GnRH agonist treatment before total laparoscopic hysterectomy for large uteri.

Study Objective: To evaluate whether uterine shrinkage induced by gonadotropin-releasing hormone (GnRH) agonists in women with a large uterus (>14 wks) may facilitate total laparoscopic hysterectomy.

Design: Randomized, prospective study (Canadian Task Force classification I).

Setting: University-affiliated hospital.

A novel type I factor X variant (factor X Cys350Phe) due to loss of a disulfide bond in the catalytic domain.

We report a novel mutation within the coagulation factor X (FX) that we have designated FX Padua 4. The phenotype and genotype of the proband and family members were studied. The proband was a child affected by a complex neurological syndrome who, after birth, experienced severe bleeding.

Management of thrombosis in patients with hematologic malignancies.

The management of thrombosis in patients with cancer is a clinical challenge. Although the prevalence of thromboembolic complications in hematologic malignancies is lower than that reported for solid tumors, thrombotic events are increasingly being reported both in patients with acute leukemia and in those with chronic myeloproliferative and lymphoproliferative disorders. Accordingly, there is the need for promptly identifying patients at a higher risk of developing thromboembolic complications, as well as instituting appropriate measures of prophylaxis and treatment.

Changes in prescription patterns of oral contraceptives in a northern Italian province: relation with venous thromboembolism.

Oral contraceptives (OC) are a definite risk for venous thrombosis. It is commonly accepted that they cause a fourfold increased risk of thrombosis compared to non-users. The prescription patterns were evaluated from 1990 to 2000 in a northern Italian province (province of Padua).

Proposal of a flow chart for thrombosis-free oral contraceptive therapy.

Oral contraceptive therapy (OCT) is associated with a fourfold increase in the risk for venous thromboembolism (VTE). Women with congenital defects have a much higher risk. Because it is impossible to screen all women undergoing OCT, it is advisable to adopt some guidelines in an attempt to define the group of women who may be particularly exposed to the risk of VTE.

Electrostatic compared with hydrophobic interactions between bovine serum amine oxidase and its substrates.

A steady-state kinetic study of bovine serum amine oxidase activity was performed, over a wide range of pH values (5.4-10.2) and ionic strength (10-200 mM), using various (physiological and analogue) substrates as specific probes of the active-site binding region.

Cystoscopy-assisted laparoscopic resection of extramucosal bladder endometriosis.

Background And Purpose: Involvement of the bladder is seen in only 1% to 2% of patients with endometriosis. The diagnosis of vesical endometriosis is difficult to formulate, and it should be confirmed by cystoscopy with biopsy. However, this examination is often insufficient because of the submucosal-transmural location of the lesion.

Conformation sensitive gel electrophoresis for detection of factor X gene mutations.

Fifteen patients from five families with laboratory data suggesting factor X (FX) deficiency were screened for causative mutations by conformation sensitive gel electrophoresis (CSGE) followed by sequencing. All exonic and flanking intronic regions of factor X gene were amplified using PCR. After heteroduplex formation, samples were analyzed onto a polyacrylamide gel for possible mismatch.

A study of hysteroscopic metroplasty in 141 women with a septate uterus.

141 patients who had a hysteroscopic septum resection of a partial uterine septum (class Vb, American Society for Reproductive Medicine, ASRM) were divided into two groups: Group I (69 patients) presented with infertility and Group II (72 patients) with recurrent abortion. The mean+/-SD post-operative follow up period was 36+/-19.5 months.

Tentative guidelines and practical suggestions to avoid venous thromboembolism during oral contraceptive therapy.

Oral contraceptive therapy (OCT) is widely used in the world. It is usually safe and effective but side effects are occasionally seen. Venous thromboembolism is one of the most feared side effects.

Total laparoscopic hysterectomy compared with abdominal hysterectomy in the presence of a large uterus.

Study Objective: To evaluate in a prospective series whether, even in presence of a large uterus, total laparoscopic hysterectomy is feasible and safe, and may be substituted for abdominal hysterectomy.

Design: Randomized comparison (Canadian Task Force classification I). Setting.

Determination of glucose oxidase immobilised as monolayer onto a flat surface.

An assay to estimate the amount of glucose oxidase immobilised as a monolayer onto a flat surface is reported. This method is based on the electrochemical detection of the flavin adenine dinucleotide (FAD) cofactor released by the immobilised enzyme in acid solutions. FAD concentration in the acid solution was measured by amperometry, using a flow injection analysis (FIA) system equipped with a wall-jet electrode, and with a sensitivity of (9.

Hepatosplenic gammadelta T-cell lymphoma presenting with immune-mediated thrombocytopenia and hemolytic anemia (Evans' syndrome).

