Disfunción miccional en el adulto. Un artículo docente / Voiding dysfunction in the adult. A teaching article

Voiding dysfunction is defined as an abnormally slow and/or incomplete micturition, and can be divided in bladder outlet obstruction (BOO) and detrusor underactivity (or hypocontractility). BOO is characterized by reduced urine flow rate and increased detrusor pressure, and can be of anatomical or functional origin. Detrusor underactivity encompasses a reduced urine flow rate associated to low pressure and/or poorly sustained detrusor contraction, and its etiology is multifactorial. Lower urinary tract symptoms are classified as storage, voiding and post micturition symptoms, may be objectively quantified with specific questionnaires, and don't correlate properly with voiding dysfunction. Patients' evaluation requires a directed physical examination of the abdomen, pelvis and genitals focused to detect anatomical and neurological abnormalities. Voiding dysfunction can be demonstrated non-invasively using uroflowmetry and pelvic ultrasound. Uroflowmetry allows determining urinary flow characteristics and their most important parameters are voided volume, maximum flow rate and shape of the curve. Pelvic ultrasound permits to estimate prostatic size and post void residual, suspect detrusor hypertrophy (due to BOO) and detect bladder stones. Invasive test must be reserved for special cases of confirmed voiding dysfunction: cystoscopy when there is concomitant hematuria, urethrocystography to study urethral stenosis and urodynamics to differentiate BOO from detrusor underactivity. (AU)

Variación en los niveles séricos de Calcio, Fósforo, Magnesio, Cobre y Zinc durante las distintas etapas productivas en cabras de leche en un tambo caprino del noroeste argentino / Variation in serum levels of Calcium, Phosphorous, Magnesium, Copper and Zinc across productive stages of dairy goats in northwestern Argentina

Resumen El objetivo de este trabajo fue evaluar los niveles séricos de calcio (Ca), fósforo (P), magnesio (Mg), cobre (Cu), y zinc (Zn) en cabras lecheras en diferentes etapas productivas. Se seleccionaron 20 cabras de raza Saanen en diferentes estadios productivos: preparto (1 a 2 semanas previas al parto), posparto (1 a 2 semanas de lactancia), pico de lactancia (6 a 8 semanas de lactancia posparto) y período de seca (15 a 30 días de finalizada la lactancia) de un establecimiento lechero del valle de Lerma, Salta. Se colectaron muestras de sangre y se midieron los niveles séricos de Ca, Mg, Cu, y Zn empleando espectrofotometría de absorción atómica y P por colorimetría. Se identificó hipocalcemia (7,7±0,2 mg/dL) e hipofosfatemia (3,4±0,4 mg/dL) durante todas las etapas productivas. El Mg, por el contrario, presentó niveles adecuados durante todo el ensayo (2,5±0,06 mg/dL). Con respecto a los microminerales evaluados, solo los niveles séricos de Zn fueron inferiores a los recomendaros en todos los periodos productivos (53±4 µg/dL). Los niveles de Cu estuvieron dentro de los límites normales (53±4 µg/dL). Estos resultados permitieron identificar anormalidades en los niveles de Ca, P y Zn durante los periodos productivos evaluados. La información sobre deficiencias minerales en cabras es escasa y debe estudiarse más al respecto.

Abstract The aim of this study was to evaluate the serum levels of calcium (Ca), phosphorus (P), magnesium (Mg), copper (Cu), and zinc (Zn) in dairy goats in different productive periods. Twenty Saanen breed goats were selected at different productive stages: prepartum (1 to 2 weeks before partum), postpartum (1 to 2 weeks of lactation), peak of lactation (6 to 8 weeks postpartum) and dry period (15 to 30 days of the final lactation) of a dairy farm in the Valle de Lerma, in the province of Salta. Blood samples were collected and then, Ca, Mg, Cu and Zn levels were measured using atomic absorption spectrophotometry, and P was measured by colorimetric. Hypocalcaemia (7,7±0,2 mg/dL) and hypophosphatemia (3,4±0,4 mg/dL) were found in all production stages. In contrast, Mg levels did not present variation during all the samplings (2.5 ± 0.06 mg / dL). In evaluated micro-minerals, only the serum levels of Zn were lower than those recommended in all the productive periods (53 ± 4 µg / dL). Serum cupper levels were within normal limits (53 ± 4 µg / dL). The obtained results allowed identifying abnormalities in Ca, P and Zn levels during the evaluated productive periods. Information about mineral deficiency in goats is restricted and it is needed to study more about it.

