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Biomedical subjects

A Rodriguez

Publications and source records attributed to A Rodriguez.

At least 235 records · Page 13Linked to original sources

The role of Igh-1 disparate congenic mouse T lymphocytes in the pathogenesis of herpetic stromal keratitis.

The corneal destruction associated with herpes simplex keratitis (HSK) is primarily the result of the host's immune response to herpes simplex virus type-1 (HSV-1) infection. We examined the role of T cells and T cell subsets in the pathogenesis of HSK. Naive and immune T cells and HSV-1 immune CD4+ and CD8+ subsets from Igh-1 disparate BALB/c congenic mice were adoptively transferred into athymic BALB/c nude mice, which normally do not develop HSK. The results demonstrated that while the transfer of naive T cells from either HSK-susceptible C.AL-20 (Igh-1d) or HSK-resistant C.B-17 (Igh-1b) mice had little influence on HSK development, transfer of either CD3+ or CD4+ HSV-1 immune T cells from C.AL-20 mice resulted in the development of severe HSK in all of the recipients. Transfer of the same cell populations from C.B-17 mice resulted in the development of only a mild keratitis in 50% of the recipients. Transfer of CD8+ cells from either donor strain did not result in stromal disease in any recipient mouse. These results clearly demonstrate the pivotal role of CD4+ T cells in the development of necrotizing herpes stromal keratitis, and further demonstrate that CD8+ T cells are not essential in HSK development in the BALB/c system.

Animals↗

The clinical significance of acute hyperamylasemia after blunt trauma.

The clinical value of total serum amylase (TSA) levels measured after blunt trauma remains controversial. To test the utility of this measurement, the authors surveyed the routine admission TSA levels of 4316 adults who were victims of blunt trauma. Most patients (58.2%) had been injured in motor vehicle accidents, and all were admitted directly from the accident scene. Patients were divided into two groups based on the admission TSA level: more than 125 U/L (abnormal) and 125 U/L or less (normal). Of the 4316 patients, 3920 (90.8%) had a normal TSA level upon admission. Hyperamylasemia was associated with a greater injury severity score (ISS) and death rate, a lower admission Glasgow Coma Scale score and an increased incidence of facial fracture, brain injury, pancreatic and hollow-viscus injuries and hypotension (p < 0.01). However, the positive predictive value of an abnormal TSA level for pancreatic and hollow-viscus injuries was 1.5% and 3.0% respectively. Also, most patients with pancreatic (65%) and hollow-viscus (83%) injuries had a normal TSA level. There was no relation between the anatomic grade of pancreatic injury and the TSA level. Acute hyperamylasemia after blunt trauma appears to be a poor predictor of pancreatic and hollow-viscus injuries. Therefore, urgent TSA determinations should not influence the clinical and radiologic evaluation of the blunt trauma victim.

Abdominal Injuries↗

[Food consumption of school children regarding their social condition. Córdoba, Republic of Argentina].

This report reveals the daily consumption of nourishing food in primary school children coming from the north of Córdoba, Argentina, in relationship with their socio economic status, SES. Four categories were determined according to the place the chief support of the family occupies in the productive system. A 24 hours recall test was applied to obtain nutritional data as well as the weight and method of measure. Differences among the established categories were pointed out by socioeconomic indicators (P < 0.001). Powder and liquid milk ingesta showed statistic differences (P < 0.005), at the same time, the consumption of this food was poor, and it was not being incorporated into the scholarship's diet. The per-capita proportion of meat ingesta was over 100 g, in the whole group. Difference (P < 0.005) were noticed among the SES when the consumption was over 200 g. The consumption of fruits and vegetables is low. On the contrary, it was shown an increase in cereals and legumes ingesta as the SES decreased (P < 0.005). Analyzing the fitness of the diet it was found that the 53% of SES IV children showed calorie shortage whereas the proteins evaluation revealed excess consumption in the 88% of the studied scholarships. Other deficiencies were also found, such as calcium, riboflavin, thiamine, niacin in the whole group. This study also showed statistic differences with respect to the consumption of energy, calcium and ascorbic acid (P < 0.05).

