Nitric oxide synthase activity in the splanchnic vasculature of patients with cirrhosis: relationship with hemodynamic disturbances.

BACKGROUND/AIMS: It has been demonstrated that an overproduction of nitric oxide plays an important role in the pathogenesis of the hyperdynamic circulation exhibited by cirrhotic patients. Nevertheless, evidence is supported by studies performed in experimental models or by indirect measurements in humans. The purpose of this study has been to evaluate nitric oxide production in splanchnic vasculature of patients with cirrhosis and to investigate its possible relationship with systemic and splanchnic hemodynamics. METHODS: Nitric oxide synthase (NOS) activity was measured in hepatic artery and portal vein tissues of nine cirrhotic patients. Samples were obtained during liver transplantation. Control samples were obtained simultaneously from the corresponding tissues of the liver donors. Hemodynamic parameters were determined with Doppler ultrasonography. RESULTS: NOS activity was significantly higher in hepatic artery of cirrhotic patients than in controls (8.17 +/- 1.30 vs 4.57 +/- 0.61 pmoles/g of tissue/min, P < 0.05). Patients with ascites showed a higher hepatic artery NOS activity than patients without ascites. Highly significant correlation was observed between cardiac output and hepatic artery NOS activity as well as between portal blood flow and hepatic artery NOS activity. CONCLUSIONS: The present study demonstrates an enhanced production of nitric oxide in the splanchnic vasculature of patients with cirrhosis.

[Plasma estrogen levels in postmenopausal women treated with estrogens alone or combined with medroxyprogesterone acetate in the same tablet]. / Niveles plasmáticos de estrógenos en mujeres postmenopausicas tratadas con estrógenos solos o asociados a acetato de medroxiprogesterona en un mismo comprimido.

A study was carried out with 30 postmenopausal women, treated with conjugated estrogens, alone, or associated with medroxyprogesterone acetate in the same tablet, assaying their plasmatic estrogen levels before and during the treatment, besides its clinical efficacy. There were no significative differences of a given doses in neither of both aspects. The conclusion was that the associated hormonal replacement therapy is a good choice that improves patients compliance with the therapy.

Experience with intravaginal culture for in vitro fertilization (IVF).

It has been reported that intravaginal culture (IVC) yields results comparable to those obtained with classic IVF techniques; furthermore, it can simplify and reduce the costs of the procedure. In our experience with IVC however, only 8 of 78 mature oocytes inseminated (10.2%) fertilized. Possible causes of this low fertilization rate were analyzed. In our opinion this new and attractive technique needs further evaluation before being extended to common clinical practice.

[Pregnancy after intracorporeal fertilization in vaginal cultures]. / Embarazo obtenido por fertilización intracorpórea en cultivo intravaginal.

In a patient carrying a secondary sterility with previous failure of surgical and medical treatment, a pregnancy due to intracorporea fertilization in vaginal culture is obtained. With this system, we avoid the in vitro Fertilization in the laboratory.

Embarazo obtenido por fertilización intracorpórea en cultivo intravaginal / Pregnancy resulted by intracorporeal fertilization in vaginal culture

En una paciente portadora de una infertilidad secundaria, con fracaso de tratamientos médicos y quirúrgicos; se obtiene un embarazo por fertilización intracorpórea en cultivo vaginal. La vagina actuando como incubadora donde se colocan los gametos, permite esta fertilización en el organismo de la madre, al revés de lo que ocurre en la FIV, donde este proceso inicial se realiza en el laboratorio