Herpes zóster diseminado: caso clínico y revisión bibliográfica / Disseminated herpes zoster: clinical case and literature review

Herpes zoster classical clinical presentation is the acute onset of multiple vesicles over an erythematous base, disposed over one or two dermatomes with up to 20 vesicles located outside the main dermatome. Disseminated herpes zoster is an atypical and rare form of presentation of herpes zoster, which manifests with lesions beyond the described territory. It occurs mainly in patients with some type of cellular immunosuppression. The diagnosis is made with the medical history and physical examination, however, it should be confirmed with laboratory tests. Treatment must be initiated early to avoid serious complications, such as bacterial infection of the lesions, post-herpetic neuralgia, or even central nervous system involvement. The drug of choice is intravenous acyclovir that must be maintained until the cessation of the appearance of new lesions, and then switch to its oral presentation for another 5-7 days. Disseminated herpes zoster mortality rounds 5-15%. There are varicella-zoster virus vaccines, that have been shown to reduce the incidence of herpes zoster relapses, however its utility to disseminated herpes zoster is uncertain and further studies are required. We present the case of a male patient with a history of rheumatoid arthritis who consults with multiple vesicles distributed throughout his body. (AU)

Enfermedad de Grover, una patología ampollar poco frecuente: a propósito de 2 casos / Grover's disease, a pathology blistering unusual: About 2 cases

Grover's disease (GD) or transient acantholytic dermatosis, is a papulovesicular pruritic disease of unknown etiology. It´s most important histopathological finding is the presence of focal acantholysis. The incidence has not been firmly established. Case report: We report two cases of papulovesicular rashes, the first one in a 79 year old man with good response to second line treatment and the second one, in a 30 year old woman. Both with different suspected triggering factors. Comment: GD predominates in white men with an average age of presentation of 61. Clinically, it presents as erythematous papules, crusted-papule and is usually pruritic. The etiopathology is still unknown, but it is associated with triggers such as: ultraviolet radiation (UVR), ionizing radiation, heat, sweat, friction and chemotherapy. Acantholysis is the classic histological finding. Management includes general measures, topical corticosteroids, calcineurin inhibitors, tretinoin, calcipotriene and antihistamines. In refractory cases, second-line treatment is used: oral isotretinoin, systemic corticosteroids and phototherapy. Paradoxically, phototherapy can also trigger GD. Conclusions: Due to the low prevalence of GD in Chile, 2 new cases are provided to the literature. In both cases, the diagnostic presumption was based on an exhaustive clinical history, confirmed by histopathological findings. (AU)

High frequency of CYP2D6 ultrarapid metabolizer genotypes in an Ashkenazi Jewish population from Argentina.

A twofold higher frequency of CYP2D6 ultrarapid metabolizers (estimated from genotype: gUMs) was reported among Ashkenazi Jews (AJ) living in New York (USA) than in other North American Caucasians, which might be important to guide the prescription for CYP2D6 substrates in AJ communities around the world. This study was aimed to determine whether the high frequency of CYP2D6 gUMs described in AJ from USA was replicated in AJ from Argentina when compared with other multiethnic admixture Argentines (GA). The frequency of the most common allelic variants and of CYP2D6 gUMs (>2 active genes) and poor metabolizers (0 active genes, gPMs) was also compared among the studied Argentine populations. CYP2D6 genotyping was performed in 173 AJ and 246 GA DNA samples of unrelated donors from the metropolitan area of Buenos Aires. CYP2D6 alleles (*2, *3, *4, *5, *6, *10, *17, *35, *41 and multiple copies), genotypes and functional phenotype frequencies were determined. The frequencies of gUMs and gPMs in AJ from Argentina were 11.5% and 5.2%, respectively, whereas in GA, the frequencies of gUM and gPMs were 6.5% and 4.9%, respectively. Comparisons between AJ and GA showed that gUMs frequencies were twofold higher (P<0.05) in AJ than GA. CYP2D6*35 allele was more frequent in GA than AJ, whereas CYP2D6*41 and *1xN were more frequent in AJ than in GA (P<0.05). This study supports the previously reported high frequency of gUMs on another Ashkenazi population in New York. The present findings also support the interethnic variability of CYP2D6 genetic polymorphism in the overall Argentine population.