Argentina↗

Antibody-dependent cellular cytotoxicity against cells infected with herpes simplex virus type 1 in Igh-1 disparate congenic mice.

The mouse Igh-1 locus on chromosome 12 influences herpetic stromal keratitis (HSK) patterns following corneal challenge with herpes simplex virus type 1 (HSV-1). Both cellular and humoral immune mechanisms appear to be important in modulating responses to HSV-1 infections, but the role of antibody-dependent cellular cytotoxicity (ADCC) is unclear. We studied the effector-cell function and antibody in an ADCC assay in Igh-1-disparate mice. Splenocytes from both HSK-susceptible C.AL-20 (Igh-1d) and HSK-resistant C.B-17 (Igh-1b) mice mediated equal amounts of ADCC to HSV-infected cell targets using monoclonal antibodies against HSV-1 glycoprotein D. Natural killer cell activity was significantly greater in C.AL-20 than in C.B-17 splenocytes. IgG2a was less efficient than both IgG1 and IgG2b in mediating ADCC to HSV-1-infected cell targets. The Igh-1 phenotype of the antibody source had no influence on ADCC activity. Our results suggest that the susceptibility of HSK observed in these Igh-1-disparate congenics cannot be explained by qualitative differences in the ADCC activity of effector cells and antibody produced in response to HSV-1 infection.

Animals↗

Reinduction of remission of chronic myeloid leukemia by donor leukocyte transfusion following relapse after bone marrow transplantation: recovery complicated by initial pancytopenia and late dermatomyositis.

A significant proportion of patients relapse after allogeneic BMT for CML. These relapses have been treated by induction of a graft-versus-leukemia effect by transfusing donor leukocytes. We have treated a 27-year-old woman with interferon and donor leukocyte transfusion and a complete haematological and cytogenetic remission was obtained coincident with the onset of GVHD. Her course was complicated by prolonged and profound pancytopenia which was fully reversed by the administration of rGM-CSF. She remains in CR with mild dermatomyositis due to chronic GVHD 17 months after the procedure.

Adult↗

Management of blunt vascular trauma to the extremities.

During a seven and one-half year period from 1984 to 1991, 106 patients admitted to a Level I trauma center had blunt vascular injury to the extremities. This subset of patients was analyzed with respect to mechanism of injury, associated injuries, method of repair, morbidity and mortality. Twenty patients sustained vascular injuries of the upper limb. Eighty percent of the patients (16 patients) underwent primary vascular repairs, 15 percent had primary amputations and 5 percent (one patient) were observed. Eighty-eight percent (14 of 16 repairs) of the vascular repairs demonstrated excellent neurologic function postoperatively. Eighty-six patients had arterial injuries of the lower extremity. Forty-eight percent (41 patients) of the injured legs were amputated, 41 percent (35 patients) underwent vascular repairs, 6 percent (five patients) underwent ligation of the primary vessel with no amputation and 24 percent (21 patients) underwent no surgical procedure. Sixty-two percent of the 37 patients (23 patients) with popliteal injuries required amputation and 57 percent (21 patients) underwent vascular repair. The overall mortality rate was 11 percent--zero percent for injuries to the upper limb and 14 percent for injuries to the lower limb.

Amputation, Surgical↗

Black-white disparities in blunt trauma.

