Therefore, cell fractions from 50 and 60% strenght Percoll were cultured together. To elicit maximal LH release (6 times the basal output), with the addition of 2 microg of pars tuberalis protein was required, suggesting that these cells produce the factor or factors which affect pars distalis gonadotrope cells. After applying the pars tuberalis culture medium on 12% SDS-PAGE, the band with biological activity was that of 66-kDal. Fifty ng protein of its eluate released almost 9 times the basal output of LH from pars distalis cells. Results suggest a modulating effect of a protein from the bovine pars tuberalis on rat cultured gonadotrope cells from the pars distalis.(AU)

Testosterone environment of splenocytes modifies the steroidogenesis of polycystic ovary in rats.

The functional relationship between the ovary and immune cells is well known. The modulation of ovarian steroidogenesis in adult rats with polycystic ovary (PCO) by secretions of cultured splenocytes treated with 10 (-6) M testosterone or 10 (-6) M testosterone plus 10 (-4) M flutamide, an androgen receptor antagonist, was investigated. Polycystic ovary was induced by estradiol valerate (2 mg/rat). Polycystic ovary splenocyte secretions decreased the release of androstenedione from PCO ovaries in contrast to the effect of non-PCO splenocyte secretions. This decrease was associated with a significant decrease in androgen receptor and IL-12 mRNA expression in PCO splenocytes. When splenocytes were treated with testosterone, their conditioned media further decreased androstenedione release from the ovary and had a greater inhibitory effect on PCO ovary compared with non-PCO ovary. This effect was reversed by flutamide. Polycystic ovary splenocytes showed a decrease in IL-1 beta mRNA expression. Their secretions scarcely affected progesterone release from non-PCO ovaries but significantly stimulated progesterone release from PCO ovary by an androgen-independent mechanism. The differential steroidogenic ability of splenocyte secretions from PCO rats is associated with the IN VITRO testosterone environment. Polycystic ovary splenocytes might exert a protective action against PCO effects through their secretions by inducing a low androstenedione response from the ovary.

Effect of losartan pretreatment on kidney lipid content after unilateral obstruction in rats.

Intrarenal concentration of angiotensin II increases after the onset of ureteral obstruction in the obstructed kidney. The effect of pretreatment with losartan, a specific angiotensin II AT1 receptor antagonist, on lipid contents, which were previously modified by unilateral ureteral obstruction (UUO), was studied in renal cortex of rats. Adult Wistar Kyoto rats were subjected to either UUO for 24 hr or control sham operation after being treated with losartan in the drinking water at 10 mg/kg rat/day for 15 days. In the cortex of obstructed kidney the increased free and esterified cholesterol concentrations were associated with the increased cholesterol synthesis measured by incorporation of 14C-acetate (0.001>p), compared with control and contralateral kidneys. The increased amount of phosphatidylcholine was related with the increased incorporation of 14C-choline into phosphatidylcholine (0.01>p). Phosphatidylethanolamine and sphingomyelin decreased slightly but total phospholipid content did not change. The level of AT1 receptor mRNA in obstructed kidney was significantly lower than in control and contralateral kidneys. Losartan pretreatment attenuated (0.01>p) the increase in cholesterol content and synthesis and restored and enhanced the AT1 angiotensin II receptor gene expression. The interference in the renin-angiotensin system before UUO may modify renal cortex cholesterol content.

Effect of dietary fat saturation on lipid metabolism, arachidonic acid turnover and peritoneal macrophage oxidative stress in mice.

We investigated the effects of a saturated fat diet on lipid metabolism and arachidonic acid (AA) turnover in mouse resident peritoneal macrophages. The pro-oxidative effect of this diet was also studied. Female C57BL/6 mice were weaned at 21 days of age and assigned to either the experimental diet containing coconut oil (COCO diet), or the control diet containing soybean oil as fat source (10 mice per group). The fat content of each diet was 15% (w/w). Mice were fed for 6 weeks and then sacrificed. The concentration of total lipids, triglycerides, (LDL+VLDL)-cholesterol, thiobarbituric acid-reactive substances (TBARS) and reduced glutathione were increased in the plasma of mice fed the COCO diet, without changes in phospholipid or total cholesterol concentrations compared to control. The concentrations of total cholesterol, free and esterified cholesterol, triglycerides, and TBARS were increased in the macrophages of COCO-fed mice, while the content of total phospholipids did not change. The phospholipid composition showed an increase of phosphatidylcholine and a decrease of phosphatidylethanolamine. The [3H]-AA distribution in the phospholipid classes showed an increase in phosphatidylcholine and phosphatidylethanolamine. Incorporation of [3H]-cholesterol into the macrophages of COCO-fed mice and into the cholesterol ester fraction was increased. The COCO diet did not affect [3H]-AA uptake but induced an increase in [3H]-AA release. The COCO diet also enhanced AA mobilization induced by lipopolysaccharide. These results indicate that the COCO diet, high in saturated fatty acids, alters the lipid metabolism and AA turnover of peritoneal macrophages in female mice and also produces a significant degree of oxidative stress.