Sarcoidosis subcutánea sin compromiso sistématico / Subcutaneous sarcoidosis without compromise systemic

We present the case of a 52 year old woman with a history of bilateral ovarian cancer operated. The patient attended the dermatology unit for a sudden onset of a left plantar nodule of three weeks of evolution, painful on walking, with no other history in particular. At physical examination, the patient presented a surface nodule slightly hyperpigmented, with ill-defined edges, round shape, firm consistency, mobile and painful to compression, one cm of diameter, in the middle third of the left plant. No concomitant scars are seen. Doppler soft tissue ultrasound is requested, showing a granulomatous nodule on the surface of the plantar aponeurosis. The biopsy lesion revealed non-caseating granulomas in cell tissue, PAS and Ziehl-Neelsen staining are negative A left plantar subcutaneous sarcoidosis is diagnosed, systemic involvement is ruled out. Within the first year of follow-up, there are no new lesions or findings compatible with systemic disease. (AU)

High frequency and founder effect of the CYP3A4*20 loss-of-function allele in the Spanish population classifies CYP3A4 as a polymorphic enzyme.

Cytochrome P450 3A4 (CYP3A4) is a key drug-metabolizing enzyme. Loss-of-function variants have been reported as rare events, and the first demonstration of a CYP3A4 protein lacking functional activity is caused by CYP3A4*20 allele. Here we characterized the world distribution and origin of CYP3A4*20 mutation. CYP3A4*20 was determined in more than 4000 individuals representing different populations, and haplotype analysis was performed using CYP3A polymorphisms and microsatellite markers. CYP3A4*20 allele was present in 1.2% of the Spanish population (up to 3.8% in specific regions), and all CYP3A4*20 carriers had a common haplotype. This is compatible with a Spanish founder effect and classifies CYP3A4 as a polymorphic enzyme. This constitutes the first description of a CYP3A4 loss-of-function variant with high frequency in a population. CYP3A4*20 results together with the key role of CYP3A4 in drug metabolism support screening for rare CYP3A4 functional alleles among subjects with adverse drug events in certain populations.

[Duodenal tube test and hepatic ultrasound in extrahepatic biliary atresia diagnosis: A four-case series]. / Prueba de sonda duodenal y ultrasonido de hígado y vías biliares en el diagnóstico de atresia de las vías biliares extrahepáticas. Serie de 4 casos.

Liver and biliary tree scintigraphy and magnetic resonance cholangiography (MRC) have taken the place of the duodenal tube test (DTT) in the study of cholestatic jaundice due to extrahepatic biliary atresia (EBA). The usefulness of DTT associated with abdominal ultrasound (AUS) in the diagnosis of EBA was demonstrated in 4 patients presenting with cholestatic jaundice that underwent DTT and AUS; one of them also had MRC. DTT was negative for bile in the 4 patients; AUS did not identify the gallbladder or showed it as small and irregular, or detected a fibrous cord; MRC identified a choledochal cyst but no associated EBA; surgery and pathology study documented EBA in all 4 patients. DTT associated with AUS demonstrated the absence of bile in the duodenum and gallbladder abnormality, respectively, leading to surgical exploration within 24 to 48 hours.

Selection of woody species for wastewater enhancement and restoration of riparian woodlands.