We describe an unusual case of hepatosplenic T-cell lymphoma in a 61-year-old man who presented with fever, hepatosplenomegaly, anemia, and thrombocytopenia. A spleen biopsy was consistent with T-cell lymphoma. Cytogenetic studies did not reveal chromosome abnormalities.

Low-dose flutamide (125 mg/day) as maintenance therapy in the treatment of hirsutism.

Objective: To evaluate the safety and efficacy of a low dose of flutamide (125 mg/day) in maintaining the clinical results already obtained using a higher dose (250 mg/day), in women suffering from hirsutism.

Method: Forty-three women suffering from hirsutism of varying origin received 250 mg/day of flutamide as an initial treatment for 12 months and, subsequently, 125 mg/day of flutamide for an additional 12 months as a maintenance treatment. Hirsutism was evaluated by the Ferriman-Gallwey score, and hair diameter and hair growth rate were determined by a special image analysis processor.

Stable free radicals as ubiquitous components of red wines.

A stable ESR signal, centred at g = 2.0037 +/- 0.0002, characterised by a single resonance and assignable to a free radical, was found in all the bottled red wines, both commercial and experimental, that we have examined.

A new factor X defect (factor X Padua 3): a compound heterozygous between true deficiency (Gly(380)-->Arg) and an abnormality (Ser(334)-->Pro).

We report a novel mutation in Factor X (FX) gene which results in a phenotype without any bleeding tendency. The proband has been found to be a compound heterozygote between a novel FX true deficiency (Gly(380)-->Arg) and a previously reported dysfunctional mutation Ser(334)-->Pro (FX Marsiglia). Prothrombin time (PT) and partial thromboplastin time (PTT) were moderately prolonged and were fully corrected by the addition of normal serum.

Mild bleeding diathesis in a boy with combined severe haemophilia B (C(10400)-->T) and heterozygous factor V Leiden.

Haemophilia B patients with factor IX (FIX) activity < 1% are usually characterized by severe bleeding episodes early in life. We report a case of sporadic severe haemophilia B, clinically characterized by mild bleeding diathesis. The presence of anamnestic thrombophlebitis in the patient's mother prompted us to investigate a possible associated hypercoagulable condition.

Early transfusion of factor VIII/von Willebrand factor concentrates seems to be effective in the treatment of gastrointestinal bleeding in patients with von Willebrand type III disease.

The association between gastrointestinal angiodysplasia and von Willebrand disease was reported 30 years ago. The clinical course of patients with von Willebrand disease and angiodysplasia is characterized by numerous admissions to hospital for gastrointestinal bleeding necessitating transfusion with packed red cells, factor VIII and plasma. The management of these patients is problematic.

Deuterium nuclear magnetic resonance for evaluating the metabolic status of livers subjected to warm ischemia.

Background: The development of reliable methods for assessing the viability of currently available livers is expected to increase the number of successful transplantations.

Methods: 2 H nuclear magnetic resonance (NMR) was used to search for metabolic markers of ischemia in explanted rat livers. Deuterium oxide (2 H2O) was used as a source of 2 H.

Prevalence of intestinal metaplasia in the distal oesophagus, oesophagogastric junction and gastric cardia in symptomatic patients in north-east Italy: a prospective, descriptive survey. The Italian Ulcer Study Group "GISU".

Background: Incidence of adenocarcinoma of distal oesophagus and gastric cardia, probably arising from areas of intestinal metaplasia, has been increasing rapidly.

Aims: To define prevalence of intestinal metaplasia of distal oesophagus, oesophagogastric junction and gastric cardia and to evaluate potential associated factors, by means of a prospective multicentre study including University and teaching hospitals, and primary and tertiary care centres.

Patients: Each of 24 institutions involved in study enrolled 10 consecutive patients undergoing first-time routine endoscopy for dyspeptic symptoms.

A dysfunctional factor X (factor X San Giovanni Rotondo) present at homozygous and double heterozygous level: identification of a novel microdeletion (delC556) and missense mutation (Lys(408)-->Asn) in the factor X gene. A study of an Italian family.

Low levels of factor X (F.X) were detected in a 4-year-old boy who experienced acute lymphoblastic leukemia and bleeding manifestations. Laboratory data suggested the presence of a dysfunctional F.

Colonic metaplasia in the long-term follow-up of the ileal neobladder.

Objective: To look for the presence of colonic metaplasia (CM), the shifting from sialomucins (SIs) to sulfomucins (SUs), considered as a probably premalignant lesion in the stomach in the mucosa of the ileal neobladder (IN).

Methods: 19 patients with IN were subjected to endoscopic biopsy; the samples were analyzed by means of histochemistry with high iron diamine, a test indicated to identify SIs and SUs.

Results: CM was never observed earlier than 1 year after the operation, was absent in 9/19 patients (mean follow-up 14 months) and present in 10/19 (mean follow-up 59 months).