A new method for trans-vaginal extraction of an impacted vaginal calculus: A case report.

Introduction: Vaginal stones are a rare pathology, with no clear guidelines on management and optimal removal techniques.

Presentation Of Case: We report a novel surgical technique, leading to safe transvaginal extraction of the largest reported impacted vaginal stone. In this case we removed an 11 cm struvite stone transvaginally from a 46 year old patient.

Incidence of Malignancy and Myoma Variants at Surgery for Presumed Benign Symptomatic Myomas.

Unlabelled: STUDY OBJECTIVE: To estimate the incidence of leiomyosarcoma; other uterine pathologies; and the frequency of use of morcellation, both mechanical and manual in laparoscopic, vaginal, and laparotomy operative routes in women undergoing hysterectomy or myomectomy for benign gynecologic indications when myomas were present.

Design: A retrospective study (Canadian Task Force classification II-3).

Setting: The Royal Women's Hospital, Melbourne, Australia.

Continuous positive airway pressure with helmet versus mask in infants with bronchiolitis: an RCT.

Background: Noninvasive continuous positive airway pressure (CPAP) is usually applied with a nasal or facial mask to treat mild acute respiratory failure (ARF) in infants. A pediatric helmet has now been introduced in clinical practice to deliver CPAP. This study compared treatment failure rates during CPAP delivered by helmet or facial mask in infants with respiratory syncytial virus-induced ARF.

Mitophagy is required for acute cardioprotection by simvastatin.

Aims: We have shown that autophagy and mitophagy are required for preconditioning. While statin's cardioprotective effects are well known, the role of autophagy/mitophagy in statin-mediated cardioprotection is not. In this study, we used HL-1 cardiomyocytes and mice subjected to ischemia/reperfusion to elucidate the mechanism of statin-mediated cardioprotection.

[Medical surveillance of Italian Red Cross Volunteers: actual limits of law, technical and scientific problems. The experience of Red Cross Provincial Committee of Monza and Brianza].

Our research describes a medical surveillance, not included in usual Occupational Health activities, carried out in last year among Red Cross Volunteers active in Monza e Brianza Provincial Committee. This medical surveillance has been managed according to internal rules of Red Cross and national specific Laws. We report data concerning medical examination of 1285 volunteers, their consequences on their voluntary activities, problems arisen during and after medical controls.

Hepatic 11 beta-hydroxysteroid dehydrogenase 1 involvement in alterations of glucose metabolism produced by acidotic stress in rat.

11 beta-hydroxysteroid dehydrogenase (HSDs) enzymes regulate the activity of glucocorticoids in target organs. HSD1, one of the two existing isoforms, locates mainly in CNS, liver and adipose tissue. HSD1 is involved in the pathogenesis of diseases such as obesity, insulin resistance, arterial hypertension and the Metabolic Syndrome.

Role of 11beta-hydroxysteroid dehydrogenase 2 renal activity in potassium homeostasis in rats with chronic renal failure.

Aldosterone concentrations vary in advanced chronic renal failure (CRF). The isozyme 11beta-hydroxysteroid dehydrogenase 2 (11beta-HSD2), which confers aldosterone specificity for mineralocorticoid receptors in distal tubules and collecting ducts, has been reported to be decreased or normal in patients with renal diseases. Our objective was to determine the role of aldosterone and 11beta-HSD2 renal microsome activity, normalized for glomerular filtration rate (GFR), in maintaining K+ homeostasis in 5/6 nephrectomized rats.

MDCK cells express serotonin-regulable 11beta-hydroxysteroid dehydrogenase type 2.

Prior to this work, we found that adrenal as well as extra-adrenal factors activate the response of renal 11beta-hydroxysteroid dehydrogenase 2 to stressful situations. These results -showing ways through which the organism hinders the pathological occupation of mineralocorticoid receptors by glucocorticoids leading to sodium retention and hypertension- prompted the present study on the nature of the above-mentioned extra-adrenal factors. Serotonin was chosen because of its properties as a widely distributed neurohormone, known to interact with glucocorticoids at many sites, also exhibiting increased levels and effects under stressful situations.

Effect of stress on hepatic 11beta-hydroxysteroid dehydrogenase activity and its influence on carbohydrate metabolism.

Stress activates the synthesis and secretion of catecholamines and adrenal glucocorticoids, increasing their circulating levels. In vivo, hepatic 11beta-hydroxysteroid dehydrogenase 1 (HSD1) stimulates the shift of 11-dehydrocorticosterone to corticosterone, enhancing active glucocorticoids at tissue level. We studied the effect of 3 types of stress, 1 induced by bucogastric overload with 200 mmol/L HCl causing metabolic acidosis (HCl), the second induced by bucogastric overload with 0.

