RESUMO
The efficiency of bovine in vitro embryo production can be significantly improved by splitting embryos at different stages. However, the blastocyst quality of in vitro-produced demi-embryos remains unexplored. The objective of this research was to compare embryo developmental rates and quality of bovine demi-embryos produced by two different strategies: (a) embryo bisection (BSEC) and (b) 2-cell blastomere separation (BSEP). To determine demi-embryos quality, we evaluated total blastocyst cell number and proportion of SOX2+ cells. Additionally, the expression of SOX2, NANOG, OCT4, CDX2, IFNT, BAX and BCL genes and let-7a and miRNA-30c Micro RNAs was analysed. BSEP resulted in improved blastocyst development, higher ICM cells and a significantly higher expression of IFNΤ than demi-embryos produced by BSEC. Let-7a, which is associated with low pregnancy establishment was detected in BSEC, while miRNA-30c expression was observed in all treatments. In conclusion, BSEP of 2-cell embryos is more efficient to improve in vitro bovine embryo development and to produce good quality demi-embryos based on ICM cell number and the expression pattern of the genes explored compared to BSEC.
Assuntos
Blastocisto , Blastômeros , Técnicas de Cultura Embrionária , Desenvolvimento Embrionário , Animais , Bovinos/embriologia , Feminino , Técnicas de Cultura Embrionária/veterinária , Blastômeros/citologia , Fertilização in vitro/veterinária , MicroRNAs/genética , MicroRNAs/metabolismo , Regulação da Expressão Gênica no Desenvolvimento , GravidezRESUMO
INTRODUCTION: The present analysis aims to evaluate the consequences of a 2-month interruption of mammographic screening on breast cancer (BC) stage at diagnosis and upfront treatments in a region of Northern Italy highly affected by the severe acute respiratory syndrome-related coronavirus-2 (SARS-CoV-2) virus. METHODS: This retrospective single-institution analysis compared the clinical pathological characteristics of BC diagnosed between May 2020 and July 2020, after a 2-month screening interruption, with BC diagnosed in the same trimester of 2019 when mammographic screening was regularly carried out. RESULTS: The 2-month stop in mammographic screening produced a significant decrease in in situ BC diagnosis (-10.4%) and an increase in node-positive (+11.2%) and stage III BC (+10.3%). A major impact was on the subgroup of patients with BC at high proliferation rates. Among these, the rate of node-positive BC increased by 18.5% and stage III by 11.4%. In the subgroup of patients with low proliferation rates, a 9.3% increase in stage III tumors was observed, although node-positive tumors remained stable. Despite screening interruption, procedures to establish a definitive diagnosis and treatment start were subsequently carried out without delay. CONCLUSION: Our data showed an increase in node-positive and stage III BC after a 2-month stop in BC screening. These findings support recommendations for a quick restoration of BC screening at full capacity, with adequate prioritization strategies to mitigate harm and meet infection prevention requirements.
