Immunogenic synthetic peptides against mycobacteria of potential immunodiagnostic and immunoprophylactic value.
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Amino Acid Sequence↗
Biomedical subjects
C Jimenez
Publications and source records attributed to C Jimenez.
Melanotic neuroectodermal tumor of infancy.
Melanotic neuroectodermal tumor of infancy is a specific but unusual tumor of infancy for which only sporadic cases have been reported in the literature. This paper presents a case in an infrequent site, the epididymis, and summarizes the literature on the subject.
Adult↗
Severe inherited "homozygous" protein C deficiency in a newborn infant.
A relapsing clinical syndrome of skin lesions and disseminated intravascular coagulation (DIC) that showed remission with the infusion of fresh frozen plasma is described in a newborn infant with homozygous deficiency of protein C antigen. This patient presented since birth a recurrent clinical picture of DIC and ecchymotic skin lesions that resembled typical ecchymosis except for the fact that they showed immediate improvement with the administration of fresh frozen plasma. Using an enzyme linked immunosorbent assay method, the determination of protein C antigen levels in the patient, without ingestion of coumarin drugs, showed very low values (less than 1%). No other deficiencies in the vitamin-K-dependent factors or in antithrombin III, antiplasmin, and plasminogen were found. Seven relatives of the infant had heterozygous deficiency in protein C antigen (values between 40-55%), without clinical history of venous thrombosis. The pedigree analysis of this family suggests an autosomal recessive pattern of inheritance for the clinical phenotype, although an autosomal dominant pattern has been postulated until now in other reported families. We conclude that our patient has a homozygous deficiency in protein C and this homozygous state may be compatible with survival beyond the neonatal period.
Blood Coagulation Disorders↗
Eosinophilic gastroenteritis.
Eosinophilic gastroenteritis is a rare condition, characterized by diffuse infiltration of the gastrointestinal tract by eosinophils. This involves mainly the stomach, duodenum and small bowel and rarely the esophagus, colon, pancreas, gallbladder, prostate and urinary bladder. Most reported cases have occurred in adults in the third decade of life. The authors report on a 15-day-old infant who initially presented with rectal bleeding and a scan that indicated a Meckel's diverticulum was present. At laparotomy, however, a Meckel's diverticulum was not found. The appendix was slightly distended and there was a mild inflammatory reaction. Appendectomy was performed. Microscopically the appendix showed diffuse eosinophilic infiltration. The blood eosinophil count was elevated. The patient recovered well, but had several minor episodes of rectal bleeding following ingestion of milk. He remained asymptomatic on a milk-free diet. The etiology of eosinophilic gastroenteritis is unknown and there is no specific treatment. In uncomplicated cases, diet, corticosteroids and adrenocorticotropic hormone are used. Operation is reserved for cases of obstruction and hemorrhage.
Age Factors↗
Paraplegia following balloon assistance after cardiac surgery.
Contrapulsation by means of an intra-aortic balloon is an effective and well-known therapeutic measure in the postoperative period after cardiac surgery, mainly when interrupting cardiopulmonary bypass in left ventricular failure situation (3, 4). We present the case of a patient who developed paraplegia 38 hours after surgery, which was attributed to contrapulsation.
Adult↗
Fletcher factor deficiency: report of a new family.
3 cases of Fletcher factor deficiency in a family not related to the 6 families already published (Hathaway et al 1965, Hattersley & Hayse 1970, Abildgaard & Harrison 1974) are studied. In the family described here, 3 of 4 siblings have a Fletcher factor level of less than 1% and the fourth has a level of 46%; the Fletcher factor level in the father is 48% and in the mother 38%. This suggests an autosomal recessive transmission. Clinically they do not present spontaneous bleedings and only one of the siblings required a unit of blood after an amygdalectomy. It is also of interest to emphasize that 3 of the siblings suffered from congenital multiple arthrogryposis and that 2 of them presented the arthrogryposis together with the Fletcher factor deficiency, a circumstance which could have been favored by the consanguinity of the parents. The fact that the family described here is white and of Mediterranean origin contradicts the idea that there exists a special predisposition among members of the black race for this disease.
Adolescent↗
A technique for the evaluation of platelet-collagen adhesiveness in vitro.
