Video laparoscopic intervention for an interstitial pregnancy after failure of clinical treatment

CONTEXT: Interstitial pregnancy is a rare form of ectopic pregnancy for which the best therapeutic course of action has yet to be determined. Surgical intervention entails a high risk of hemorrhage due to the great vascularization of the cornual region of the uterus. Case descriptions facilitate the analysis of results and aid clinicians in determining the most appropriate course of action in these situations. CASE REPORT: In a patient with an ultrasound diagnosis of interstitial pregnancy, clinical treatment using methotrexate was chosen. However, after one week, there was a marked decline in the serum level of the β subunit of chorionic gonadotropin hormone, although an ultrasound examination revealed embryonic cardiac activity. A second dose of the chemotherapy was administered. Embryonic cardiac activity persisted 48 hours later. Video laparoscopy was performed to achieve right-side cornual resection, which resulted in satisfactory resolution of the case.

Mesenchymal stem cells (MSC) prevented the progression of renovascular hypertension, improved renal function and architecture

Renovascular hypertension induced by 2 Kidney-1 Clip (2K-1C) is a renin-angiotensin-system (RAS)-dependent model, leading to renal vascular rarefaction and renal failure. RAS inhibitors are not able to reduce arterial pressure (AP) and/or preserve the renal function, and thus, alternative therapies are needed. Three weeks after left renal artery occlusion, fluorescently tagged mesenchymal stem cells (MSC) (2×10(5) cells/animal) were injected weekly into the tail vein in 2K-1C hypertensive rats. Flow cytometry showed labeled MSC in the cortex and medulla of the clipped kidney. MSC prevented a further increase in the AP, significantly reduced proteinuria and decreased sympathetic hyperactivity in 2K-1C rats. Renal function parameters were unchanged, except for an increase in urinary volume observed in 2K-1C rats, which was not corrected by MSC. The treatment improved the morphology and decreased the fibrotic areas in the clipped kidney and also significantly reduced renal vascular rarefaction typical of 2K-1C model. Expression levels of IL-1β, TNF-α angiotensinogen, ACE, and Ang II receptor AT1 were elevated, whereas AT2 levels were decreased in the medulla of the clipped kidney. MSC normalized these expression levels. In conclusion, MSC therapy in the 2K-1C model (i) prevented the progressive increase of AP, (ii) improved renal morphology and microvascular rarefaction, (iii) reduced fibrosis, proteinuria and inflammatory cytokines, (iv) suppressed the intrarenal RAS, iv) decreased sympathetic hyperactivity in anesthetized animals and v) MSC were detected at the CNS suggesting that the cells crossed the blood-brain barrier. This therapy may be a promising strategy to treat renovascular hypertension and its renal consequences in the near future.

Emerging role of angiotensin type 2 receptor (AT2R)/Akt/NO pathway in vascular smooth muscle cell in the hyperthyroidism

Hyperthyroidism is characterized by increased vascular relaxation and decreased vascular contraction and is associated with augmented levels of triiodothyronine (T3) that contribute to the diminished systemic vascular resistance found in this condition. T3 leads to augmented NO production via PI3K/Akt signaling pathway, which in turn causes vascular smooth muscle cell (VSMC) relaxation; however, the underlying mechanisms involved remain largely unknown. Evidence from human and animal studies demonstrates that the renin-angiotensin system (RAS) plays a crucial role in vascular function and also mediates some of cardiovascular effects found during hyperthyroidism. Thus, in this study, we hypothesized that type 2 angiotensin II receptor (AT2R), a key component of RAS vasodilatory actions, mediates T3 induced-decreased vascular contraction. Marked induction of AT2R expression was observed in aortas from T3-induced hyperthyroid rats (Hyper). These vessels showed decreased protein levels of the contractile apparatus: α-actin, calponin and phosphorylated myosin light chain (p-MLC). Vascular reactivity studies showed that denuded aortic rings from Hyper rats exhibited decreased maximal contractile response to angiotensin II (AngII), which was attenuated in aortic rings pre-incubated with an AT2R blocker. Further study showed that cultured VSMC stimulated with T3 (0.1 µmol/L) for 24 hours had increased AT2R gene and protein expression. Augmented NO levels and decreased p-MLC levels were found in VSMC stimulated with T3, both of which were reversed by a PI3K/Akt inhibitor and AT2R blocker. These findings indicate for the first time that the AT2R/Akt/NO pathway contributes to decreased contractile responses in rat aorta, promoted by T3, and this mechanism is independent from the endothelium.