Assuntos
Neoplasias da Mama/diagnóstico por imagem , Neoplasias da Mama/patologia , Neoplasias da Mama/terapia , COVID-19 , Programas de Rastreamento/organização & administração , Idoso , Neoplasias da Mama/epidemiologia , Neoplasias da Mama Masculina/diagnóstico por imagem , Feminino , Humanos , Itália/epidemiologia , Metástase Linfática/diagnóstico por imagem , Masculino , Mamografia/estatística & dados numéricos , Mastectomia , Pessoa de Meia-Idade , Terapia Neoadjuvante , Estudos Retrospectivos , Fatores de TempoRESUMO
BACKGROUND: The optimal time interval between the end of neoadjuvant systemic therapy (NST) and breast surgery is still unclear. It is not known if a delay in surgery might influence the benefit of primary chemotherapy. The aim of this study is to evaluate the relationship between time to surgery (TTS) and survival outcomes. PATIENTS AND METHODS: According to TTS, women with diagnosis of BC treated with NST were divided into two cohorts: group A = 21 days or fewer and group B = longer than 21 days. OS and RFS were estimated and compared according to TTS and known prognostic factors. RESULTS: A total of 319 patients were included in the study: 61 in group A and 258 in group B. Median TTS was 34 days. No association between clinical stage, nuclear grade, type of chemotherapy, type of surgery and TTS was detected. OS and RFS were significantly worse for group B compared with group A, with a hazard ratio of 3.1 (95% CI, 1.1-8.6 p = 0.03) and 3.1 (95% CI, 1.3-7.1 p = 0.008) respectively. Multivariate analysis confirmed that TTS was an independent prognostic factor in term of OS (p = 0.03) and RFS (p = 0.01). Even in the subgroup of patients with pCR, TTS continued to be an independent prognostic factor for both OS and RFS (p = 0.05 and p = 0.03). CONCLUSIONS: TTS after NST seems to influence survival outcomes. BC patients underwent surgery within 21 days experienced maximal benefit from previous treatment: this advantage is consistent and maintained over time.
Assuntos
Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Neoplasias da Mama/cirurgia , Mastectomia Segmentar/métodos , Terapia Neoadjuvante , Tempo para o Tratamento/estatística & dados numéricos , Adulto , Idoso , Idoso de 80 Anos ou mais , Antraciclinas/administração & dosagem , Axila , Neoplasias da Mama/mortalidade , Neoplasias da Mama/patologia , Quimioterapia Adjuvante , Estudos de Coortes , Intervalo Livre de Doença , Feminino , Humanos , Excisão de Linfonodo/métodos , Mastectomia/métodos , Pessoa de Meia-Idade , Análise Multivariada , Gradação de Tumores , Estadiamento de Neoplasias , Prognóstico , Modelos de Riscos Proporcionais , Radioterapia Adjuvante , Estudos Retrospectivos , Taxa de Sobrevida , Taxoides/administração & dosagem , Fatores de TempoRESUMO
Inhibitor studies of the only known eukaryotic methionyl-tRNA transformylase (10-formyltetrahydrofolate:L-methionyl-tRNA N-transformylase, EC 2.1.2.9) were carried out. All the natural pteroylglutamic acid derivatives examined, with the exception of pteroylglutamic acid, are inhibitors. The most effective is 5-methyltetrahydrofolate (5-CH3-H4PteGlu) (KI = 3 . 10(-6) M), which is the only noncompetitive inhibitor of the enzyme. All the other derivatives tested are competitive, and H4PteGlu shows a cooperative inhibition. These and other data obtained with pteroylglutamic analogues show that, in contrast to the bacterial enzyme, Euglena transformylase is also inhibited by compounds without a fully reduced pyrazine ring and is very sensitive to compounds with a methyl group in position 5 or 10 of the pteridine ring.
Assuntos
Aciltransferases/antagonistas & inibidores , Euglena gracilis/enzimologia , Ácido Fólico/análogos & derivados , Hidroximetil e Formil Transferases , Animais , Fenômenos Químicos , Química , Ácido Fólico/farmacologia , Cinética , N-Formilmetionina/antagonistas & inibidores , Aminoacil-RNA de Transferência/antagonistas & inibidores , Tetra-Hidrofolatos/farmacologiaRESUMO
BACKGROUND: Thiopental is an anaesthetic drug that is largely used in both short-term and long-term infusion. After long-term infusion of thiopental, non-linear and inter-individual-dependent pharmacokinetics occur because of the saturation and/or induction of the metabolism. Clinical monitoring is important so that therapeutic adjustments can be made in many of the different pharmacological treatments, especially when long-term infusion is required. We describe a new, rapid HPLC method for the determination of plasma thiopental. METHODS: Sample preparation involved precipitation of plasma proteins using a mixture of methanol, zinc sulfate and ethylene glycol, and containing the internal standard 5-ethyl-5-p-tolyl-barbituric acid. After adding trichloroacetic acid, the sample was centrifuged and the supernatant was injected into a C(18) reversed-phase column. The mobile phase used was water-methanol-acetonitrile (50:40:10, v/v). The eluent was monitored at 290 nm. RESULTS: The calibration curve was linear from 0.2 to 100 microg/mL. Precision, calculated as the coefficient of variation (%), was in the range of 3.62-0.70% for the within-day assay and 5.77-1.51% for the between-day assay. The absolute recoveries obtained from supplemented samples were never less than 100%. CONCLUSIONS: This technique shows good reliability and seems to be suitable for a very fast and simple therapeutic monitoring of plasma thiopental.