To uncover causes of increased mortality rates in black accident victims, patterns of injury and access to trauma care were compared between black and white patients. Over a 41-month period (February 1985 to June 1988), 2120 white and 468 black patients, each with an Injury Severity Score (ISS) > 14 as a result of blunt trauma, were admitted to a Level I regional trauma center, part of a statewide trauma system. Blacks were significantly older and more of them had premorbid illnesses. Although vehicular crashes accounted for the majority of injuries in both groups, blacks had significantly more injuries resulting from falls, pedestrian accidents, and assaults. Whereas 70.6% of whites were transported from the scene and 73% were transported by helicopter, 52.7% of blacks were transported from the scene and 44% by helicopter. Blacks made up 18% of the study group and accounted for 20% of deaths (mortality rate 17.3% for blacks and 14.9% for whites). Mortality was significantly increased for black patients admitted with a Glasgow Coma Scale (GCS) score > or = 13. Private medical insurance, available for 46.3% of black patients, accounted for 78% of payments for all trauma admissions. Increased mortality of black trauma patients may be related to risk factors (age, premorbid illness), increased rates of pedestrian accidents and falls, and disparities in access to Level I trauma centers.

Adolescent↗

Six new cases of a caterpillar-induced bleeding syndrome.

We describe six new cases of a hemorrhagic diathesis induced by contact with Lonomia achelous caterpillars. Onset of clinical bleeding varied between a few hours and 10 days post-exposure. Laboratory coagulation tests showed prolonged PT, PTT and ThT; normal platelets and a marked decrease of fibrinogen, factor V, plasminogen and factor XIII (including its subunits A and S). Factors VII, II and alfa 2 anti-plasmin were variably affected. In addition, activation of the fibrinolytic system and the generation of a procoagulant effect could also be demonstrated. Two cases developed severe hemorrhagic diathesis and one of them died of a cerebral hemorrhage. Different aspects of this rare syndrome are discussed in relation to its complex physiopathology and the variability observed in all clinical and laboratory manifestations. Therapeutic recommendations and some possible hazards following replacement transfusions are also considered.

Adult↗

Structural changes in sperm from the fiddler crab, Uca tangeri (Crustacea, Brachyura), during the acrosome reaction.

The acrosome reaction (AR) was induced in sperm from the brachyuran crustacean Uca tangeri either by mixing male and female gametes in filtered seawater or by treating the spermatozoa with the divalent cation ionophore A23187. This latter method provided a sufficient number of reacted spermatozoa to allow a detailed ultrastructural study of the AR. The process consists of two separate phases: a) initial release of the acrosomal vesicle contents, and b) further elongation of the acrosomal filament, which causes reversal of the rigid capsule limiting the acrosomal vesicle contents. The elongate acrosomal filament consists of an apical perforatorium and a basal columnar structure called here the proximal piece. The former derives from the perforatorium of the uninduced sperm stage with only small ultrastructural changes. The proximal piece forms from myelin-like membrane layers which are initially distributed all around the subacrosomal region and then accumulate in a column at the perforatorial base, thus promoting a sudden forward projection of the perforatorium. The AR in brachyurans is thought to be a passive mechanism that utilizes the negative pressure exerted on the nucleus--caused by emptying of the acrosomal vesicle--for an organized accumulation of membrane-rich material immediately behind the perforatorium, with the final result of the raising of a 3 microns long acrosomal filament.

Acrosome↗

Genioglossus hemorrhage after blunt facial trauma.

We present the case of a 28-year-old man admitted to a Level I trauma center after a motorcycle crash in which he sustained blunt trauma to the face and neck, including a mandibular ramus fracture. The patient had no airway compromise on admission, but he acutely developed significant partial upper airway obstruction necessitating emergency endotracheal intubation and subsequent tracheostomy approximately 36 hours after admission. This obstruction was caused by an expanding hematoma of the genioglossus muscle. Potential causes of this complication are presented, and signs and symptoms of upper airway obstruction and airway management strategies are discussed. The etiology of traumatic upper airway obstruction is reviewed.

Accidents, Traffic↗

Magnetic resonance imaging in traumatic diaphragmatic rupture: case reports.