Reduced endothelium-dependent relaxation to anandamide in mesenteric arteries from young obese Zucker rats

Impaired vascular function, manifested by an altered ability of the endothelium to release endothelium-derived relaxing factors and endothelium-derived contracting factors, is consistently reported in obesity. Considering that the endothelium plays a major role in the relaxant response to the cannabinoid agonist anandamide, the present study tested the hypothesis that vascular relaxation to anandamide is decreased in obese rats. Mechanisms contributing to decreased anandamide-induced vasodilation were determined. Resistance mesenteric arteries from young obese Zucker rats (OZRs) and their lean counterparts (LZRs) were used. Vascular reactivity was evaluated in a myograph for isometric tension recording. Protein expression and localization were analyzed by Western blotting and immunofluorescence, respectively. Vasorelaxation to anandamide, acetylcholine, and sodium nitroprusside, as well as to CB1, CB2, and TRPV1 agonists was decreased in endothelium-intact mesenteric arteries from OZRs. Incubation with an AMP-dependent protein kinase (AMPK) activator or a fatty acid amide hydrolase inhibitor restored anandamide-induced vascular relaxation in OZRs. CB1 and CB2 receptors protein expression was decreased in arteries from OZRs. Incubation of mesenteric arteries with anandamide evoked endothelial nitric oxide synthase (eNOS), AMPK and acetyl CoA carboxylase phosphorylation in LZRs, whereas it decreased phosphorylation of these proteins in OZRs. In conclusion, obesity decreases anandamide-induced relaxation in resistance arteries. Decreased cannabinoid receptors expression, increased anandamide degradation, decreased AMPK/eNOS activity as well as impairment of the response mediated by TRPV1 activation seem to contribute to reduce responses to cannabinoid agonists in obesity.

Die Perspektiven des MERCOSUR in den internationalen Beziehungen mit der Freihandelszone Amerikas ALCA, FTAA und der Europäischen Gemeinschaft

Die Perspektiven des MERCOSUR in den internationalen Beziehungen mit der Freihandelszone Amerikas ALCA/FTAA und der Europäischen Gemeinschaft Rita de Cassia Carvalho de Carvalho Abstract In dieser Arbeit wird MERCOSUR, Gemeinsamer Markt des Südens, als ein politischer Integrationsprozeß zwischen Entwicklungsländern, der mit der Integrationsherausforderung i. S. des wandelnden Völkerrechts, konfrontiert ist, vorgestellt. Damit sind die rechtspolitischen Perspektiven für MERCOSUR eng mit der Trilogie EU, ALCA und WTO verbunden. Aus integrationsrechtlichem Blickwinkel entwickelte sich MERCOSUR zu einem sui generis Integrationsprozeß mit der Gewährleistung der vier Marktfreiheiten nach dem EU-Vorbild. Im MERCOSUR-Recht herrscht die Zwischenstaatlichkeitsklausel. Die Herren der Verträge und Träger von Kompetenz-Kompetenz i. S. v. pouvoir constituant sind die Mitgliedsstaaten. Obwohl die fehlende Rechtssicherheit die Vertiefung des Gemeinsamen Marktes gefährdet, bietet die Übernahme des EU-Modells keine Lösung, weil die Problematik eher bei der schwachen Rechtsdurchsetzung in den Entwicklungsländern zu finden ist. Angesichts der ALCA-Logik, d. h. im Handels-, Investitions- und Dienstleistungswesen wettbewerbs¬fähig zu werden, dafür aber Rückschritte in Umwelt-, Sozial- und Arbeitsrechtsstandard hinnehmen zu müssen, übernimmt MERCOSUR die aktive Hauptrolle in Lateinamerika in den Verhandlungen mit den USA. In der WTO-Ordnung mit einer quasi-obligatorischen Gerichtsbarkeit, welche kaum Umwelt- und Menschenrecht einbezieht, sollte MERCOSUR die Politik des dritten Weges mit anderen Entwicklungsländern führen um einen Weg mit quasi der Entwicklung und Umsetzung einer neuen Wirtschafts- und Gesellschaftsordnung, die Umwelt- und Menschenrecht garantieren soll, zu gewährleisten.

Compound specific stable isotopes, BIT, pollen and spores of Miocene to Pliocene sediments of ODP Hole 175-1085A

Pollen and stable carbon (d13C) and hydrogen (dD) isotope ratios of terrestrial plant wax from the South Atlantic sediment core, ODP Site 1085, is used to reconstruct Miocene to Pliocene changes of vegetation and rainfall regime of western southern Africa. Our results reveal changes in the relative amount of precipitation and indicate a shift of the main moisture source from the Atlantic to the Indian Ocean during the onset of a major aridification 8 Ma ago. We emphasise the importance of declining precipitation during the expansion of C4 and CAM (mainly succulent) vegetation in South Africa. We suggest that the C4 plant expansion resulted from an increased equator-pole temperature gradient caused by the initiation of strong Atlantic Meridional Overturning Circulation following the shoaling of the Central American Seaway during the Late Miocene.

