ABSTRACT
La enfermedad del tronco se encuentra en el 5 a 7% de pacientes sometidos a angiografía coronaria. El síndrome coronario agudo (SICA) secundario a la complicación de la placa ateromatosa a este nivel, frecuentemente en porción distal, tiene una tasa de mortalidad de 50% en los siguientes tres años. Se presenta el caso de una mujer de 20 años, con enfermedad renal crónica terminal en hemodiálisis, con historia de dolor torácico y disnea recurrente, siendo el último episodio durante la sesión de hemodiálisis, en la cual mostró cambios electrocardiográficos y ecocardiográficos compatibles con SICA, y obstrucción del 95% de arteria epicárdica izquierda principal en porción proximal (enfermedad troncal ostial) en la angiocoronariografía. Se discute sobre las dos posibles opciones terapéuticas, la cirugía de revascularización y el intervencionismo coronario percutáneo, optando por este último, el cual finalmente tuvo éxito en el caso presentado. (AU)
Coronary arterial trunk disease is found in 5-7% of patients undergoing coronary arteriography. Acute coronary syndrome (ACS) resulting from complications of an atheromatous plaque in the distal portion of the arterial trunk has a mortality rate of 50% in the following 3 months. We present the case of a 20-year-old woman with end stage renal disease undergoing dialysis who presented an acute history of chest pain during the procedure, her EKG and heart ultrasound images were compatible with ACS, and 95% obstruction of the main left coronary artery in its distal portion was found in the coronary angiography. The two possible interventions were discussed, surgery and percutaneous procedures opting for the second one with success. (AU)
Subject(s)
Humans , Female , Young Adult , Renal Dialysis , Coronary Disease , Renal Insufficiency, Chronic , Acute Coronary SyndromeABSTRACT
A substrate cycle composed of phosphofructo 1-kinase I (PFK) and fructose 1,6 bisphosphatase I (FBPase) has been proposed in rat spermatids. This substrate cycle can explain the ability of glucose to induce a decrease in intracellular ATP, a phenomenon that was related to regulation of [Ca(2+)]i in these cells. In spite of the importance of this metabolic cycle, the expression and activities of the enzymes that compose such cycle have not been systematically studied in spermatogenic cells. Here, we show that PFK and FBPase activities were present in pachytene spermatocytes and round spermatids extracts. Expression of PFK at the mRNA and protein levels showed a relatively similar expression in spermatogenic cells, but a stronger expression in Sertoli cells. Instead, expression of FBPase at the mRNA and protein levels was stronger in round and elongating spermatids as compared to other spermatogenic cells. A similar pattern was observed when evidencing FBPase activity by a NADPH-nitroblue tetrazolium-linked cytochemical assay in isolated pachytene spermatocytes and round spermatids. Rat spermatids also showed the ability to convert lactate to fructose- and glucose-6-P, indicating that both glycolytic and gluconeogenic fluxes are present in these cells. Our results indicate that a coordinated expression of key substrate cycle enzymes, at the level of PFK/FBPase, appear in the last stages of spermatogenic cell differentiation, suggesting that the co-regulation of these enzymes are required for the ability of these cells to respond to glucose and induce metabolic and Ca(2+) signals that can be important for sperm development and function.