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Biomedical subjects

A Redondo

Publications and source records attributed to A Redondo.

At least 37 records · Page 2Linked to original sources

Parathyroid hormone-related peptide stimulates DNA synthesis and insulin secretion in pancreatic islets.

Parathyroid hormone (PTH)-related protein (PTHrP) is present in the pancreatic islet. Recent data in transgenic mice suggest that PTHrP might modulate islet mass and insulin secretion. In the present study, we assessed the effect of the N-terminal PTH-like region of PTHrP on DNA synthesis in isolated rat islets. PTHrP (1-34), between 1 pM and 10 nM, for 48 h stimulated []thymidine incorporation into rat islets. This effect was maximally induced, about 2.5-fold over control, by 10 pM of this peptide, decreasing thereafter. In contrast, PTHrP (38-64) amide or PTHrP (107-139) were ineffective in increasing DNA synthesis in islets. Using reverse transcription followed by PCR, we confirmed that rat islets express PTHrP and the type I PTH/PTHrP receptor. Addition of a neutralizing anti-PTHrP antibody to the incubation medium of proliferating islets decreased islet DNA synthesis by 30%. The effect of a submaximal dose (30 pM) of PTHrP (1-34) on DNA synthesis in rat islets was abolished by 25 nM bisindolylmaleimide I, a protein kinase C (PKC) inhibitor, but not by 25 microM adenosine 3',5'-cyclic monophosphorothioate, Rp-isomer, a protein kinase A inhibitor. Moreover, 100 nM phorbol-12-myristate-13-acetate for 48 h also increased DNA synthesis 2-fold over controls in islets. PTHrP (1-34), at 100 nM, in contrast to 50 microM forskolin or 10 mM NaF, failed to affect adenylate cyclase activity in islet membranes. PTHrP, at 30 pM, was also found to increase 2-fold insulin released into the islet-conditioned medium within 24-48 h. Our results suggest that PTHrP is a modulator of pancreatic islet growth and/or function by a PKC-mediated mechanism.

Adenylyl Cyclases↗

[Surgical management of cerebral metastases].

Surgical treatment of metastatic brain tumors had been controversial until two prospective randomized trials demonstrated that surgery followed by radiation is superior to radiation alone in patients with single metastasis. In this report, we reviewed current perspectives on the neurosurgical treatment of brain metastasis. The goals of surgery is to establish a histologic diagnosis, relieve symptoms and provide local cure through gross total resection. The results which established surgery as the preferred treatment for single brain metastasis were largely a result of advances in neurosurgical techniques of localization and neuroimaging, microdissection, and functional mapping. These modern methods have reduced the operative mortality to 3% and the morbidity to less than 10%. The indications of surgical treatment should be related to clinical and radiological criteria. Surgical treatment is best indicated for single and accessible metastasis and is also accepted for patients with multiple lesions especially when there is a life-threatening lesion or when two lesions are accessible through the same craniotomy or for recurrent brain metastasis. Surgery can also be a good option for recurrent metastasis. Altogether, surgery improves quality of life and the median survival time, all the more as pronostic factors are present such as age>60 years, long interval between diagnosis of the primary tumor and the metastasis, the absence of systemic disease and a Karnofsky score> 70.

Adult↗

Brain Abscesses of Ear, Nose, and Throat Origin: Comparison between Otogenic and Sinogenic Etiologies.

This retrospective study analyzed 29 cerebral abscesses of ear, nose, and throat (ENT) origin. The mean follow-up of patients was 37 months. ENT etiologies included 45% otitis media (n = 13), 48% sinusitis (n = 14), and 7% ethmoidal sinus tumors (n = 2). Thirty-eight percent (n = 5) of otogenic abscesses occurred within 15 days after a mastoidectomy. Sinogenic abscesses were never due to surgery but were associated in 31% of cases (n = 5) with anterior skull base defects. The main locations of otogenic abscesses were the temporal lobe (54%; n = 7) and the cerebellum (23%; n = 3), whereas sinogenic abscesses were located in the frontal lobe in 75% of cases (n = 12). Because of this location, sinogenic abscesses were less symptomatic than otogenic ones and had greater size and encapsulation at the time of diagnosis. Thus, they required longer antibiotic treatment (p = 0.05) and more numerous surgical drainages (p = 0.02). Bacteriologic abscesses samples were positive in 90% of cases. Bacteria found in brain abscesses were different from the ones found in ENT samples in 62% of cases. Thus, the results of ENT bacteriologic samples were not helpful for choosing adequate antibiotic agents in case of negative brain abscess samples. Although mortality was not significantly higher in otogenic abscesses (31%; n = 4) than in sinogenic ones (6%; n = 1, p = 0.08), otogenic abscesses appeared more threatening. Indeed, they represented 80% (n = 4) of lethal cases and encompassed more clinical or radiological prognosis pejorative factors than sinogenic ones (p = 0.006). In conclusion, higher danger of otogenic abscesses mainly resulted both from their temporal or cerebellous locations and from the bacteria that were more frequently resistant to antibiotics.