Adrenal 11-beta hydroxysteroid dehydrogenase activity in response to stress.

This work studied the effect of stresses produced by simulated gavage or gavage with 200 mmol/L HCl two hours before adrenal extraction, on the activities of the 11beta-hydroxysteroid dehydrogenase 1 and 11beta-hydroxysteroid dehydrogenase 2 isoforms present in the rat adrenal gland. These activities were determined on immediately prepared adrenal microsomes following incubations with 3H-corticosterone and NAD+ or NADP+. 11-dehydrocorticosterone was measured as an end-product by TLC, and controls were adrenal microsomes from rats kept under basal (unstressed) conditions.

Adrenal gland involvement in the regulation of renal 11beta-hydroxysteroid dehydrogenase 2.

Renal 11beta-hydroxysteroid dehydrogenase 2 (HSD2) catalyzes the conversion of active glucocorticoids to inert 11beta-keto compounds, thereby preventing the illicit binding of these hormones to mineralocorticoid receptors (MRs) and, thus, conferring aldosterone specificity. Absence or inhibition of HSD2 activity, originates a hypertensive syndrome with sodium retention and increased potassium elimination. Recent studies from our laboratory reported an increment of HSD2 activity in intact-stressed rats.

Memories and history of Hansen's disease in Brazil told by witnesses (1960-2000).

This report is a preliminary result of a survey on memories and history of Hansen's disease, or 'hanseniasis', prepared by the Fundação Oswaldo Cruz (Fiocruz) and the Universidade Federal do Rio de Janeiro (UFRJ) using statements from those who have been afflicted by the disease or those that have fought against it. It outlines the methodology used by the authors and gives a succinct history of Hansen's disease in Brazil, together wish information on the stage of the survey with extracts from our archives of statements. The founding and the role of Movement for the Reintegration of People Afflicted by Hansen's Disease (Morhan) are explained in the testimony of Thomas Frist, a social scientist who worked in Brazil in the 1970s and 1980s, when the country's old colonies were being restructured, and Cristiano Torres, a former patient who spent time in prevention centers and leproseries in Pará state and who is now active in proposing new policy for the control of Hansen's disease.

The mechanisms of brush border Na+/H+ exchanger activation by corticosteroids.

Background: Previously we showed that corticosterone and aldosterone increased proton fluxes in proximal tubule, by micropuncture and stationary microperfusion. Since the Na+/H+ exchanger is responsible for the main proximal proton secretion, we have now evaluated the effects aldosterone on Na+/H+ exchange activity in brush border vesicles. In order to evaluate the mechanism of action of glucocorticoids and mineralocorticoids, we studied the comparative effects of corticosterone and aldosterone on the abundance of NHE3 and NHE2 isoforms.

In vitro and in vivo evaluation of proximal tubular acidification in aging rats.

The normal aging process is accompanied by a progressive deterioration of renal function. We studied the kinetics of proximal tubular acidification of young (3 mo) and aging (22 mo) rats using in vivo and in vitro techniques. Blood acid-base parameters were similar in both groups.

Activity of renal 11betahydroxysteroid dehydrogenase 2 (11betaHSD2) in stressed animals.

The enzyme 11betaHSD2 protects the non-selective mineralocorticoid receptor from occupation by glucocorticoids in aldosterone target tissues. We studied the effect of stress elicited by intubation with a rubber catheter and administration of 10 ml of 0.45% NaCl (G3), of 10 ml of 200 mM HCl (G4) or intubation alone (G2) on the kinetics of the renal enzyme compared with untreated rats (G1).

Dose-dependence of the effects of corticosterone and the non-glucocorticoid, 18-hydroxycorticosterone, on the brush-border Na+/K+ exchanger.

Up to now, only glucocorticoids were thought to act on the renal proximal Na+/H+ exchanger. Using fluorimetric techniques we studied the kinetics of Na+/H+ exchange in brush border vesicles from ADX rats treated with increasing doses of corticosterone (B) and 18-hydroxycorticosterone (18OHB). Significant linear correlations were obtained when the Vmax of each treatment were plotted against log doses.

Acute effects of two natural corticosteroids on the kinetics of the Na+/H+ exchanger in rat renal brush-border membranes.

We studied the effect of adrenalectomy and acute hormone replacement, using physiological doses of natural corticosteroids, on the kinetics of the Na+/H+ exchanger in brush border membrane vesicles. We collected the data using the acridine orange uptake technique. Adrenalectomized (ADX) rats presented a decreased maximal rate (Vmax) when compared with sham-operated animals (30,000 versus 41,000 fluorescent units/min, respectively).

Regulation of nephron acidification by corticosteroids.

