Trophoblast-induced spiral artery remodelling and uteroplacental haemodynamics in pregnant rats with increased blood pressure induced by heme oxygenase inhibition.

INTRODUCTION: The aim of the present study was to determine the contribution of the heme oxygenase (HO) system to the adaptation of the uteroplacental circulation to pregnancy in the rat, and its relationship with the maintenance of blood pressure during late gestation. METHODS: The HO inhibitor, stannous mesoporphyrin (SnMP), or vehicle were administered intraperitoneally to virgin and midpregnant rats. Mean arterial pressure (MAP) was measured before and after the treatment, in the conscious rats. Uterine and radial arteries blood flow velocities were obtained from pregnant rats at days 14 and 19 of gestation using high frequency ultrasonography. Trophoblast invasion and spiral arteries remodelling were analyzed in the mesometrial triangle of pregnant rats by immunohistochemistry. RESULTS: HO activity inhibition during late gestation induced a significantly increase in the MAP of pregnant rats (114 ± 1 mmHg vs 100 ± 2 mmHg, p < 0.05) but it did not affect this parameter in virgin rats (121 ± 2 mmHg vs 124 ± 3 mmHg). MAP elevation was associated with marked (p < 0.05) decreases in the systolic and diastolic flow velocities in uterine and radial arteries, as compared with pregnant control rats. Furthermore, spiral arteries of pregnant rats treated with SnMP showed lower (p < 0.001) proportion of lumen circumference covered by trophoblast (21 ± 3%) and a higher (p < 0.05) proportion of vascular smooth muscle (33 ± 5%) than control pregnant rats (59 ± 5% and 16 ± 5%, respectively) DISCUSSION: These data indicate that HO system play an important role in the adaptation of the uteroplacental circulation to pregnancy and in the blood pressure regulation during late gestation.

Lipoma vulvar gigante / Large vulvar lipoma

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[Incidental prostatic adenocarcinoma in the ere of the PSA]. / Adenocarcinoma de próstata incidental en la era del PSA.

Prostate adenocarcinoma is occasionally and incidentally found in the prostate gland after enucleation through adenomectomy or transurethral resection (incidentaloma). We contribute 17 cases (3.38%) of incidentaloma found among 503 patients who underwent adenomectomy vs. TUR due to prostate obstructive-irritative symptomatology of likely benign etiology. The diagnostic methods, pathological findings, treatment and evolution in our series versus other recent ones are explained.

[Clinical assessment and treatment of spontaneous perirenal hemorrhage]. / Evaluación clínica y tratamiento de la hemorragia perirrenal espontánea.

OBJECTIVES: Four cases of spontaneous perirenal hemorrhage are reviewed, with special reference to the clinical features, diagnosis and treatment. METHODS/RESULTS: Two were due to tumor (sarcomatoid carcinoma and angiomyolipoma) and the rest were secondary to renal lesions. All patients underwent nephrectomy due to hemodynamic instability. CONCLUSIONS: Nephrectomy appears to be the best treatment since this condition may arise from a malignant tumor which, to date, cannot be determined by any diagnostic method.

[Testicular cavernous angioma: a difficult clinical diagnosis]. / Angioma cavernoso de testículo: difícil diagnóstico clínico.

OBJECTIVE: The present report highlights the difficulty encountered in the diagnosis of cavernous testicular angioma in spite of the ultrasound study. METHODS/RESULTS: The clinical and ultrasound data of a patient with cavernous angioma of the testis were analyzed. To our knowledge, only 10 such cases have been reported in the literature. This condition could not be diagnosed on the basis of the clinical or ultrasound findings. CONCLUSIONS: Only pathological analysis and, therefore, surgical exploration can accurately diagnose cavernous angioma of the testis.