Effect of dietary fat saturation on lipid metabolism, arachidonic acid turnover and peritoneal macrophage oxidative stress in mice

We investigated the effects of a saturated fat diet on lipid metabolism and arachidonic acid (AA) turnover in mouse resident peritoneal macrophages. The pro-oxidative effect of this diet was also studied. Female C57BL/6 mice were weaned at 21 days of age and assigned to either the experimental diet containing coconut oil (COCO diet), or the control diet containing soybean oil as fat source (10 mice per group). The fat content of each diet was 15 percent (w/w). Mice were fed for 6 weeks and then sacrificed. The concentration of total lipids, triglycerides, (LDL + VLDL)-cholesterol, thiobarbituric acid-reactive substances (TBARS) and reduced glutathione were increased in the plasma of mice fed the COCO diet, without changes in phospholipid or total cholesterol concentrations compared to control. The concentrations of total cholesterol, free and esterified cholesterol, triglycerides, and TBARS were increased in the macrophages of COCO-fed mice, while the content of total phospholipids did not change. The phospholipid composition showed an increase of phosphatidylcholine and a decrease of phosphatidylethanolamine. The [ H]-AA distribution in the phospholipid classes showed an increase in phosphatidylcholine and phosphatidylethanolamine. Incorporation of [ H]-cholesterol into the macrophages of COCO-fed mice and into the cholesterol ester fraction was increased. The COCO diet did not affect [ H]-AA uptake but induced an increase in [ H]-AA release. The COCO diet also enhanced AA mobilization induced by lipopolysaccharide. These results indicate that the COCO diet, high in saturated fatty acids, alters the lipid metabolism and AA turnover of peritoneal macrophages in female mice and also produces a significant degree of oxidative stress.

Polymorphisms in cytokines and growth factor genes and their association with acute rejection and recurrence of hepatitis C virus disease in liver transplantation.

Acute rejection (AR) and recurrence of hepatitis C virus (HCV) infection are complications after liver transplantation (LTx). Genetic factors play a role in cytokine production as a consequence of polymorphisms within cytokine genes. Our goal was to identify genetic factors that might be associated with AR and recurrence of HCV in liver transplant recipients (LTxRs). We studied 77 Caucasian LTxRs and 100 Caucasian healthy individuals. We studied single-nucleotide polymorphisms (SNPs) in tumor necrosis factor-alpha[TNF-alpha, interleukin-6 (IL-6), IL-10, transforming growth factor-beta1, and angiotensin-converting enzyme genes by SNaPSHOT trade mark Multiplex assay. SNPs were classified as high producers (HP), intermediate producers (IP), or low producers (LP), and their association with AR and recurrence of HCV were studied. The frequency of TNF-alpha IP and HP genotypes was significantly higher in LTxRs with AR in comparison to patients without AR (TNF-alpha HP -238: 63 vs 20%, p < 0.001; TNF-alpha HP -308: 47.4 vs 20%, p = 0.02). The frequency of IL-6 IP and HP genotypes was higher in patients with AR episodes, but the difference was not statistically significant (p = 0.14). However, when we analyzed the simultaneous presence of pro-inflammatory genotypes in the same patient, we found a significant difference between patients with and without AR, respectively (42.1 vs 14.6%, p = 0.012). Moreover, the frequency of the IL-10 LP genotype was higher in LTx patients with AR (p = 0.001) compared to patients without AR. There was an association between pro-inflammatory genotypes and HCV recurrence. Our data suggest that cytokine gene polymorphisms might play a role in AR and HCV recurrence in LTxRs.