Growth and nutrient uptake of seven tree species were evaluated with the goal of selecting the species that can be used for wastewater enhancement by dendro-purification, or green tree filtering, and for restoration of riparian woodlands. Trees were grown in pots with an inert mixture of perlite and vermiculite and irrigated with either nutrient solution or treated wastewater We measured the effects of species and irrigation water on biomass and nutrient content of leaves, stems and roots. For most of the species, treated wastewater had a positive effect on final biomass and above ground: below ground ratio compared to that of nutrient solution. However, growth of Cupressus sempervirens and Populus nigra were inhibited by water sodium concentration. Nerium oleander, Tamarix africana and Vitex agnus-castus were the species with the greatest final biomass. Pistacia terebinthus had the highest nitrogen and phosphorus content in leaves, stems and roots, while N. oleander and V. agnus-castus showed the best potassium accumulation. In general, P. terebinthus, N. oleander, T. africana and V. agnus-castus were the best qualified species for purification of wastewater.

Obras de estabilización de procesos erosivos en suelos loéssicos (Cárcavas) / Infraestructure for stabilization of gully erosion in loess

En el sur de la provincia de Córdoba (región central de Argentina) se encuentran numerosos arroyos afectados por procesos erosivos de carcavamiento. En este artículo en particular se presenta en caso de estudio del arroyo "El Gato", el cual cruza la Ruta Nacional Nº 8 cerca del pueblo de Sampacho. Allí se observa un severo proceso de incisión de su cauce como consecuencia del fenómeno de erosión en cárcava al que se encuentra sometido. Este fenómeno se materializa mediante la formación de un escalón en el lecho fluvial sobre el cual se desarrolla una cascada de aproximadamente 13 m de altura; presentando una fosa de socavación debido al impacto del agua. El impacto de este proceso es altamente significativo, ya que afecta negativamente su área cercana, reduciendo áreas de uso agrícola y dañando las obras de infraestructura existentes (caminos, ferrocarriles, puentes y poliductos). Asimismo, el impacto ambiental es altamente negativo, fundamentalmente por las consecuencias asociadas a la incisión del cauce, el descenso del nivel freático y el incremento del transporte de sedimentos hacia aguas abajo. En este trabajo se presentan los estudios básicos realizados para caracterizar el fenómeno y se describe la solución adoptada para estabilizar el cauce de este arroyo. Además, se presentan las modificaciones realizadas en la etapa de obra y los detalles del seguimiento durante la operación y mantenimiento de la misma (AU)

Endocavitary patch repair for a left ventricular pseudoaneurysm: an alternative approach.

We present a case of postinfarction posterolateral left ventricular wall pseudoaneurysm with severe mitral regurgitation and poor left ventricular function. The patient had New York Heart Association (NYHA) class IV heart failure at the time of surgery, which was performed on an emergency basis. The surgical approach included coronary revascularization, surgical posterior mitral leaflet detachment with patch closure of the pseudoaneurysm neck from inside of the left ventricular cavity followed by mitral valve reconstruction, and subsequent implantation of a mitral annuloplasty ring.

Aproximación al efecto del programa de desayunos escolares sobre el rendimiento intelectual en alumnos de educación inicial y primaria del Perú / Aproach to the effect of the school breakfast program on the intellectual performace in elementary and primary school students in Peru

Objetivos: Evaluar el efecto de Programas de Desayunos Escolares (PDE), sobre el rendimiento intelectual en alumnos pertenecientes al nivel inicial y primario, atendidos por el PDE en el año 2001. Materiales y métodos: En este estudio transversar descriptivo se evaluaron mediante las pruebas cognitivas Catell 1 (4-8 años) y Catell 2 (9-13 años) escolares de 4 a 13 años (seleccionados por muestreo probabilístico multietápico) de los distritos atendidos por el PDE, calculándose los promedios del puntaje total y puntaje de cada uno de los subtests incluidos en estas pruebas. Para identificar a los niños que recibieron la intervención, se usó dos modalidades: el testumonio del profesor de "consumo usual" del desayuno escolar y la observación del consumo el día de la evaluación. Resultados: Fueron evaluados 1787 escolares: 922 de inicial y 865 de primaria. La proporción de niñas y niños fue similar. El consumo reciente del desayuno mostró efectos positivos en el puntaje total y su test específico en escolares de inicial de Lima, la costa y la selva con el Catell 1 y en escolares de primaria de la costa con el Catell 2. El consumo usual mostró efectos positivos en el puntaje total y su test específicos en escolares de inicial de la costa y la selva con el Catell 1. Conclusiones: Existen efectos positivos del consumo reciente y consumo regular de la ración del PDE con el rendimiento intelectual, siendo en este efecto mayor en escolares del nivel inicial y en lugares de la costa y la selva