Journal Article↗

Anterior skull base osteoid osteoma: case report.

Osteoid osteoma is a benign bone tumour which rarely occurs in the skull. A case of such a tumour in the posterior ethmoid region bulging into the anterior cranial fossa is reported in a 42-year-old woman who presented with intense frontal headaches. Excision of the tumour was performed through a subfrontal approach.

Adult↗

Tuberculoma of the cavernous sinus: case report.

OBJECTIVE AND IMPORTANCE: The cavernous sinus is an exceptional location for intracranial tuberculomas. A rapid diagnosis, based on pathological findings, improves the prognosis. CLINICAL PRESENTATION: A case of left cavernous sinus tuberculoma, revealed by frontal headaches and ipsilateral palsies of Cranial Nerves III and V, in a 48-year-old patient is reported. The lesion mimicked an aggressive meningioma in radiological examinations. INTERVENTION: The lesion was excised through a subtemporal approach. The diagnosis was based on the pathological examination of the mass. Postoperative antituberculous chemotherapy completed the treatment. Neurological symptoms regressed rapidly. CONCLUSION: Although the incidence of intracranial tuberculomas is decreasing in developed countries, a high index of suspicion must be maintained for the diagnosis of intracranial masses in the presence of risk factors for tuberculosis.

Antitubercular Agents↗

[Other infections (Streptococcus pneumoniae, Haemophilus influenzae, Pseudomonas aeruginosa, Salmonella spp., Campylobacter spp., Nocardia asteroides, Rhodococcus equi and Bartonella spp.)].

People infected with human immunodeficiency virus (HIV) are at increased risk for bacterial infections due to HIV-associated immunologic defects. Bacterial infections were found to be, both a predictor of progression to AIDS and a substantial cause of mortality in pre-AIDS stages. Most bacterial infections are caused by Streptococcus pneumoniae, Haemophilus influenzae, Salmonella spp. and Pseudomonas aeruginosa. Rhodococcus equi, Nocardia spp., Campylobacter spp. and Bartonella spp. are less common. Data derived from two AIDS Clinical Trials Group studies showed that the most common bacterial infections were sinusitis (8.5 per 100 episodes per person years [py]), bacterial pneumonia (5.0 per 100 py), bronchitis (4.1 per 100 py) and soft tissue infections (3.5 per 100 py). In this review clinical characteristics and treatment recommendations according to data available in the literature for these infections are summarized.

AIDS-Related Opportunistic Infections↗

Syringomyelia and Arnold Chiari in scoliosis initially classified as idiopathic: experience with 25 patients.

The authors analysed the clinical and radiological findings and the surgical management of 25 patients admitted for scoliosis classified as idiopathic at first presentation, but in fact associated with spinal cord and/or brain stem anomalies. Twenty patients had syringomyelia, 19 had Chiari malformation. Scoliosis was the only presenting symptom when all these patients were referred to the orthopaedic surgeon. On examination, five patients had normal neurological findings, while the others showed very mild neurological deficits. The diagnosis of syringomyelia and Chiari malformation was established by MRI, which is the best form of neuroradiological examination for discovering spinal abnormalities. Neurosurgical treatment is strongly recommended as the first step in the management of "pseudo" idiopathic scoliosis.

Adult↗

Effect of autoclaving on dietary fibre content of beet root (Beta vulgaris). Evaluation by different methods.

Modifications of dietary fibre in beet root during autoclaving have been evaluated by different methods: acid detergent (raw = 1.45%; processed = 1.17%) and neutral detergent (raw = 2.30%; processed = 2.00%), the enzymatic-gravimetric method of Asp (raw = 3.35%; processed = 3.34%), HPLC (raw = 1.42%; processed = 1.60%) and 3,5-dimethylphenol (raw = 0.36; processed = 0.28%). The correlation between different methodologies was studied. Autoclaving was carried out at 121 degrees C under pressure for 15 min. Variance analysis indicated that quantitative variations originating in the thermic treatment were not statistically significant (P > 0.05).

Carbohydrates↗

Tonic immobility reaction and heterophil to lymphocyte ratio in hens from three Spanish breeds laying pink eggshells.