Acute traumatic diaphragmatic rupture is usually diagnosed by plain chest x-ray studies or at laparotomy. On occasion, ancillary diagnostic procedures such as computed tomography (CT) and fluoroscopy are necessary for diagnosis. Suspected acute traumatic diaphragmatic rupture was definitively diagnosed by magnetic resonance (MR) imaging in two patients. In another three patients, MR imaging was used to rule out diaphragmatic rupture. Magnetic resonance imaging may be the ancillary diagnostic procedure of choice following equivocal chest radiographs.

Adult↗

Sonography in blunt abdominal trauma: a preliminary progress report.

Evaluation of blunt abdominal trauma is clinically challenging. Diagnostic peritoneal lavage (DPL) and computed tomographic (CT) scanning have become primary diagnostic modalities. We examined the efficacy and role of ultrasonographic (US) studies in the initial abdominal evaluation of blunt trauma patients. Over an 8-month period, patients whose abdominal work-up indicated the need for DPL or CT were evaluated sonographically within the first hour after admission by trauma fellows (PGY-6) with at least 1 hour of theoretical training and 1 hour of practical training. Sonograms considered positive were those showing free peritoneal fluid or organ disruption. Hard copies of the sonograms were evaluated by a staff radiologist without knowledge of the fellows' interpretations or of DPL or CT results. Based on the fellows' interpretation of the real-time sonograms, among the first 163 patients studied were 11 true-positive, 146 true-negative, one false-positive, and five false-negative results. Sixteen patients had intra-abdominal injury documented by DPL, CT, or laparotomy. Ultrasonography was 91% sensitive in detecting the presence of hemoperitoneum. Overall, ultrasonography was 69% sensitive, 99% specific, and 96% accurate in diagnosing abdominal injury. We conclude that emergency sonography on admission can serve as a valuable adjunct to the physical diagnosis of clinically significant hemoperitoneum. It is noninvasive, portable, and accurate in determining the need for further diagnostic/surgical intervention.

Abdominal Injuries↗

Body habitus as a predictor of injury pattern after blunt trauma.

The records of obese and nonobese victims of blunt trauma were compared to determine if obese individuals are predisposed to a specific injury pattern. Prospectively collected data on 6368 adults admitted to a level I trauma center over a 4-year period were analyzed. Twelve percent (743 patients) met Body Mass Index (weight/height2) criteria for obesity (greater than or equal to 30 kg/m2). The obese group was older (p less than 0.01) and had lower ISSs (p less than 0.05) and higher GCS scores (p less than 0.01). More obese patients were injured in vehicular crashes (62.7% vs. 54.1% [p less than 0.01]). The obese victims were more likely to have rib fractures, pulmonary contusions, pelvic fractures, and extremity fractures and less likely to have incurred head trauma and liver injuries (p less than 0.05). Obese people injured in vehicular crashes had a similar injury pattern with no difference in seating position, direction of impact, seat belt use, and ejection.

Accidents, Traffic↗

Retinal detachment after refractive surgery for myopia.

Refractive surgery has been used widely in some countries for the last 20 years for the correction of myopia. Radial keratotomy and keratomileusis, the most common procedures, may concur with retinal detachment. A total of 14 eyes in 12 patients, 7 after keratomileusis and 7 after radial keratotomy, which had either asymptomatic or symptomatic retinal breaks, subclinical and clinical rhegmatogenous retinal detachments, or both, are discussed here. Five eyes were treated with either laser photocoagulation or cryopexy alone, seven eyes with a scleral buckling procedure, one eye with vitrectomy, and one eye was not operated on. At the final follow-up examination, anatomic reattachment had been achieved in 12 of 14 eyes (85.7%). Visual acuity improved in 3 eyes (21.4%), remained stable in 9 eyes (64.3%), and was worse in 2 eyes (14.3%). The scleral buckling procedures used in the repair of retinal detachment induced refractive changes by modifying axial length and corneal curvature, with recurrence of myopia and astigmatism. Myopia increased a mean of -3.00 diopters in 6 of 7 eyes (86%). Myopic astigmatism power changed a mean of -1.00 diopter in 5 eyes (71%), and the astigmatic axes shifted in 3 eyes (43%). This situation could be prevented with an early peripheral search for and treatment of peripheral retinal degenerative pathologic changes, by avoiding encircling bucklings, or by using alternative methods of treatment.