Assuntos
Anestésicos Intravenosos/sangue , Cromatografia Líquida de Alta Pressão/métodos , Tiopental/sangue , Anestésicos Intravenosos/farmacocinética , Cromatografia Líquida de Alta Pressão/economia , Análise Custo-Benefício , Humanos , Padrões de Referência , Reprodutibilidade dos Testes , Tiopental/farmacocinéticaRESUMO
The enzymatic methods for measuring D-glucaric acid in urine are based on the conversion of D-glucaric acid into its 1,4-lactone and measurement of inhibition of 1,4-lactone against beta-glucuronidase at pH 5.0. All the enzymatic methods described suffer from the disadvantage of a procedure that is complicated and inherently inaccurate, because the nature of glucaric acid/1,4-lactone equilibrium has not been properly considered in the development of such methods. After elucidating the factors influencing glucaric acid/1,4 lactone equilibrium in more detail, a low-pH enzymatic method has been developed in which the 1,4-lactone is formed in the urine sample by acid boiling at pH 3.8 and assayed at the same pH using beta-glucuronidase from Limpets. This procedure allows the acid/lactone equilibrium to remain stable during both the lactonization step and the enzymatic assay. The coefficient of variation for the proposed method (within-run and between-day precision) was from 4.2 to 8.7. The analytical recovery varied from 92-108%.
Assuntos
Ácido Glucárico/urina , Glucuronidase/antagonistas & inibidores , Açúcares Ácidos/urina , Temperatura Alta , Humanos , Concentração de Íons de Hidrogênio , Lactonas/farmacologia , Lactonas/urina , Métodos , Moluscos/enzimologiaRESUMO
Girolando (Gir x Holstein) is a very common dairy breed in Brazil because it combines the rusticity of Gir (Bos indicus) with the high milk yield of Holstein (Bos taurus). The ovarian follicular dynamics and hormonal treatments for synchronization of ovulation and timed artificial insemination were studied in Girolando heifers. The injection of a gonadotrophin-releasing hormone (GnRH) agonist was followed 6 or 7 days (d) later by prostaglandin F2alpha (PGF2alpha). Twenty-four hours after PGF2alpha injection either human chorionic gonadotropin (hCG, GPh-d6 and GPh-d7 groups) or estradiol benzoate (EB, GPE-d6 and GPE-d7 groups) was administered to synchronize ovulation and consequently allow timed artificial insemination (AI) 24 and 30 h after hCG and EB injection, respectively. Follicular dynamics in Girolando heifers was characterized by the predominance of three follicular waves (71.4%) with sizes of dominant follicles (10-13 mm) and corpus luteum (approximately 20 mm) similar to those for Bos indicus cattle. In the GnRH-PGF-hCG protocol, hCG administration induced earlier ovulation (67.4 h, P<0.01) compared to the control group (GnRH-PGF) and a better synchronization of ovulation, since most of it occurred within a period of 12 to 17 h. Pregnancy rate after timed AI was 42.8 (3/7, GPh-d6) to 50% (7/14, GPh-d7). In contrast, estradiol benzoate (GnRH-PGF-EB protocol) synchronized ovulation of only 5 of 11 heifers from the GPE-d7 group and of none (0/7) from the GPE-d6 group, which led to low pregnancy rates after timed AI (27.3 and 0%, respectively). However, since a small number of Girolando heifers was used to determine pregnancy rates in the present study, pregnancy rates should be confirmed with a larger number of animals.