Tonic immobility reaction and heterophil:lymphocyte ratio were studied in hens laying pink eggs from three brown egg Spanish breeds (Barred Red Vasca, Red Vasca, Red Villafranquina). There was no significant difference among breeds in terms of tonic immobility duration or heterophil:lymphocyte ratio. Tonic immobility duration was significantly shorter in the pink (220 + or - 23 s) than in the normal brown shell group of hens (416 + or - 23 s; P < 0.001). Differences were consistent across the breeds, tonic immobility of hens laying pink eggs being shorter than that of control hens in all three breeds. Birds of the group with pink shells appeared to be less fearful when defined by either the duration of tonic immobility or the number of inductions to achieve it. There was a significant difference in the heterophil:lymphocyte ratio between the two groups of hens (P < 0.001), mean value being significantly higher in the pink shell (0.73 + or - 0.03) than in the control group (0.35 + or - 0.03). The heterophil:lymphocyte ratio from the pink shell hens increased significantly in the three breeds. Hens that laid pink eggs had significant heterophilia and lymphopenia (P < 0.001). Thus, hens laying pink eggs were less fearful and more stressed than control hens, as indicated by the tonic immobility reaction and the heterophil:lymphocyte ratio, respectively. A significant negative correlation was found between both measurements (r = A).28; P < 0.01). A similar significant negative association (P < 0.001) was found between pink shell color and shell strength.

Analysis of Variance↗

[Neurosurgical aspects of Rendu-Osler disease. Apropos of 6 recent cases and review of the literature].

Six patients with neurological complications in Rendu-Osler-Weber disease were reviewed. There were 4 patients (3 int the same family) with a brain abscess, one patient with a brain abscess and a spinal cord subarachnoid hemorrhage, one patient with a recurrent intracerebral hemorrhage due to a vascular malformation. The infectious complications are related to the presence of pulmonary arterio-venous fistula, which should be treated, whenever diagnosed. Because of the potentially severe outcome of these neurological complications of the Rendu-Osler-Weber disease, screening of the patient's relatives is highly recommended.

Adult↗

Perineural spread of cutaneous squamous cell carcinoma manifesting as ptosis and ophthalmoplegia (orbital apex syndrome).

This paper reports two cases of orbital apex syndrome. The most salient clinical signs, ophthalmoplegia and eyelid ptosis, arose from perineural spread of facial squamous cell carcinomas that were previously excised with tumour-free surgical margins and exhibited no signs of local or other regional recurrence. The interest of these two cases lies in the fairly rare occurrence of this type of tumour spread and the highly aggressive nature of the tumour, unequivocal diagnosis of which usually arrives too late for a surgical solution. Awareness of the possibility of such perineural spread may allow the clinician to establish an early diagnosis and thus undertake radical surgery, thereby increasing the likelihood of success in combination with postoperative radiotherapy.

Aged↗

[Subdural empyema. Apropos of 17 cases].

Seventeen patients with subdural empyema were treated from 1985 to 1993. These included 13 males and 4 females with 11 patients aged between 12 and 30 years old. Sinusitis was found to be the primary source of infection in 16 cases. The clinical presentation was classic and the preoperative diagnosis was established on the first CT in 12 cases. In the remaining cases a second or third CT was necessary to demonstrate the empyema, 24 to 48 hours later. Surgical management was first made by burr holes with a small craniectomy in 15 cases. A large craniotomy was performed in 2 patients. Soft catheter drainage was carried out in 6 cases, 9 patients received surgical treatment once (3) or twice (6). Two patients, operated on while in a coma (stage IV of Bannister scale) died and one patient survived with severe disability (operated at stage III). The others (14) made a good recovery (6 in grade A and 8 in grade B of Mauser). These results were compared with those in the literature and we concluded that the mean factor of prognosis is the level of consciousness at the time of initial treatment. In most of the cases, burr holes or a small craniotomy, carried out on the basis of CT or MRI data, are the easiest and most effective method of surgical treatment.

Adolescent↗

[Frontal cerebral abscess, a rare complication of nasosinusal polyposis. Apropos of a case].

Sinusonasal polyposis is frequent but usually benign. A 77-year-old woman with an history of sinusonasal polyps, presented with fever and neurologic impairment. Radiologic imaging showed a polypoïd mass filling the nose and sinuses, eroding the ethmoïd bone, progressing intracranially, and causing brain abscess. The literature is reviewed, according to the relations between brain abscess development and nasal polyposis, with emphasis on intracranial extension of sinusonasal polyps. Treatment of the nasal polyps, usually based on the use of local or general corticosteroïds, can avoid this serious complication.

Aged↗

High-performance liquid chromatographic determination of dietary fibre in raw and processed carrots.

An HPLC method was developed to determine dietary fibre in carrots (Daucus carota L.). Primary hydrolysis of dietary fibre residue was performed with 12 M H2SO4 for 2 h at 40 degrees C and secondary hydrolysis with 0.414 M H2SO4 for 3 h at 100 degrees C. For the neutralization step prior to injection, AG4-X4 resin (Bio-Rad) was used. Neutral monosaccharides were separated using an HPX-87P column (Bio-Rad). This method was applied for evaluation of the quantitative variation of dietary fibre content in carrots during autoclaving.