Adult↗

Discriminative criteria for Neisseria meningitidis isolates that are moderately susceptible to penicillin and ampicillin.

The prevalence of Neisseria meningitidis isolates that are moderately susceptible to penicillin and ampicillin has increased very quickly in Spain; the current prevalences in our hospital are 48.4 and 55.6%, respectively. We studied the reliability of the disk diffusion method for discriminating between fully susceptible (MIC, less than or equal to 0.06 microgram/ml) and moderately susceptible (MICs, 0.12 to 1.0 microgram/ml) isolates. Thirty-eight isolates (12 Pen(s) Amp(s), 18 Penr Ampr, and 8 Pen(s) Ampr) were assayed by the disk diffusion and plate dilution methods by use of disks of 1, 2, 5, and 10 U of penicillin, 2 and 10 micrograms of ampicillin, and 1 microgram of oxacillin on Mueller-Hinton agar with or without 5% sheep blood. Breakpoints were generated, and their discriminative values were determined with a collection of 195 meningococcal strains isolated consecutively from cerebrospinal fluid or blood. None of the strains produced beta-lactamase. Penicillin- and ampicillin-susceptible strains (MIC, less than or equal to 0.06 microgram/ml) had oxacillin inhibition zones of greater than or equal to 11 mm on blood agar. Moderate susceptibility to ampicillin and penicillin was suggested by an inhibition zone of less than or equal to 10 mm around the 1-microgram disk and an inhibition zone of less than or equal to 26 mm around the 2-U penicillin disk. We conclude that discrimination between fully susceptible and moderately susceptible populations of N. meningitidis can be accomplished by the disk diffusion method by use of Mueller-Hinton agar plus 5% sheep blood with the 1-microgram oxacillin disk (which is especially suited for screening methods) and the 2-U penicillin disk. The lack of an oxacillin inhibition zone indicates moderate susceptibility to either penicillin or ampicillin or both.

Ampicillin↗

Aromatase activity and estradiol in human breast cancer: its relationship to estradiol and epidermal growth factor receptors and to tumor-node-metastasis staging.

PURPOSE: The present report attempts to clarify whether there is a relationship between aromatase activity (ARAC) and estradiol (E2), hormonal receptors, E2 receptor (ER), and epidermal growth factor receptor (EGFR), as well as with tumor stage and histopathology in human breast cancers. MATERIALS AND METHODS: We studied 225 breast carcinomas, 67 of which were premenopausal and 158 postmenopausal. In each sample, ARAC, EGFR, ER, and E2 were quantified. ARAC was quantified by Thompson and Siiterii's method, EGFR was quantified with a two-point assay method using radioactive iodine (125I)-EGF as ligand, and ER was measured by the Scatchard method using 3H-E2. E2 was quantified by radioimmunoassay in the diethylether tumor extract. RESULTS: ARAC was found in 64% of the cancers studied. There is a strong direct association between ARAC and tumor size in postmenopausal patients (P = .001). In the postmenopausal group, the proportion of ARAC-positive (ARAC+) tumors is significantly higher among ER-positive (ER+) than ER-negative (ER-) ones (P less than .001). ER+ tumors also have significantly higher levels of E2 than do ER- ones (P less than .0001); similarly, ARAC+ tumors have significantly higher levels of E2 than do ARAC- ones (P less than .0001). There is a significant multiple linear correlation between the log of the levels of ARAC, ER, and EGFR and the log of tumor E2 (P less than .0001). The correlation coefficients obtained show that ARAC and ER have a positive effect on tumor E2. CONCLUSION: The results obtained suggest the importance of tumor ARAC in the tumoral levels of E2 and reinforce the possible biologic significance of tumor ARAC, especially in postmenopausal breast carcinoma patients.

Adult↗