[Liver cirrhosis and pregnancy. An infrequent association. A rare case of liver cirrhosis with 3 pregnancies]. / Cirrosis hepática y embarazo. Asociación poco frecuente. Un caso raro de cirrosis hepatica con tres embarazos.

A chronic etylist 46 year old female patient with a chronic active hepatitis of a probable alcoholic origin in presented. Between 1983 an 1987 she became pregnant three times and had normal children. We suggest probable hypotheses for etiology of hepatic cirrhosis, hypogonadism and sterility.

Cirrosis hepática y embarazo. Asociación poco frecuente. Un caso raro de cirrosis hepatica con tres embarazos. / [Liver cirrhosis and pregnancy. An infrequent association. A rare case of liver cirrhosis with 3 pregnancies]

A chronic etylist 46 year old female patient with a chronic active hepatitis of a probable alcoholic origin in presented. Between 1983 an 1987 she became pregnant three times and had normal children. We suggest probable hypotheses for etiology of hepatic cirrhosis, hypogonadism and sterility.

Cirrosis hepática y embarazo. Asociación poco frecuente. Un caso raro de cirrosis hepatica con tres embarazos. / [Liver cirrhosis and pregnancy. An infrequent association. A rare case of liver cirrhosis with 3 pregnancies]

A chronic etylist 46 year old female patient with a chronic active hepatitis of a probable alcoholic origin in presented. Between 1983 an 1987 she became pregnant three times and had normal children. We suggest probable hypotheses for etiology of hepatic cirrhosis, hypogonadism and sterility.

[Hemopexin and immunoglobulins in benign and malignant ascites. Experience in 66 patients]. / "Hemopexina e inmunoglobulinas en las ascitis benignas y malignas. Experiencia en 66 pacientes".

Sixty six patients with ascites of different etiologies were studied. Both serum and peritoneal fluids were examined through proteic electrophoresis, being the haemopexin determined in the peritoneal fluids. Immunoglobulins usually show high values in neoplastic effusions, especially igG (x +/- ES = 928.57 +/- 86.87 mg/dl) and IgA (x +/- ES = 157 +/- 17.84 mg/dl). However, the highest determinations were found in those of the congestive heart failures. The quotients obtained from the ascites immunoglobulin/serum immunoglobulin ratio are useful from a statistics point of view, though their practical value is limited. No plasma/ascites correlation was observed either in cirrhotic or in neoplastic patients. Quantification of haemope in proved to be conclusive in differential diagnosis. The 100% of benign ascites (cirrhosis, congestive heart failure and kidney failure) showed lower values than 170 mg/dl while 90.5% of neoplastic patients showed higher figures than said value. The average was 30.79 +/- 5.31 mg/dl for cirrhotic patients and 205.19 +/- 9.62 mg/dl for neoplastic patients with a statistically significative different for both groups (p less than 0.001). There is a high probability that its determination could show the etiology of the process. It was useful not only in cases of both neoplastic and cirrhotic ascites but also in those which had a cardiac origin, in which it showed intermediate values (mean +/- ES = 83.75 +/- 15.77 mg/dl). We feel that its incorporation to the routine followed when studying peritoneal effusions will afford a quick etiologic orientation.

[quot ]Hemopexina e inmunoglobulinas en las ascitis benignas y malignas. Experiencia en 66 pacientes[quot ]. / [Hemopexin and immunoglobulins in benign and malignant ascites. Experience in 66 patients]

Sixty six patients with ascites of different etiologies were studied. Both serum and peritoneal fluids were examined through proteic electrophoresis, being the haemopexin determined in the peritoneal fluids. Immunoglobulins usually show high values in neoplastic effusions, especially igG (x +/- ES = 928.57 +/- 86.87 mg/dl) and IgA (x +/- ES = 157 +/- 17.84 mg/dl). However, the highest determinations were found in those of the congestive heart failures. The quotients obtained from the ascites immunoglobulin/serum immunoglobulin ratio are useful from a statistics point of view, though their practical value is limited. No plasma/ascites correlation was observed either in cirrhotic or in neoplastic patients. Quantification of haemope in proved to be conclusive in differential diagnosis. The 100

of benign ascites (cirrhosis, congestive heart failure and kidney failure) showed lower values than 170 mg/dl while 90.5

of neoplastic patients showed higher figures than said value. The average was 30.79 +/- 5.31 mg/dl for cirrhotic patients and 205.19 +/- 9.62 mg/dl for neoplastic patients with a statistically significative different for both groups (p less than 0.001). There is a high probability that its determination could show the etiology of the process. It was useful not only in cases of both neoplastic and cirrhotic ascites but also in those which had a cardiac origin, in which it showed intermediate values (mean +/- ES = 83.75 +/- 15.77 mg/dl). We feel that its incorporation to the routine followed when studying peritoneal effusions will afford a quick etiologic orientation.

[Gastrointestinal involvement in progressive systemic sclerosis]. / Compromiso gastrointestinal en la esclerosis sistémica progresiva.

25 patients with clinical, radiological and manometrical features of PSS in the gastrointestinal tract were reviewed, looking mainly for the esophageal involvement. All of the data obtained in our serie agreed with those of most of the authors. Outlining: The lack of relationship between the evolution of the skin involvement and GI tract involvement. The high incidence of esophageal involvement, especially functional alterations even in the absence of clinical and/or radiological symptomatology. The usefulness of manometric method in the diagnosis of motor involvement of esophages, especially for the evaluation of lower esophageal esphincter. Although the esophageal and intestinal involvement are more frequent and well known, any area of the GI tract may be damaged during the course of this disease. Since up to now, an ethiological therapy to stop the course of the disease is not known, it's important to search for earlier alterations in order to start with a pathophysiological and symptomatic treatment to avoid complications.

Feocromocitoma maligno del organo de Zuckerkandl. / Malignant pheochromocytoma of the organ of Zuckerkandl

Se presenta una paciente mujer de 15 anos de edad portadora de un feocromocitoma maligno del organo de Zuckerkandl con multiples metastasis oseas (craneo, clavicula, vertebras). Se destaca su prolongada sobrevida (7,5 anos desde el momento del diagnostico) y el beneficio obtenido (clinico y bioquimico) con la extirpacion quirurgica y la radioterapia administrada. Su buena evolucion se vincula estrechamente con el control hemodinamico de la enfermedad logrado con la terapeutica combinada de alfa y beta bloqueantes

Compromiso gastrointestinal en la esclerosis sistémica progresiva. / [Gastrointestinal involvement in progressive systemic sclerosis]

25 patients with clinical, radiological and manometrical features of PSS in the gastrointestinal tract were reviewed, looking mainly for the esophageal involvement. All of the data obtained in our serie agreed with those of most of the authors. Outlining: The lack of relationship between the evolution of the skin involvement and GI tract involvement. The high incidence of esophageal involvement, especially functional alterations even in the absence of clinical and/or radiological symptomatology. The usefulness of manometric method in the diagnosis of motor involvement of esophages, especially for the evaluation of lower esophageal esphincter. Although the esophageal and intestinal involvement are more frequent and well known, any area of the GI tract may be damaged during the course of this disease. Since up to now, an ethiological therapy to stop the course of the disease is not known, its important to search for earlier alterations in order to start with a pathophysiological and symptomatic treatment to avoid complications.