Two cases of confined placental mosaicism for chromosome 4, including one with maternal uniparental disomy.

Two cases of trisomy 4 mosaicism are reported including one with molecularly confirmed uniparental disomy (UPD) of chromosome 4. Cytogenetic analysis of a chorionic villus sample (CVS) in Case 1 showed complete trisomy 4 in trophoblast and diploidy in chorionic stroma. Amniotic fluid analysis demonstrated a 46,XX complement. After intrauterine fetal death at 30 weeks, molecular analysis confirmed the presence of trisomy 4 of maternal meiotic origin, while fetal tissues showed maternal UPD for chromosome 4. Cultured CVS in Case 2 revealed trisomy 4 in 2/30 cells analyzed. This pregnancy resulted in a healthy livebirth with biparental inheritance of chromosome 4. Molecularly confirmed UPD4 has not been previously reported, and therefore, although the adverse outcome in Case 1 is likely due to the trisomy 4 in the placenta, an imprinting effect associated with UPD4 cannot be excluded.

[Primary ciliary dyskinesia. Experience in 6 patients]. / Disquinesia ciliar primaria. Experiencia en 6 pacientes.

BACKGROUND: Primary ciliary dyskinesia is characterized by a congenital alteration of the ciliary ultrastructure and function. As a consequence, their respiratory tract sweeping action is lost and recurrent respiratory infections ensue. AIM: To analyze a clinical series of patients with primary ciliary dyskinesia, their clinical and laboratory features. PATIENTS AND METHODS: A retrospective review of patients with primary ciliary dyskinesia seen a University Hospital, between 1994 and 1998. Bronchial biopsies were obtained with 3.6 mm diameter Olympus fibrobronchoscope, using a cayman type forceps. Ultrastructural alterations of respiratory tract ciliated cells were recorded. RESULTS: Six patients (four male) aged 9 months to 13 years old were reviewed. Three patients had situs inversus. All had repeated bouts of obstructive bronchitis and pneumonia, five had sinusitis, four atelectasis, three recurrent otitis and three had bronchiectasis. Cystic fibrosis and immunological alterations were ruled out in five children. Ultrastructural analysis revealed absence of dynein arms in three cases, absence of the internal dynein arm in one, additional peripheral microtubules and absence of dynein arms in one case. CONCLUSIONS: Primary ciliary dyskinesia must be considered in the differential diagnosis of recurrent respiratory infections. Ultrastructural analysis of ciliary structure can be done in bronchial biopsies obtained through bronchoscopy.

[Obtention and characterization of murine beta-NGF. Application in a model of cerebral aging]. / Obtención y caracterización del beta-NGF murino. Aplicación en un modelo de envejecimiento cerebral.

INTRODUCTION: beta-NGF is a basic protein of 118 aminoacids which acts are a trophic factor for sensory and sympathetic neurons of the peripheral nervous system, and on cholinergic neurons of the anterior basal cerebrum. OBJECTIVES: In view of the functional effect of beta-HGF and its possibilities as a therapeutic agent in neurodegenerative disease, including Alzheimer's disease in this study our aim was to obtain, characterize and show the main results of the application of beta-NGFm in a model of cerebral ageing in rats with cognitive disorders. MATERIAL AND METHODS: For the obtention of beta-NGFm we followed Mobley's method as modified by Ebendal and used mouse submaxillary gland as a source of raw material. The characterization studies were carried out by application of seven techniques which allowed physicochemical characterization and demonstration of the biological activity of the product. Application of beta-NGF obtained under these conditions was carried out in a mode of cerebral ageing and the effects of treatment were assessed by conduct studies, measurement of the activity of the enzyme acetyl cholinesterase and study of neural plasticity. CONCLUSIONS: Characterization studies carried out on the beta-NGFm showed that the protein obtained consists of a mixture of molecules of beta-NGFm which are intact at their extreme N-Terminal, and molecules which have lost the octapeptide of the N-terminal position and show some modification increasing hydrophobicity. All these species were recognized immunologically by the specific antibody anti-NGFm and showed biological activity.