Assuntos
Gonadotropina Coriônica/farmacologia , Dinoprosta/farmacologia , Estradiol/farmacologia , Sincronização do Estro/efeitos dos fármacos , Hormônio Liberador de Gonadotropina/agonistas , Indução da Ovulação/veterinária , Análise de Variância , Animais , Bovinos/fisiologia , Feminino , Hormônio Liberador de Gonadotropina/farmacologia , Inseminação Artificial/veterinária , Folículo Ovariano/efeitos dos fármacos , Folículo Ovariano/fisiologia , Gravidez , Progesterona/análise , Radioimunoensaio , Fatores de TempoRESUMO
It was the purpose of this study to analyze the behavior of Tutoplast bone allograf to fill cavities produced by the removal of benigning bone tumors of those with local malignancy. X-ray and MR images obtained during follow-up demonstrated an increase in the signal in all of the sequences within the graft, indicating complete rehabitation of the grafted area.
Assuntos
Neoplasias Ósseas/cirurgia , Transplante Ósseo/métodos , Imageamento por Ressonância Magnética , Adolescente , Adulto , Neoplasias Ósseas/patologia , Transplante Ósseo/patologia , Criança , Desidratação , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , SolventesRESUMO
The current limitations for obtaining ovaries from slaughterhouses and the low efficiency of in vivo follicular aspiration necessitate a complete understanding of the variables that affect oocyte developmental competence in the equine. For this reason, we assessed the effect on equine oocyte meiotic competence and the subsequent in vitro cloned embryo development of 1) the time interval between ovary collection and the onset of oocyte in vitro maturation (collection-maturation interval time) and 2) the pregnancy status of the donor mares. To define the collection-maturation interval time, collected oocytes were classified according to the slaughtering time and the pregnancy status of the mare. Maturation rate was recorded and some matured oocytes of each group were used to reconstruct zona free cloned embryos. Nuclear maturation rates were lower when the collection-maturation interval time exceeded 10 h as compared to 4 h (32/83 vs. 76/136, respectively; P = 0.0128) and when the donor mare was pregnant as compared to nonpregnant (53/146 vs. 177/329, respectively; P = 0.0004). Low rates of cleaved embryos were observed when the collection-maturation interval time exceeded 10 h as compared to 6 to 10 h (11/27 vs. 33/44, respectively; P = 0.0056), but the pregnancy status of donor mares did not affect cloned equine blastocyst development (3/49 vs. 1/27 for blastocyst rates of nonpregnant and pregnant groups, respectively; P = 1.00). These results indicate that, to apply assisted reproductive technologies in horses, oocytes should be harvested within approximately 10 h after ovary collection. Also, even though ovaries from pregnant mares are a potential source of oocytes, they should be processed at the end of the collection routine due to the lower collection and maturation rate in this group.