Palynological record and radiocarbon dates for sediment core T89-16, Congo River mouth

We present a high-resolution reconstruction of tropical palaeoenvironmental changes for the last deglacial transition (18 to 9 cal. kyr BP) based on integrated oceanic and terrestrial proxies from a Congo fan core. Pollen, grass cuticle, Pediastrum and dinoflagellate cyst fluxes, sedimentation rates and planktonic foraminiferal d18O ratios, uK37 sea-surface temperature and alkane/alkenone ratio data highlight a series of abrupt changes in Congo River palaeodischarge. A major discharge pulse is registered at around 13.0 cal. kyr BP which we attribute to latitudinal migration of the Intertropical Convergence Zone (ITCZ) during deglaciation. The data indicate abrupt and short-lived changes in the equatorial precipitation regime within a system of monsoonal dynamics forced by precessional cycles. The phases of enhanced Congo discharge stimulated river-induced upwelling and enhanced productivity in the adjacent ocean.

¿Revelarse o no revelarse? Hay una autofiguración de filiación española o suramericana en la escritura bellatiniana?

El escritor mexicano Mario Bellatin persigue obsesivamente la representación de sí mismo. Por ello, echa mano de una estrategia ficcional que desafía los paradigmas de la autobiografía no recurriendo al compromiso de revelar la verdad al lector, acercándose así a aquello que la crítica literaria nombra como 'autofiguración'. El crítico español Manuel Alberca en el ensayo ¿'Existe la autoficción hispanoamericana'?, plantea si hay una autofiguración, género muy sintomático de lo contemporáneo, de raíz hispanoamericana, es decir si habría rasgos que identificarían en el género características de la hispanidad. Basados, entonces, en el pensamiento de Alberca, nos cuestionaremos en este trabajo: ¿cuál es el lugar de lo español en la autofiguración bellatiniana? ¿Hay rasgos en la escritura del mexicano que señala su filiación a la tradición de la literatura española? Analizaremos la obra Los fantasmas del masajista, en la cual el narrador protagonista no revela su nombre, pero presenta un conjunto de informaciones que pueden ser relacionadas a su autor, Mario Bellatin. De esa forma, cabe al lector el papel de rellenar los vacíos y silencios del texto. ¿Cómo leer las coincidencias de la trama sin relacionarlas, exclusivamente, al sujeto referencial Mario Bellatin? Dicho de otra manera, ¿Cómo leer este relato en la clave de la pura ficción sin traer las huellas de lo real? Inspirados por el pensamiento de Wolfang Iser, podemos preguntarnos: ?'Cómo puede algo que, aun existiendo, no posea el carácter de realidad'? Para echar luz a la cuestión, buscaremos una perspectiva que no entienda los géneros de acuerdo a la mirada normativa con los que históricamente se construyó. No impondremos límites entre la autofiguración y la autobiografía. Antes bien, nos acercaremos a una idea de género con relación al concepto de 'horizonte de expectativa', que nos permitiría, entre muchas otras cosas, considerar lo novedoso y lo conservador de la escritura bellatiniana para la tradición literaria española y suramericana

AMS radiocarbon dates and pollen analysis of ODP Hole 175-1078C

ODP Site 1078 situated under the coast of Angola provides the first record of the vegetation history for Angola. The upper 11 m of the core covers the past 30 thousand years, which has been analysed palynologically in decadal to centennial resolution. Alkenone sea surface temperature estimates were analysed in centennial resolution. We studied sea surface temperatures and vegetation development during full glacial, deglacial, and interglacial conditions. During the glacial the vegetation in Angola was very open consisting of grass and heath lands, deserts and semi-deserts, which suggests a cool and dry climate. A change to warmer and more humid conditions is indicated by forest expansion starting in step with the earliest temperature rise in Antarctica, 22 thousand years ago. We infer that around the period of Heinrich Event 1, a northward excursion of the Angola Benguela Front and the Congo Air Boundary resulted in cool sea surface temperatures but rain forest remained present in the northern lowlands of Angola. Rain forest and dry forest area increase 15 thousand years ago. During the Holocene, dry forests and Miombo woodlands expanded. Also in Angola globally recognised climate changes at 8 thousand and 4 thousand years ago had an impact on the vegetation. During the past 2 thousand years, savannah vegetation became dominant.