Osteosarcoma cardiaco / Cardiac osteosarcoma

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Reactive oxygen species participate in the control of mouse embryonic cell death.

Programmed cell death or apoptosis is an essential process during the morphogenesis of a large number of structures. Evidence obtained over the past few years indicates that, in some cases, the generation of reactive oxygen species (ROS) is an important event during the course of apoptosis. Using an in vitro culture system in which digit individualization of developing limbs normally occurs, we assayed the effect of different antioxidants on the cell death that takes place at interdigits. The addition of phenol, dimethyl sulfoxide, or 2',7'-dichlorodihydrofluorescein diacetate (DCDHF-DA) to murine developing limbs in culture prevented digit individualization as well as the typical interdigital cell death. Two ROS-sensitive dyes, 3-(4,5-dimethylthiazol)-2,5-diphenyl tetrazolium bromide and DCDHF-DA, stained interdigits and the so-called "necrotic zones," implying that they contain cells under oxidative stress. Very few interdigital cells were doubly stained with the ROS probes and two cell death indicators (i.e., acridine orange and propidium iodide), suggesting that they detect a different stage during the course of apoptosis. Furthermore, we found cells stained for ROS that did not express a specific macrophage marker and in a few cases were seen surrounded by a macrophage. Surprisingly, many regions of the midgestation mouse embryo that are undergoing cell death correlated with those that have a markedly higher level of ROS. Our data suggest that the generation of oxidative stress is a common requirement for cell death that occurs during mouse embryonic development.

Incidence of nausea and vomiting in outpatients undergoing general anesthesia in relation to selection of intraoperative opioid.

STUDY OBJECTIVE: To measure the incidence of nausea and vomiting in outpatients in relation to selection of, or withholding of, intraoperative opioid. DESIGN: Prospective, randomized, double-blind control trial. SETTING: University general hospital. PATIENTS: 200 unpremedicated ASA status 1 and 11 patients, 8 to 80 years old, undergoing general anesthesia for ambulatory surgery. INTERVENTION: Patients were randomized to four groups, three of which received equipotent doses of different opioids intravenously (i.v.) during induction of anesthesia. Group 1 received nalbuphine 0.25 mg/kg, Group 2, alfentanil 20 ug/kg; Group 3, fentanyl 2 ug/kg; and Group 4, normal saline. MEASUREMENTS AND MAIN RESULTS: We evaluated (1) incidence and severity of nausea and vomiting in the postanesthesia care unit (PACU) and over the next 24 hours; (2) time to PACU discharge; (3) need for antiemetic therapy; and (4) need for analgesic rescue in the PACU. The incidences of nausea and vomiting were similar in all groups, as were time to discharge, antiemetic, and nonsteroidal antiinflammatory drug requirements. The highest incidences of nausea and vomiting occurred at 6 hours in all groups (23% and 9.5%, respectively). Group 1 required lower rescue doses of morphine in the PACU but this result may have been an artifact due to employing the mixed agonist-antagonist opioid, nalbuphine, in this group. CONCLUSIONS: Opioid administration at the doses employed during induction of anesthesia does not promote postoperative nausea or vomiting, nor increase length of stay in the PACU.

[Abdominal hysterectomy at the Hospital de Especialidades Dr. Miguel Dorantes Mesa, S.S. A report on 140 cases]. / La histerectomía abdominal en el Hospital de Especialidades Dr. Miguel Dorantes Mesa, S.S. Informe de 140 casos.

Results from a study involving 140 hysterectomies performed at the "Miguel Dorantes Mesa" Hospital S.S. of Xalapa, Veracruz, between 1990 and 1992, are presented. The variables considered in the study were age, gyneco-obstetric history, pre-operatory indication, associated surgery, anatomopathology diagnosis and its correlation with the pre-operatory diagnosis, operatory technique, associated surgery, size of the uterus, type of endometrium of the quirurgic piece and complications in the immediate and late transoperatory. The results obtained here were also compared with some available from similar studies. The results showed that the main indication was due to pre-malign lesions, followed by benign neoplasias and only 4% due malign processes. The most frequent type of surgery was found to be the extrafascial hysterectomy with the salpingo-oophorectomy as associated surgery. The confirmation of the diagnosis by the anatomopathologic study was 76.1%. The most common type of complications encountered were two bladder lesions, and one of ureter; which were repaired during the transoperatory; two vesicovaginal and one ureterovaginal fistula. There was no mortality.

[Laparoscopic ureterolithotomy]. / Ureterolitotomía laparoscópica.

Laparoscopic techniques have been proposed for the management of different pathologies of the urinary system. This study reports our initial experience in laparoscopic surgery as an alternative treatment of ureteral calculus. Five patients with proximal ureteral calculus were submitted to laparoscopic ureterolithotomy. The technique and its possible indications are discussed.