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TUTELA DELLA FERTILITÀ NELLE PAZIENTI AFFETTA DA SINDROME DI TURNER

Polyomavirus-associated nephropathy (PVAN) has become an important cause of graft loss in the last few years. The typical course of PVAN is characterized by an asymptomatic period of viruria followed, within weeks, by the development of viremia in the context of stable renal function. The persistence of viral replication characterized by high viremia, leads to parenchymal injuries and causes the development, within months, of PVAN that could lead to deterioration in graft function and graft loss. We reported, in a patient who received a renal transplant, an unusual presentation of PVAN characterized by the development of acute renal failurte earlier than would be expected after transplantation, where the histological presentation alone could be confused with an acute rejection. We underline the importance of the association of histological findings with the viral load in urine and blood and with ancillary techniques such as immunohistochemistry and polymerase chain reaction (PCR) in situ for virus detection. We also want to emphasize that decoy cells and PCR for BK virus DNA research could be considered among the diagnostic tools for possible acute renal failure in kidney transplant.

Este volumen nace con dos finalidades precisas. La primera, dar a conocer los trabajos de investigación etnográfica que un grupo de nueve estudiantes de la Universidad de Bologna (Italia) y otro de la Pontificia Universidad Católica del Perú han desarrollado en la provincia de Huari, Ancash, Perú, durante seis años, entre 2003 y 2008 en el marco del Proyecto Arqueológico y Antropológico “Antonio Raimondi”. La segunda finalidad es realizar la difusión de las únicas miradas etnográficas que hasta hoy se han producido sobre la región Conchucos. Otro objetivo, más teórico y más implícito, es desplegar a lo largo del camino de la lectura de los casos etnográficos, una visión processual y dinamista de la escritura etnográfica y de la especulación antropológica, procedente de una manera precisa de hacer trabajo de campo. Los artículos aquí propuestos presentan, mediante varios estilos y diferentes acercamientos, una realidad sociocultural en movimiento, en constante cambio. Construyendo cuadros de varios aspectos sociales, políticos y culturales de la provincia de Huari, los autores delinean un escenario en proceso en el cual diferentes actores, ámbitos y dinámicas socioculturales se interrelacionan, participando de maneras diferents en la transformación.

Endometrial cancer is the most common gynaecological malignancy and its incidence is increasing. In 1998, international federation of gynaecologists and obstetricians (FIGO) required a change from clinical to surgical staging in endometrial cancer, introducing pelvic and paraaortic lymphadenectomy. This staging requirement raised controversies around the importance of determining nodal status and impact of lymphadenectomy on outcomes. There is agreement about the prognostic value of lymphadenectomy, but its extent, therapeutic value, and benefits in terms of survival are still matter of debate, especially in early stages. Accurate preoperative risk stratification can guide to the appropriate type of surgery by selecting patients who benefit of lymphadenectomy. However, available preoperative and intraoperative investigations are not highly accurate methods to detect lymph nodes and a complete surgical staging remains the most precise method to evaluate extrauterine spread of the disease. Laparotomy has always been considered the standard approach for endometrial cancer surgical staging. Traditional and robotic-assisted laparoscopic techniques seem to provide equivalent results in terms of disease-free survival and overall survival compared to laparotomy. These minimally invasive approaches demonstrated additional benefits as shorter hospital stay, less use of pain killers, lower rate of complications and improved quality of life.

Not present

Our purpose was to determine the effects of the coculture of embryos on human granulosa cells (GCs) in patients in the first cycle of IVF-ET treatment and in patients with repeated implantation failures and to investigate the presence of specific proteins in a 48-hr GC conditioned medium and the GC ultrastructural characteristics.Eighteen patients with tubal or idiopathic infertility were enrolled in this study: 7 patients (Trial 1) were in the first cycle of IVF-ET treatment and 11 patients (Trial 2) had repeated implantation failures (one to five). Embryos from each patient were cocultured randomly either on homologous granulosa cells or on a conventional culture medium.At the end of the coculture period (day 5 or 6), 50% of the embryos (Trial 1) reached the blastocyst stage, with respect to 35% in Trial 2. The pregnancy rate per retrieval was 14.2 and 9%, respectively, in Trial 1 and in Trial 2. Many conditioned media showed proteins of 24-29 kDa. and some of them showed additional proteins of 90 kDa. The ultrastructural analysis of GCs showed healthy, metabolically active, protein-synthesizing, and mostly steroidogenic cells.GC cultures improve embryo development but not pregnancy rates both in Trial 1 and in Trial 2.

Chemiluminescence is the light emission produced by a chemical reaction in which chemically excited molecules decay to the ground state. The phenomenon is utilized in various analytical techniques in which small amounts of analytes or enzymes can be detected and quantified by measurement of the light emitted by bio- or chemiluminescent reactions. Recently chemiluminescence has been proposed as a valid alternative to radioactive or colorimetric methods in in situ hybridization assays, in which target nucleic acids are localized by labeled probes inside individual cells with the preservation of cell morphology. Chemi-luminescence in situ hybridization is performed using probes that are detected using enzymes with their appropriate chemiluminescent substrates. The luminescent signal from the hybrid formation is detected, analysed and measured with a high performance low light level imaging apparatus connected to an optical microscope and to a personal computer for quantitative image analysis. Generally, the instrumental system to detect positive signals after in situ hybridization operates in three steps: firstly tissue structures and cells are recorded in transmitted light then the luminescent signal is measured with an optimized photon accumulation; and then, after a computer elaboration of the luminescent signal with pseudocolors corresponding to the light intensity, an overlay of the two images on the screen provided by the transmitted light and by the luminescent signal allows the spatial distribution of the labeled probe to be localized and evaluated. The main advantages of chemiluminescence in situ hybridization are mainly the sensitivity, the quantifi-cation of the data, the objectivity of the evaluation and the digital imaging of the results. The chemiluminescence in situ hybridization assay, which can be applied to cell smears, archival frozen and paraffin embedded tissue samples, can be a useful tool for a sensitive and specific diagnosis of viral infections and for the detection and study of specific genic sequences inside the cells. The use of the chemi-luminescent in situ hybridization assay is also promising for an estimation and quantification of nucleic acids present in tissue samples or cellular smears and for imaging gene expression in cells.