Assuntos
Clonagem de Organismos/veterinária , Cavalos/fisiologia , Técnicas de Maturação in Vitro de Oócitos/veterinária , Recuperação de Oócitos/veterinária , Animais , Feminino , Técnicas de Maturação in Vitro de Oócitos/métodos , Recuperação de Oócitos/métodos , Ovário , Gravidez , Fatores de Tempo , Doadores de TecidosAssuntos
Aciltransferases/metabolismo , Euglena gracilis/enzimologia , Aciltransferases/isolamento & purificação , Cloroplastos/enzimologia , Formiltetra-Hidrofolatos/metabolismo , Cinética , Magnésio/farmacologia , Metionina , Metionina tRNA Ligase/metabolismo , Peso Molecular , Potássio/farmacologia , RNA de Transferência/metabolismo , Estreptomicina/farmacologiaAssuntos
Acetilcisteína/administração & dosagem , Bronquite/tratamento farmacológico , Sistema Cardiovascular/efeitos dos fármacos , Ornitina Carbamoiltransferase/sangue , Enfisema Pulmonar/tratamento farmacológico , Idoso , Fosfatase Alcalina/sangue , Proteínas Sanguíneas/análise , Nitrogênio da Ureia Sanguínea , Colesterol/sangue , Creatinina/sangue , Eletrocardiografia , Humanos , Injeções Intravenosas , Masculino , Pessoa de Meia-Idade , Transaminases/sangueRESUMO
Brain damage in Alzheimer's disease (AD) and mild cognitive impairment (MCI) is widespread with involvement of large portions of the neocortex and the subcortical white matter. A quantitative measure of neuronal damage of the entire brain might be valuable in the context of large-scale, longitudinal studies of these patients. This study investigated the extent of neuroaxonal injury of patients with AD and MCI using a novel unlocalized proton magnetic resonance spectroscopy ((1)H-MRS) technique, which allows quantification of the concentration of N-acetylaspartate from the whole of the brain tissue (WBNAA). Conventional brain MRI and WBNAA were obtained from 28 AD patients, 27 MCI patients and 25 age-matched controls. Normalized brain volume (NBV) was also measured using an automated segmentation technique. WBNAA and NBV showed a significant heterogeneity between groups (P < 0.001). WBNAA concentration was different between controls and MCI patients (P = 0.003), but not between MCI and AD patients (P = 0.33). NBV differed both between controls and MCI patients (P = 0.02) and between MCI and AD patients (P = 0.03). A multivariate regression model retained WBNAA as the best MRI predictor of the Mini Mental State Examination score (P = 0.001). Significant neuronal damage, which is related to the extent of cognitive decline, can be quantified in the whole brain tissue of patients with AD, using a novel (1)H-MRS approach. The demonstration in patients with MCI of MR structural and metabolic findings, intermediate between those of healthy volunteers and those of AD patients, indicates that neuronal damage is already evident and widespread in individuals with MCI before they are clinically demented.
Assuntos
Doença de Alzheimer/patologia , Doença de Alzheimer/psicologia , Ácido Aspártico/análogos & derivados , Encéfalo/patologia , Transtornos Cognitivos/patologia , Transtornos Cognitivos/psicologia , Idoso , Ácido Aspártico/metabolismo , Atrofia , Química Encefálica , Feminino , Humanos , Imageamento por Ressonância Magnética , Espectroscopia de Ressonância Magnética , Masculino , Escalas de Graduação Psiquiátrica , Valores de ReferênciaRESUMO
OBJECTIVE: To define the nature and the temporal evolution of neuronal/axonal injury in patients at the earliest clinical stage of multiple sclerosis (MS), using whole brain N-acetylaspartate (WBNAA) proton MR spectroscopy (1H-MRS). METHODS: Thirty-five patients at presentation with clinically isolated syndromes (CIS) and MRI evidence of disease dissemination in space were studied. The following scans of the brain were acquired within 3 months from the onset of the disease and after 12 months: 1) dual-echo; 2) WBNAA 1H-MRS; 3) pre- and postcontrast T1-weighted. The same scans were obtained in 12 age-matched healthy subjects, without contrast administration. In patients, conventional MRI scans were also repeated 3 months after the first scanning session, to assess the presence of early disease dissemination in time (DIT). RESULTS: Over the study period, 24 patients showed MRI evidence of disease DIT, thus fulfilling the criteria for a diagnosis of MS. The average WBNAA amount was lower in CIS patients than in controls both at baseline (13.7 vs 16.9 mM, p < 0.001) and at 1-year follow-up (12.6 vs 16.2 mM, p < 0.001), but the average yearly percentage change of WBNAA did not differ between the two groups. No MRI or 1H-MRS quantities were significantly associated with the disease DIT over the study period. CONCLUSION: Irreversible brain damage associated with axonal dysfunction occurs at a very early stage in patients with clinically isolated syndromes, but it does not seem to be related with the disease evolution in the subsequent short-term period.
