RESUMO
Recent data suggest that steroidogenic enzyme messenger ribonucleic acids (mRNAs) may be overexpressed in thecal cells, and LH receptors may be prematurely expressed in granulosa cells in women with polycystic ovaries. The purpose of this study was to determine whether there is abnormal gene expression in thecal and granulosa cells from polycystic ovaries. Ovarian tissue specimens were obtained from 12 women with PCOS and 24 regularly cycling control women. The granulosa cells and the theca interna were microdissected from individual follicles. LH receptor, steroidogenesis acute regulatory protein (StAR), cholesterol side-chain cleavage cytochrome P450 (CYP11A), and 17alpha-hydroxylase/C(17-20) lyase cytochrome P450 (CYP17) mRNAs were measured by RT-PCR. There was no difference between 3- to 7-mm control follicles and dominant follicles with respect to LH receptor mRNA expression in either thecal or granulosa cells. CYP11A and CYP17 mRNAs were higher in thecal cells from 3- to 7-mm follicles than in dominant follicles, but StAR expression was not different. In granulosa cells, StAR and CYP11A mRNA expression was higher in dominant follicles than in 3- to 7-mm follicles. The mean levels of LH receptor, StAR, CYP11A, and CYP17 mRNA expression were higher in thecal cells from PCOS follicles than in size-matched control follicles. In granulosa cells, the mean levels of LH receptor and CYP11A, but not StAR, mRNA expression were higher in PCOS than in control follicles. These data demonstrate that regulatory protein and steroidogenic enzyme mRNAs are overexpressed in thecal and granulosa cells from polycystic ovaries and support the conclusions that the thecal cells are hyperstimulated and the granulosa cells may be prematurely luteinizing.
Assuntos
Enzima de Clivagem da Cadeia Lateral do Colesterol/genética , Ovário/metabolismo , Fosfoproteínas/genética , Síndrome do Ovário Policístico/metabolismo , Receptores do LH/genética , Esteroide 17-alfa-Hidroxilase/genética , Adulto , Feminino , Expressão Gênica , Células da Granulosa/química , Células da Granulosa/metabolismo , Humanos , Modelos Lineares , RNA Mensageiro/análise , Reação em Cadeia da Polimerase Via Transcriptase Reversa , Células Tecais/química , Células Tecais/metabolismoRESUMO
14 cases of Pott's disease of the spinal column treated by surgery is described. The operation was performed by an anterior approach and evacuation of abscess, removal of granulation tissue, seguesterated bone and disc material achieved. Any mechanical compression by bony ridges, dense fibrotic tissue or fibrotic posterior longitudinal ligament was removed making it possible for anti TB treatment to have full effect. Stability of the spine was achieved by means of anterior bone grafts which accelerated bony fusion and eradication of the disease. It is stressed that this type of radical surgery in Pott's allows for histological diagnosis, corrects the deformity thus preventing future cardio-respiratory complications, prevents paraplegia of late onset, and shortens the duration of hospital stay allowing the patient to return to his previous occupation.