The present paper reviews work from our laboratories evaluating the importance of adrenal cortical hormones in acidification by proximal and cortical distal tubules. Proximal acidification was determined by stationary microperfusion, and measurement of bicarbonate reabsorption using luminal pH determination was performed with H(+)-ionsensitive microelectrodes. Rats were adrenalectomized (ADX) 48 h before the experiments, and corticosteroids (aldosterone (A), corticosterone (B), and 18-OH corticosterone (18-OH-B)) were injected intramuscularly 100 and 40 min before the experiments.

Effects of chronic treatments with adrenal steroids on acid-base homeostasis in the rat.

Urinary parameters related to acid base homeostasis were studied in adrenalectomized rats (ADX) as well as in ADX treated with physiological doses of corticosterone (B), aldosterone (aldo) or 18-Hydroxycorticosterone (18HOB) during 1, 3 or 5 days, under basal conditions and after gravage with 200 mM HCI. The results showed: a) persistent effect of B and 18HOB increasing titratable acidity principally in response to acidosis; b) an increased phosphate elimination in acidotic B treated ADX on the first day, and in 18 HOB treated ADX on days 3 and 5; c) pronounced increases in blood pH and blood bicarbonate levels provoked by the three steroids on day 1; d) increments of ammonium elimination in response to acidosis by aldo treatments on the first day, while B and 18HOB increase ammonium elimination under almost all conditions during the whole experiment; e) the effects of B and 18 HOB would be independent of an increase in sodium retention as well as glomerular filtration rate.

Sodium-retaining activity of some natural and synthetic 21-deoxysteroids.

The effect of progesterone and six other C21-deoxysteroids on renal sodium retention by male adrenalectomized rats was compared with the effect exerted by the natural corticoids aldosterone, 11-deoxycorticosterone, and corticosterone. Steroids were active in the following order: aldosterone > 11,19-oxidoprogesterone > 5 alpha H-3,20-pregnanedione > or = 5 beta H-3,20-pregnanedione > progesterone = 11-ketoprogesterone > 6,19-oxidoprogesterone = 11-keto-6,19-oxidoprogesterone > or = corticosterone. All C21-deoxysteroids, except 11,19-oxidoprogesterone, exhibited parabolic log dose-response functions, indicating an effect that opposes renal sodium retention at high doses.

Role of corticosteroids in distal acidification of amiloride-treated rats.

The role of amiloride-dependent sodium channels in the action of adrenal cortical steroids on urine-blood PCO2 (U-B PCO2) differences was studied in bicarbonate-infused and amiloride-treated adrenalectomized rats. U-B PCO2 was significantly reduced by amiloride in bicarbonate-infused control rats. Adrenalectomy further reduced U-B PCO2 in amiloride-treated, bicarbonate-infused rats (from 27.

Effect of cutaneous cell-mediated immune response to rIFN gamma on Mycobacterium leprae viability in the lesions of lepromatous leprosy.

1. Studies were carried out to determine the effect of intra-dermal injections of recombinant human interferon-gamma (rIFN gamma) on the viability of Mycobacterium leprae. Twenty-three untreated and 4 treated multibacillary patients, 12 with lepromatous leprosy (LL) and 15 with borderline lepromatous leprosy (BL), were selected for intradermal administration of rIFN gamma or PPD.

In vitro uptake of 18-hydroxycorticosterone by regions of the central nervous system.

The specific uptake of tritiated 18-hydroxycorticosterone (18-OH-B) by purified cell nuclear fractions and cytosol of medulla oblongata, pons, amygdala, anterior pituitary, hypothalamus, hippocampus, preoptic-area and lung from adrenalectomized animals was investigated after incubation of tissue sections with radioactive ligand. We found that 18-OH-B was taken up mainly by nuclei obtained from pons and medulla oblongata; this profile differs from previous observations with the closely related steroids corticosterone and aldosterone, which are mostly concentrated by the limbic system. Based on this finding, as well as on former studies with 18-OH-B, we suggest that this steroid may exert its action on renal excretion of protons as well as on central nervous system structures involved in respiratory regulation, related to that excretion.

Effects of adrenalectomy and acute replacement by corticosteroids on distal acidification.

The role of adrenocortical steroids in distal nephron acidification was studied in rats by measuring urine minus blood PCO2 differences (U-B PCO2) in control, sham-operated, and adrenalectomized (ADX) animals. Operations were performed 48 h before experiments. During the experiments, all rats received an infusion of 0.

[Secondary sulfone resistance--presentation of a case of leprosy-Oswaldo Cruz Foundation, Rio de Janeiro-Brazil].

Report on a case of dapsone resistance in a BL patient with clinical diagnosis and laboratory confirmation. The resistance appeared after 17 years of dapsone treatment, and the laboratory tests revealed total resistance to all the tested dapsone concentrations. The case reported occurred in the city of Rio de Janeiro (Brazil) which presents a leprosy prevalence of 1.