Is it useful to add an anticholinergic treatment to beta 2-adrenergic medication in acute asthma attack?

The aim of our study was to determine whether the combination of an anticholinergic treatment with a beta 2-adrenergic medication is a more effective treatment for acute asthma attack than the two treatments individually. The association of salbutamol-ipratropium was compared to treatment with salbutamol and ipratropium alone. It was a prospective double-blind study in children with acute asthma attack, participating as outpatients. Their clinical history and characteristics of bronchial obstruction were recorded on a standard form. Afterwards, they were included in one of the three following study groups: group one, 100 micrograms/inh salbutamol; group two, 20 micrograms/inh ipratropium; group three, 100 micrograms/inh of salbutamol plus 20 micrograms/inh ipratropium. There were 40 patients in each group, with Tal score +/- 5 and PEF < 80% of the predicted value. They were evaluated at the beginning (0 min), and at 15, 30, 45, 60, 80, 100 and 120 min. Each patient was treated with two inhalations of the study medication and was then evaluated for variations in Tal score. The mean age was 7.3 years; Tal score was 5.6, 5.6 and 6.0 at 0 min (p > 0.05). Decrease in Tal score after 15 min meant p < 0.01 for salbutamol-ipratropium and salbutamol vs. ipratropium. At 30 min p < 0.05 for salbutamol-ipratropium vs. salbutamol, and at 45 min p < 0.01 for salbutamol-ipratropium vs. salbutamol. PEF at 0 min was 70.9%, 71.3% and 68.6% (p > 0.05) increasing after 15 min. At 30 min p < 0.05 for salbutamol-ipratropium vs. salbutamol, and p < 0.01 vs. ipratropium. At 45 min p < 0.01 for salbutamol-ipratropium vs. salbutamol and ipratropium. A total 4.7 doses of salbutamol were needed to improve the asthma attack, 5.3 of ipratropium and 3.7 of salbutamol-ipratropium, with p < 0.01 for salbutamol-ipratropium vs. salbutamol and ipratropium. We conclude that the combination of salbutamol and ipratropium is more effective than each medication alone in treating acute asthma attacks in pediatric patients.

Obtenci›n y caracterizaci›n del beta NGF murino: aplicaci›n en un modelo de envejecimiento cerebral / Obtention and characterization of murine beta-NGF: application a model of cerebral ageing

Introducci›n. El á-NGF es una proteina bÿsica de 118 aminoÿcidos que actœa como factor tr›fico de neuronas sensoriales y simpÿticas en el sistema nervioso perif rico y sobre neuronas colin rgicas del cerebro basal anterior. Objetivo. Atendiendo a los efectos funcionales del á-NGF y su posibilidad como agente terap utico en enfermedades neurodegenerativas, entre ellas la enfermedad de Alzheimer, en este trabajo nos hemos propuesto obtener, caracterizar y mostrar los principales resultados de la aplicaci›n del á-NGF murino (á-NGFm) en un modelo de envejecimiento cerebral en ratas con trastorno cognitivo. Material y m todos. Para la obtenci›n de á-NGFm se sigui› el m todo de Mobley modificado por Ebendal, y como fuente natural se utiliz› glÿndula submaxilar de rat›n. Los estudios de caracterizaci›n se realizaron por medio de la aplicaci›n de siete t cnicas que posibilitaron la caracterizaci›n fisicoqu­mica, as­ como la demostraci›n de la actividad biol›gica de este producto. La aplicaci›n del á-NGFm obtenido en nuestras condiciones se efectu› en un modelo de envejecimiento cerebral y los efectos del tratamiento se evaluaron por estudios conductuales, medici›n de la actividad de la enzima acetil colino-esterasa y estudio de plasticidad neural. Conclusiones. Los estudios de caracterizaci›n realizados al á-NGFm evidencian que la proteina obtenida estÿ constituida por una mezcla de mol culas de á-NGFm intactas en su extremo N-terminal y mol culas que han perdido el octap ptido de la posici›n N-terminal y presentan alguna modificaci›n que aumenta su hidrofobicidad. Todas estas especies fueron reconocidas inmunol›gicamente por el anticuerpo espec­fico anti-NGFm y mostraron actividad biol›gica(AU)