Assuntos
Axônios/patologia , Sistema Nervoso Central/patologia , Esclerose Múltipla/diagnóstico , Degeneração Walleriana/diagnóstico , Adulto , Sistema Nervoso Central/fisiopatologia , Diagnóstico Diferencial , Progressão da Doença , Diagnóstico Precoce , Feminino , Humanos , Espectroscopia de Ressonância Magnética , Masculino , Esclerose Múltipla/fisiopatologia , Valor Preditivo dos Testes , Prognóstico , Degeneração Walleriana/etiologia , Degeneração Walleriana/fisiopatologiaRESUMO
The authors describe a case of non-ossifying fibroma which, because of its particular clinical and radiographic features, had previously been diagnosed as osteoid osteoma. Taking this as the starting point, the relationship and the differential diagnosis between these two well-known disorders is discussed.
Assuntos
Doenças do Desenvolvimento Ósseo/diagnóstico por imagem , Neoplasias Ósseas/diagnóstico por imagem , Osteoma Osteoide/diagnóstico por imagem , Adulto , Doenças do Desenvolvimento Ósseo/cirurgia , Diagnóstico Diferencial , Erros de Diagnóstico , Seguimentos , Humanos , Masculino , RadiografiaRESUMO
The authors describe the features of regional migratory osteoporosis, a rare form of idiopathic algodystrophy, with special reference to the fact that 8 of the 13 patients in this series belonged to two families. The clinical, radiological and histological manifestations are discussed and the treatment described. The latter involves a combination of chemotherapy, orthopaedic measures and physiotherapy. The fact that so many different clinical manifestations of the same pathological entity occurred in the same family, and in particular the high incidence of a familial factor in the case material reported in the literature, appear to indicate the existence of a predisposition to local disturbances of bone turnover in the peri-articular bone tissue. A precipitating factor, which is often clearly evident, then causes the disease to become clinically manifest.
Assuntos
Atrofia Muscular/etiologia , Osteoporose/complicações , Adolescente , Adulto , Idoso , Criança , Feminino , Humanos , Artropatias/diagnóstico por imagem , Artropatias/genética , Masculino , Pessoa de Meia-Idade , Atrofia Muscular/genética , Osteoporose/diagnóstico por imagem , Osteoporose/genética , Radiografia , RecidivaRESUMO
A synthesis of the new oxazolone 2, functionalized with the ethoxycarbonyloxy group on methylenic carbon, is presented, starting from 4-hydroxymethylenoxazolone 1 and ethyl chlorocarbonate. Oxazolone 2 was reacted with cyclopentadiene in the presence of EtAlCl(2), giving the two diastereoisomeric cycloadducts exo-3 and endo-3 in a 70:30 ratio. Selective hydrolysis of the lactone ring (THF, HCl) gave the corresponding acids 5 and 6 which were transformed into hydroxyacid derivatives 7 and 8, respectively, operating in an ethanolic solution of Me(2)NH. The new 3-hydroxy-2-aminonorbornane-2-carboxylic acids 11 and 12, in which the serine skeleton is included, were obtained by reduction of acids 5 and 6 to derivatives 9 and 10 and a subsequent hydrolysis with HCl.
