The imperative of arachidonic acid in human reproduction.

We are presenting new evidence on essential fatty acids (EFA) in prenatal human development. We have demonstrated, for the first time, the detailed process of active selection of some fatty acids by the placenta (biomagnification) and rejection of others (bioreduction) and how this strategy is of supreme importance for understanding of the biology of human reproduction. The biomagnification process by the placenta is dominated by arachidonic acid (ArA) and its allies: di-homo-gamma-linolenic acid (DGLA), adrenic acid and ω6 docosapentaenoic acid. Stearic acid is similarly bio-magnified which is likely to provide for the sn-1 position in membrane synthesis. In contrast there is a bioreduction of oleic, linoleic and all ω3 precursors for docosahexaenoic acid (DHA), including eicosapentaenoic acid (EPA). Although DHA is biomagnified, the amplification from mother to fetus is small compared to ArA. We report on the dominant compartmentalisation of ArA from mother to fetal plasma, cell membranes of red cells, mono-nuclear cells, endothelium and the placenta. We conclude that ArA and its allies, play a paramount role in the development of the products of conception. It is plausible that inadequate provision of ArA may be relevant to the neuro-vascular complications of prematurity and neurodevelopmental disorders associated with premature birth. We present evidence of ArA's universal role from an identical arachidonic acid-based strategy observed in contrasting cultures. The dominance of ArA in the prenatal and in post-natal nutritional provision by human milk makes a compelling case for re-evaluation of its role, especially in reproductive biology

Cistoadenoma de apêndice: relato de caso e revisão da literatura sobre tumores mucinosos do apêndice vermiforme Cyst adenoma of appendix: case report and literature review about mucinous vermiform appendix neoplasms

INTRODUÇÃO: Mucocele do apêndice (MA) é uma lesão rara, caracterizada pelo acúmulo de secreção mucoíde em sua luz. Diagnóstico precoce é fundamental para evitar o extravasamento de secreção mucoíde na cavidade peritoneal, causando pseudomixoma peritoneal. RELATO DE CASO: Paciente sexo masculino, 62 anos com história de dor abdominal em fossa ilíaca direita há cerca de 6 meses. Realizou uma ultra-sonografia do abdome que evidenciou no flanco direito pequena estrutura cística compatível com MA. Colonoscopia, exames laboratoriais e dosagem do CEA encontravam-se sem alterações. O paciente foi submetido à laparotomia exploradora com ressecção do apêndice e do seu meso em monobloco. O exame histológico mostrou tratar-se de cistoadenoma do apêndice vermiforme. O paciente evoluiu sem intercorrências. DISCUSSÃO: A MA é um achado raro. As principais causas patológicas incluem cisto de retenção, mucocele secundária a epitélio hiperplásico, cistoadenomas e cistoadenocarcinomas. A doença é geralmente assintomática e o diagnóstico pré-operatório é raro. O tratamento para mucocele do apêndice é cirúrgico e a preocupação principal do cirurgião é evitar o extravasamento do conteúdo da mucocele na cavidade abdominal. CONCLUSÃO: A MA é uma entidade incomum e com alto potencial de complicação, usualmente curável com tratamento cirúrgico adequado.<br>INTRODUCTION: Appendiceal mucocele (AM) is a rare lesion that is characterized by an appendiceal lumen distended with mucus. Early diagnosis and prompt surgical intervention are mandatory to prevent spillage of the mucinous content into the peritoneal cavity, causing pseudomyxoma peritonei. CASE REPORT: A 62-year-old male was presented with a 6-months history of recurrent right lower quadrant abdominal pain. Ultrasonography showed a lesion in the right lumbar region compatible with AM. Colonoscopy, routine laboratory tests and CEA were normal. The patient underwent an appendectomy and complete excision of the cystic lesion. Pathologic examination revealed a mucinous cyst adenoma of appendix. The patient was symptom free after treatment. DISCUSSION: AM is a rare condtion. Mucoceles are histologically subdivided into retention mucocele, mucocele secondary a hiperpalsic epithelium, mucinous cystadenoma and mucinous cystadenocarcinoma. This disease is often asymptomatic and pre-operative diagnosis is rare. The treatment is essentially surgical and the surgeon need to avoid spillage of the mucinous content into the peritoneal cavity. CONCLUSION: AM is an uncomum entity and with high pontential of complication, usually curable with adequate surgical aproach