Inhibición de la actividad citotóxica no restringida por MHC de células NK y de clones T CD8+alfa-beta por la agregación de moléculas MHC de clase I / Inhibition of non MHC-restricted cytotoxicity of human NK cells and a CD8+alfa-beta T cell clone by MHC class I cross-linking

La lista de ligandos del sistema inmune que se convierten en receptores es cada día más amplia. Nuestros datos experimentales muestran que la agregación de moléculas MHC de clase I humanas por anticuerpos monoclonales inhibe la lisis no específica de células Natural Killer (NK) y de linfocitos T citotóxicos. Estos resultados sugieren que las moléculas MHC de clase I humanas expresadas por células efectoras T citotóxicas (CTL) o células NK pueden transmitir señales negativas tras su interacción con ligandos expresados por las células que necesitan protegerse de la citotoxicidad no específica. En consecuencia, las moléculas MHC I no son únicamente ligandos del receptor de antígeno T o de receptores NK no reordenados, sino que también son moléculas transmisoras de señales por sí mismas probablemente tras co-localización en grupos de activación supramolecular o asociación con receptores con capacidad de transducción de señales. Además, nuestros resultados experimentales pueden tener consecuencias en el estudio de las señales inhibitorias que modulan la respuesta citotóxica de linfocitos T y células NK en donde está generalizado el uso de anticuerpos anti-MHC I. En resumen, nuestros datos sugieren una nueva función de las moléculas MHC de clase I humanas relevante en el estudio de las señales reguladoras que controlan la actividad de las células efectoras NK y citotóxicas T (AU)

Programa de adiestramientoy resultados en la inserciónhisteroscópica dedispositivos para laesterilización tubáricapermanente / Training program and results of hysteroscopic insertion of devices for permanent tubal sterilization

Objetivos: Evaluar la metodología utilizada para aprender la técnica de inserción de los dispositivos Essure®, antes de proceder a su colocación, en mujeres que deseaban un método contraceptivo permanente. Sujetos y métodos: En una primera fase, el adiestramiento comenzó con sesiones teoricoprácticas de manejo del material, utilizando maquetas uterinas de plástico. En la segunda fase, se insertaron los dispositivos a 6 pacientes que iban a ser sometidas a una histerectomía por enfermedad benigna. En una tercera fase, se procedió a la inserción de los dispositivos a 25 mujeres voluntarias, en el marco de un ensayo clínico multicéntrico de fase II. Resultados: Se consiguió la inserción correcta de ambos dispositivos en 23 de las 25 participantes (92 por ciento). Las únicas complicaciones fueron dos reflejos vagales (8 por ciento) que no precisaron ingreso hospitalario. No se objetivó ningún embarazo. Conclusión: El elevado porcentaje de inserciones satisfactorias, el escaso número de complicaciones y la efectividad del método como contraceptivo demuestran la eficacia del entrenamiento efectuado (AU)

[The effect of pregnancy on the consumption of tobacco and alcohol]. / El embarazo como factor modulador del consumo de tabaco y alcohol.

OBJECTIVES: To determine if the knowledge of pregnancy modifies smoking and drinking habits and if some socio-demographic variables exert any influence in these changes. DESIGN: Descriptive observational study with a sectional design (prevalence study). SETTING: Obstetric service of a Spanish general hospital, and also three private centres in the same area. PARTICIPANTS: 271 women (mean age of 29 years) under 14 weeks of gestation (mean of 9 weeks) who attended to their first gynaecology visit and accepted to participate in the study. INTERVENTIONS: By means of direct interview to women, investigators filled a questionnaire with demographic characteristics, obstetric data, smoking and drinking habits and changes in these habits as a response to their pregnancy were also recorded. MEASUREMENTS AND MAIN RESULTS: Almost eighty percent of them planned their pregnancy, and 14.8% were using some contraceptive method when they became pregnant. Before learning of their pregnancy most of the women smoked cigarettes (53.5%), and a low proportion consumed alcohol at meals (20.3%) or between meals (10.7%). After knowledge of their pregnancy, 46.9% of smokers, 56.4% of drinkers during meals, and 86.2% of drinkers between meals, stopped these habits. Those women who smoked fewer cigarettes showed a higher capacity to stop consumption. It was also observed that those who gave up drinking at meals were those who drank less alcohol and who had no university degree. CONCLUSIONS: A high prevalence of smoking among fertile women was observed, although an important proportion of them stopped this consumption after learning about their pregnancy. This change was less frequent among the heavy smokers. Consequently, the establishment of specific programs for encouraging abstinence of alcohol and cigarette consumption in several population groups as described, could be recommended.

Comparison of cytospat and pipelle endometrial biopsy instruments.

OBJECTIVE: To compare two endometrial biopsy techniques, based on the quality of material obtained, cost effectiveness, and pain during the procedure. STUDY DESIGN: A single blind, randomized prospective study. RESULTS: A total of 365 women with peri/postmenopausal bleeding were randomized into two groups: 174 biopsied cytospat (C) and 191 biopsied with pipelle (P). Both procedures were then followed by either dilatation and curettage (D&C) or hysterectomy. Pain was evaluated in 379 patients, with the result being better tolerance for P vs. C (3.55 vs. 4.06, P = 0.07). With C, the sensitivity in histological evaluation was 82% for benign endometrium, 60% for endometrial hyperplasia and 60% for corpus uterine neoplasia as compared to the D&C and hysterectomy material. With P the sensitivity was 84, 71 and 60%, respectively for the three diagnoses, as compared to the D&C and hysterectomy material. Insufficient tissue for pathologic evaluation was present in 24% of C, 25% of P and 9.8% of D&C samples. CONCLUSIONS: Cost effectiveness for pipelle is slightly higher than for Cytospat.

Complications of Operative Hysteroscopy

We conducted a retrospective study of 324 operative hysteroscopies performed from January 1993 to December 1995 to evaluate and analyze possible complications. Our complication rate was 5.2%, with uterine perforation being the most common at 1.8%. We had no cases of water intoxication.

[Response of growth hormone (GH) to glucagon-propranolol stimulation in diabetic subjects (author's transl)]. / Respuesta de la hormona de crecimiento (GH) al estímulo con glucagón-propranolol en sujetos diabéticos.

The functional study of growth hormone (GH) requires at least three different stimulation tests. To obtain a degree of hypoglycemia good enough to stimulate GH release is difficult in diabetic patients, and this fact has prompted us to utilize the stimulation induced by glucagon-propranolol. The test was performed in 15 diabetic patients and the results compared to those of 15 non-diabetic subjects. In the diabetic patients GH increased after stimulation from a mean basal level of 2.14 ng/ml to 15.32 ng/ml (p less than 0.01). Peak GH levels in plasma were reached between 120 and 180 minutes. Two failures were found and there were only minimal side effects. The results indicate that the test is valuable for the study of GH release in diabetic patients, and that it may substitute for the induction of hypoglycemia, which is more difficult to obtain in these patients. Finally, the results are compared to those obtained by other authors.