Biomedical subjects
S Morcos
Publications and source records attributed to S Morcos.
Up-regulation of renal and vascular nitric oxide synthase in iron-deficiency anemia.
Anemia is frequently associated with increased cardiac output and reduced vascular resistance. The latter has been attributed to reduced inactivation of nitric oxide (NO) by hemoglobin. We hypothesized that in addition to reducing NO inactivation, anemia may up-regulate NO production. To test this hypothesis, male Sprague-Dawley rats with chronic iron-deficiency anemia (produced by multiple phlebotomies and an iron-free diet) were studied. The results were compared with those obtained in a group of normal control animals. The anemic group showed marked increases in urinary excretion, plasma concentration, and renal and aorta tissue contents of NO metabolites (total nitrates and nitrites, NOx). This was accompanied by a significant rise in urinary excretion of cGMP, the second messenger for NO. In addition, NO synthase (NOS) activity and endothelial constitutive (ecNOS) and inducible NOS (iNOS) proteins of the thoracic aorta were markedly increased in the anemic group. Likewise, renal tissue ecNOS and iNOS proteins were greatly increased in the anemic animals. NOS activity and protein values were inversely related to hematocrit and directly related to plasma, tissue and urinary NOx. The constellation of these findings points to an increased NOS expression and NO production as opposed to the mere reduction of NO inactivation in iron-deficiency anemia. Further studies are planned to determine the mechanism of NOS up-regulation in iron-deficiency anemia.
Use of frozen meals by and food preferences of various age groups of adults.
This article discusses a research project which involved determining use of frozen meals by the elderly and identifying their food preferences. A total of 113 adults provided information about appliances in their home for storing and heating frozen meals, their frequency of use of frozen meals, and their preference for 48 commercially frozen meal menus. Results indicated that older individuals used frozen meals more frequently than younger respondents. Older individuals also indicated a higher preference or acceptance of most menu items.
High fecundity of amenorrhoeic women in embryo-transfer programmes.
There is uncertainty over whether the steady decline in human fertility with increasing maternal age is due to quality of the oocyte or of the endometrium. To clarify the issue age-related implantation and pregnancy rates in two embryo-transfer programmes were examined in relation to embryo quality and type of menstrual cycle. In both the UK and the US programmes rates were higher in previously amenorrhoeic (acyclic) women than in eugonadal women, irrespective of age and number of embryos replaced. Oocyte quality, as determined by age of oocyte donor, in-vitro growth of embryo, and proportion of defective embryos in culture, did not contribute to the difference, nor did type of cycle during therapy. If a uterus that has not been subjected to regular menstrual cycles is a favourable factor, a period of induced amenorrhoea might be beneficial for infertile women.
Heterotopic pregnancies after in vitro fertilization and embryo transfer.
Seventeen cases of heterotopic pregnancies are reported among 1648 clinical pregnancies after in vitro fertilization. The high prevalence of tubal damage among IVF patients and the use of superovulation and multiple embryo transfer might predispose patients to the condition. Nine patients reported abdominal pain and vaginal bleeding, five patients did not have symptoms, and three had acute abdominal emergencies. Transvaginal ultrasonography was superior to transabdominal ultrasonography in the diagnosis of extrauterine pregnancies. The presence of an intrauterine gestation sac in a patient without symptoms should not exclude the diagnosis of a concomitant extrauterine pregnancy until the pelvis is carefully visualized. Early diagnoses of viable ectopic pregnancies before rupture abolishes mortality and morbidity and offers the chance of patient selection for conservative treatment. In two patients the extrauterine gestation sac was treated by transvaginal aspiration and injection of potassium chloride under ultrasonographic guidance. The outcome of the intrauterine pregnancy was favorable regardless of the method of treatment of the ectopic pregnancy.
Rare ectopic pregnancies after in-vitro fertilization: one unilateral twin and four bilateral tubal pregnancies.
Between 1985 and 1989, one unilateral twin and four bilateral tubal pregnancies were encountered among 124 extrauterine pregnancies and 1648 intrauterine pregnancies following in-vitro fertilization and embryo transfer. The two factors associated with this high incidence of single and multiple extrauterine pregnancies were tubal damage and multiple embryo transfer. Embryos at different stages of development appear to have the capacity to implant ectopically. Despite advances in diagnostic capabilities, ectopic pregnancy remains a major cause of maternal mortality. Early diagnosis prior to rupture must be made if mortality and morbidity are to be abolished. The use of transvaginal sonography has improved the diagnosis of ectopic pregnancy and should be routinely used in all pregnancies following assisted conception. The identification of an intrauterine pregnancy should not be sufficient to rule out the possibility of an extrauterine pregnancy or even bilateral tubal pregnancies.
Spontaneous spinal extradural hematoma during pregnancy.
BACKGROUND: Spontaneous spinal hematomas are rare in pregnancy, and only two cases have previously been described. This report reviews other similar cases and discusses the aetiology and management of this condition in relation to pregnancy. CASE: A 26-year-old primigravida presented at 35 weeks of gestation with a history of sudden onset of back pain and weakness with loss of sensation of her legs. On examination there was tenderness over the seventh thoracic vertebra with loss of sensation below the level of the T7 dermatome and reduced power in both lower limbs. Magnetic resonance imaging demonstrated an anterior extradural lesion in the mid-thoracic region of the spinal cord. An elective cesarean section was performed followed by a costotransversectomy and removal of an extradural hematoma. The patient's neurological function subsequently improved. CONCLUSION: Acute spontaneous spinal extradural hematoma occurring during pregnancy can be associated with successful outcome following prompt diagnosis and surgical treatment.