A neuroimmune regulation at peripheral level on the steroidogenesis of polycystic ovary in rats.

It is known that noradrenergic sympathetic nerve fibers connect the ovary and the spleen from the celiac ganglion. The modulation of the ovarian steroidogenesis in rats with polycystic ovary (PCO) by secretions of culture splenocytes from control (non PCO), PCO and PCO rats with superior ovarian nerve transection (PCO+SON-t) is investigated. Splenocytes from PCO rats increased progesterone (P) and decreasing estradiol (E) and androstenedione (A) release, a steroidogenic response different from that obtained with splenocytes of control rats. PCO also decreased the number of splenocyte beta-adrenergic receptors (betaR). SON transection reverted the effect of PCO on splenocytes betaR numbers and secretions of these splenocytes also reverted the stimulatory effect of PCO on P release, while norepinephrine (NE) treatment to PCO+SON-t splenocytes decreased their betaR number and their secretions restored the stimulation on progesterone release. Inversely, PCO+SON-t splenocyte secretions intensified the inhibition in estradiol with no effect on A. Treatment of PCO+SON-t splenocytes with NE or neuropeptide Y partially reverted the effects of PCO and SON-t The P and E-A response of PCO ovary might be differentially regulated by the splenocyte secretions through the neural connection involving ovary, SON, celiac ganglion and spleen and the neurotransmitter NE.

Secretion from neuropeptide-treated splenocytes modifies ovarian steroidogenesis.

There are evidences for modulation of immune function by the sympathetic nervous system and its principal neurotransmitter norepinephrine (NE) through superior ovarian nerve (SON)-coeliac ganglion-noradrenergic postganglionic innervation of the spleen. Seven days after SON transection at 53 days of age, the rat splenocytes were isolated and then cultured for 48 h. These culture media, used to stimulate ovaries from 60-day-old intact rats (neither SON-transected nor sham-operated) at diestrus 2 stage, in in vitro incubations, showed a decrease in progesterone release, an increase in estradiol release and no change in androstenedione release in relation to splenocyte culture media from control (sham-operated) rats. When splenocytes from SON transected (SON-t) rats were treated with vasoactive intestinal peptide (VIP) or neuropeptide Y (NPY), both at 10(-6) M for 24 h, their secretions increased the progesterone release while decreasing the estradiol release from the intact ovaries, compared with the secretions of untreated splenocytes from SON-t rats. Although the secretions of splenocytes treated with VIP decrease the androstenedione release from the ovaries, the treatment with NPY produced no change in hormone release. In the present paper the ovarian steroidogenic response, which was modified by the effects of an in vivo SON transection on spleen cells, was reverted by an in vitro system in which the splenocytes were treated with VIP or NPY. This could indicate that the spleen of SON-t rats does not receive those neuropeptides by neural route however, when they are added to splenocyte culture in vitro, the cell secretions revert the profile of steroid hormones released from the intact ovary. We also present functional evidence for modulation of the immune function by sympathetic nervous system and neurotransmitters other than NE.

Covalently bonded polysaccharide derivatives as chiral stationary phases in high-performance liquid chromatography.

Polysaccharide derivatives have been extensively used as chromatographic chiral selectors in chiral stationary phases (CSPs) for the separation of enantiomers by HPLC. When coated onto a silica matrix, they represent nowadays one of the most popular type of CSPs. However, they are only compatible with a limited choice of solvents. The main drawback of these CSPs is related to the solubility of the chiral selector in a number of solvents, which limits their applicability. The different attempts which have been described up to now to overcome this problem by covalently fixing the chiral selector to a matrix are reviewed in this paper.

Preparative HPLC resolution of the CIS cyclohexane analogs of phenylalanine.

The analytical resolution of different derivatives of cis c(6)Phe (cyclohexane analogs of phenylalanine) was tested by HPLC using the mixed 10-undecenoate/3,5-dimethylphenylcarbamate of amylose bonded on allylsilica gel as the chiral stationary phase. The same chiral support has allowed the enantioseparation of racemate cis-4 on a semipreparative column (150 x 20 mm ID) with a mixture of n-hexane/2-propanol/chloroform as the mobile phase. Some 200-300 mg of the optically pure enantiomers were isolated and transformed into the N-benzyloxycarbonyl amino acids. The X-ray diffraction structure of (1R;2R)-4 is reported.