Assuntos
Norbornanos/síntese química , Serina/química , Ciclização , Hidrólise , Espectroscopia de Ressonância Magnética , Norbornanos/química , Espectrofotometria Infravermelho , EstereoisomerismoRESUMO
Digoxin assay in plasma/serum samples is used for therapeutic measurements as a guide to clinical management of cardiac patients. A thin dry film multilayer monoclonal immunoassay for digoxin, Vitros, was evaluated for analytical performance. The effect of digoxin-like immunoreactive substances (DLIS) was studied assaying plasma samples taken from 100 renal disease patients, 62 hepatic disease patients and 40 pregnant women not receiving digoxin. The Vitros digoxin assay was compared with the AxSym digoxin II assay using plasma samples from 180 patients treated with digoxin. The results revealed satisfactory precision and accuracy for therapeutic drug monitoring purposes: the coefficient of variation (CV%) was lower than 5%; results for dilutions were linear in the range 0.4-3.9 microlg/L and mean analytical recovery was 105%. Measurable DLIS concentrations were observed in 29% of hepatic disease patients and in 7% of renal disease patients with apparent digoxin concentration ranging from 0.4 to 0.75 microg/L. The incidence of DLIS was comparable to that observed with AxSym digoxin II. Comparative results from patient samples gave a regression line equation: Yvitros 950=0.96XAxym +0.14, r=0.89. The data revealed a mean difference of 0.09+/-0.26 microg/L significantly greater than zero (p=0.02). We concluded that Vitros digoxin assay for precision, accuracy and extent of DLIS interference may be a good method for therapeutic drug monitoring; care needs to be taken since assay results generated by Vitros and AxSym analysers are not necessarily interchangeable.
Assuntos
Anticorpos Monoclonais/imunologia , Digoxina/sangue , Imunoensaio/métodos , Adulto , Calibragem , Digoxina/imunologia , Feminino , Humanos , Imunoensaio/normas , Nefropatias/sangue , Hepatopatias/sangue , Gravidez/sangueRESUMO
The enantioselective synthesis of 2-amino-3-hydroxynorbornene-2-carboxylic acid derivatives (5) was studied using the Diels-Alder reaction between cyclopentadiene and different dienophiles, i.e., alkyl 5-oxo-2-phenyloxazol-4-methylenecarbonates (1) or 2-benzoylamino-3-alkoxycarbonyloxy-acrylates (12), operating with different Lewis acids and both with thermal and with ultrasound conditions. The enantioselective synthesis of the exo/endo compounds 5c,d and 5'c,d was achieved starting from the chiral menthyl acrylates 12b,c using Mg(ClO(4))(2) as the catalyst and ultrasound. The cycloadducts were obtained in very good yield, in mild conditions, in short time, and in good diastereomeric excess (exo, 80%; endo, 87%). Finally, the use of alkylidene-oxazolones or acrylates and EtAlCl(2) or Mg(ClO(4))(2) as the catalyst allowed control of the cycloaddition reaction in favor of the exo or endo products.
RESUMO
It is accepted that the laboratory and clinical so-called "transurethral resection syndrome" reflects passage into the body of a large fraction of the water used to perfuse the field of endoscopic resection. The major complete syndrome (dyspnoea, nausea, hypertension, raised central venous pressure, bradycardia then pulmonary oedema, cerebral oedema, cardiovascular shock and renal insufficiency) is rare: 1.5 per cent of cases of transurethral resection of the prostate in the literature, 0.6% in a series of the last 300 resections performed by the authors (2/300). Also was it not possible to hope for a complete physiological study of sufferers from this complication. Nevertheless, it may be considered that all transurethral resections of the prostate may be associated with similar movements of water to a minimal extent. In order to attempt to demonstrate this, the authors studied in a series of 19 patients pre- and postoperative blood volumes by a radio-immunological technique using pre- and postoperative serum albumin haematocrits. In this short series, patients who had undergone a short endoscopic resection (35 minutes on average) of a small adenoma (13 grams on average) with a mean irrigation of 10 litres of water rendered isotonic by the addition of glycocolle, without any transfusion or infusion being necessary during the course of the resection, the conclusion was simple: no variation in blood volume was demonstrated. Is the physiopathological hypothesis advanced to explain this phenomenon false? And is the problem in fact one of peroperative septicaemia?