Carbohydrates↗

Incidence of ember burns in Andalusia (Spain).

A 6-year analysis of 2000 cases of burns was carried out. Half of the patients were from rural and the other half from urban locations. One hundred and sixty-two patients out of the 2000 suffered from ember burns. The number of rural patients affected was greater than urban patients (117 vs. 45). Ember burns are frequent in Andalusia and have severe aesthetic and functional sequelae. Burns of this type are more common in children than in adults, so they carry an added social and medical relevance.

Adolescent↗

[Comparative pharmacokinetics of antibiotics in blood, csf and brain].

The Knowledge of the antibiotic's cerebral diffusion is essential to define a of neurosurgical antibioprophylaxis' strategy. Without references in the medical world-literature, we've decided to compare the pharmacological kinetics in the blood, the cerebrospinal fluid and the sound cerebral tissue of common used molecules in neurosurgery that is to say: amoxicillin, cefamandole, metronidazole and pefloxacin. The results show that the cerebral levels of metronidazole and pefloxacine are rapidly high with an extended duration (> 10 times the M.I.C. of the sensitive bacteriae), but the tissue penetration of amoxicillin is hazardous and shot-duration for cefamandole (undosable after 3 hours).

Adult↗

Balloon occlusion of the internal carotid artery in 40 cases of giant intracavernous aneurysm: technical aspects, cerebral monitoring, and results.

We have studied the results of carotid occlusion in the treatment of giant intracavernous carotid artery (ICA) aneurysms in 40 patients. Clinical, angiographic, Doppler and cerebral blood flow (CBF) criteria for tolerance of occlusion are discussed. The patients had headaches (47.5%), cranial nerve compression (87.5%), decreased visual acuity (20%), ruptured aneurysm (15%) and 5% were asymptomatic. Balloon occlusion tests were performed under light sedation anaesthesia: a successful test required perfect clinical tolerance and adequate angiographic collateral circulation in arterial, parenchymatous, and venous phases. Additional criteria included xenon 133 CBF measurements, and transcranial Doppler sonography of the middle cerebral artery. According to these criteria, 5 patients did not tolerate test occlusion and required an extra-intracranial (EC-IC) bypass. Mean follow-up was 4.7 years. All patients were radiologically cured of their aneurysm, and in 35 the symptoms resolved, although 3 had persistent ocular motor nerve palsies, and in 4 visual defects were unchanged. Complications were 1 permanent and 3 transient neurological deficits. Balloon occlusion of the ICA is an effective, reliable form of treatment for intracavernous giant aneurysm and should replace surgical ligation of the cervical carotid artery. With CBF or Doppler monitoring, the risk of neurological deficit is diminished. EC-IC bypass prior to ICA occlusion is indicated if test occlusion is not tolerated.

Adolescent↗

Characterization of the 5-hydroxytryptamine receptor modulating the release of 5-[3H]hydroxytryptamine in slices of the human neocortex.

In the rat brain, the presynaptic 5-hydroxytryptamine (5-HT) autoreceptors located on 5-HT terminals correspond to the 5-HT1B subtype. The presence of a 5-HT receptor probably located on 5-HT nerve endings and modulating transmitter release in the human neocortex has been reported, but its detailed pharmacological characterization is not yet available. On the other hand, receptor binding and autoradiographic results indicate that the 5-HT1B receptor subtype is not present in the human brain. We, therefore, studied the modulation of the electrically evoked release of [3H]5-HT by various 5-HT receptor agonists and antagonists in preloaded slices of human neocortex obtained from 18 patients undergoing neurosurgery. The nonselective 5-HT1A/1B/1D receptor agonist 5-carboxamidotryptamine produced a potent inhibition (70% at 0.03 microM) of the electrically evoked release of [3H]5-HT which was blocked by 5-HT receptor antagonists with the following relative order of potency: methiothepin greater than metergoline = methysergide greater than propranolol. The selective 5-HT1A receptor agonist 8-hydroxy-2-(di-n-propylamino)tetralin at 0.1 microM did not modify the electrically evoked release of [3H]5-HT. The 5-HT1A/1B receptor agonist RU 24969 was 10 times more potent at inhibiting [3H]5-HT overflow in the rat frontal cortex than in the human neocortex. The potent 5-HT1B receptor antagonist cyanopinodolol did not modify the 5-carboxamidotryptamine-induced inhibition of the electrically evoked release of [3H]5-HT in slices of the human neocortex, but produced by itself a small inhibition of [3H]5-HT overflow.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