Severe fetal malformations associated with trisomy 16 confined to the placenta.

Chorionic villus sampling (CVS) and amniocentesis were performed on a pregnant woman during her 24th week of amenorrhoea following an ultrasound scan which showed a fetus with hydrocephaly, intrauterine growth retardation (IUGR), and a single umbilical artery. The direct karyotype from the cytotrophoblast was non-mosaic 47,XXX,+16, while in amniotic fluid and several fetal tissues, studied post-mortem, a normal 46,XX karyotype was found in more than 400 cells. Uniparental disomy (UPD) was excluded by molecular genetic studies. Autopsy confirmed the echographic findings; in addition, agenesis of the corpus callosum and polysplenia were observed. This is the second example of congenital abnormality associated with confined placental mosaicism (CPM) for trisomy 16, without evidence of either UPD or an apparent contribution of abnormal cells to the fetus.

Effect of chronic thyroid hormone treatment on cycling, ovulation, serum reproductive hormones and ovarian LH and prolactin receptors in rats.

We studied the effect on cycling, ovulation and hormone secretion of a chronic thyroxine treatment (HT, 1 mg/kg,S.C., daily, initiated at oestrus) on female rats. HT rats showed normal 4-day vaginal cycles on the first three cycles after initiation of the treatment, but on the fourth cycle had a prolonged oestrus and subsequently entered in constant di-oestrus. In spite of the normal vaginal cycles only 66%, 50%, 33% and 10% of the HT rats ovulated on cycles 1 to 4 respectively. In contrast, during cycles 2 and 3, ovulating HT rats shed a significantly greater number of ova than controls. Hormones were measured at 12.00 and 18.00 h (pre-ovulatory) on prooestrus and at 11.00 h on oestrus. HT ovulating rats had normal LH levels on the first two cycles, but low levels on the third one, while non-ovulating HT rats had low preovulatory LH levels. Serum FSH concentrations were elevated in all the HT rats on cycles 1 and 2 and on pro-oestrus morning in cycle 3 and may have been responsible for the increase in ovulation rate. On oestrus, ovulating HT rats had higher FSH values than nonovulating ones. Serum prolactin levels were similar to controls in all the HT rats on cycle 1, but on the subsequent cycles pre-ovulatory levels were lower than controls in all the HT rats, while values were increased in the non-ovulating HT rats on the third and fourth oestrus mornings. Pro-oestrous serum oestradiol concentrations in all the HT rats were not different from controls on cycles 1 and 2 and diminished on 3 and 4. Oestrous levels were significantly lower on the cycle 1 and only on the nonovulating HT rats on cycle 2. Serum progesterone levels had values similar to those of FSH, with increased values in the first two cycles. Serum corticosterone levels were increased in the mornings of cycles 2 and 3, but values were normal on the fourth one. Ovarian prolactin and LH receptor mRNAs, measured on HT rats on the third prooestrus by Northern blotting, showed significant increases in all the majoritary molecular forms (2.5 and 7 kb for LH receptor and 0.9, 2.9-3, 5 and 10 kb for the prolactin receptor) with respect to control pro-oestrous rats. These results show a progressive disruption of cycling, ovulation and hormonal secretion after the initiation of a chronic thyroid hormone treatment in rats, which eventually lead to an anovulatory state. These results may be of importance for the interpretation of the reproductive disfunctions provoked by hyperthyroidism in women.