A method for the evaluation in vitro of platelet-collagen adhesiveness has been developed. This method is based on counting platelets both before and after their contact with an insoluble collagen (IC) suspension. The results are expressed as adhesiveness index (AI). A number of variables which could influence the test has been evaluated and standardized in a way suitable for the routinary use of the technique described.
Blood Cell Count↗
On methylating activity of L-(methyl-14C)-methionine in metabolism of phospholipids by insect Ceratitis capitata.
The methylating activity of L-(methyl-14C)-methionine in different stages of developmenent of the insect Ceratitis capitata was studied in a series of in vitro and in vivo experiments. Larval and pharate adult homogenates of the insect were used in the in vitro conditions, and the utilization of the methyl group of methionine for the synthesis of different classes of phospholipids was evaluated. Incorporation of radioactivity in lipids by pharate adult homogenates was significantly higher than that by larval homogenates. In both cases, phosphatidyl ethanolamine showed the highest levels of radioactivity incorporation. Free bases from total lipid hydrolysates were resolved and identified by paper chromatography, and the labeling was investigated by radioactivity scanning of paper chromatograms. Significant differences were observed in the activity of both stages of development of the insect. Larval and pharate adult homogenates incorporated mainly the labeled methyl groups into ethanolamine. Monmethyl ethanolamine was the only methyl derivative that appeared in the hydrolysates of lipids synthesized by larval homogenates, whereas mono-,di-and trimethyl ethanolamine clearly were detected in those synthesized by pharate adult homogeneates. Administration of L-(methyl 14C)-methionine to larvae confirmed the existence of methylation reactions in the metabolic activity of the insect.
Animals↗
Methylating activity of (methyl-14C)-S-adenosylmethionine by microsomes of the insect Ceratitis capitata.
The methylating activity of (methyl-14C)-S-adenosylmethionine by microsomes from different stages of development of the insect Ceratitis capitata was studied in a series of in vitro experiments. Larval and pharate adult microsomal preparations were used in the in vitro conditions, and the utilization of the methyl group of the S-adenosylmethionine for the synthesis of phospholipids was evaluated. Incorporation of radioactivity in lipids by pharate adult microsomes was significantly higher than that by larval preparations. In both cases, phosphatidyl ethanolamine showed the highest levels of radioactivity incorporation. Free bases from total lipid hydrolysates were resolved by paper chromatography, and the labeling was investigated by radioactivity scanning of paper chromatograms. Larval and pharate adult preparations showed clearly the presence of dimethylethanolamine and choline. The presence in the incubation media of phosphatidyldimethylethanolamine and deoxycholate enhanced the radioactivity incorporation into choline, whereas, the first stages of methylation were inhibited. These findings confirmed previous results using insect homogenates.
Animals↗
[Mid-term fate of Beall's prosthesis in the mitral or mitro-tricuspid position. Apropos of 100 cases].
Aiming at investigation, a Beall's valve was implanted in mitral or in mitral-tricuspid positions only on 100 patients, between November 1969 and February 1972. The details of the initial valve lesions, the clinical condition of the patients, and the modalities of prosthetic replacement are described. The causes of death within the first month were analysed. None could be related with the prosthesis itself. At distance, 17 patients were lost of sight, 18 died and 51 were studied from 12-42 months after operation. It results from this investigation: -- that 84% of the patients reexamined were improved. Most of them were included in a better functional class; -- that the incidence of thrombo-embolic accidents amounted to 12% for the whole group of patients, a percentage similar to that observed with other types of prostheses; -- that in contraat, haemolysis is an obvious disadvantage of Beall's prosthesis (20 of 51 cases); -- that abnormal wears in two valves resulted in valve dysfunction compelled to re-operation. These latter two incidents have lead to abandoning this type of prosthesis.
Adolescent↗
[Total anomalous pulmonary venous drainage].
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Heart Defects, Congenital↗
Peroxidase deficiency in familial goiter with iodide organification defect.
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Adolescent↗
Reuse of liver grafts after early death of the first recipient.
Three cases are reported of reuse of a transplanted liver graft after early death of the first recipient due to cerebral hemorrhage. The good condition of the donors; the excellent biochemical evolution of the graft in the first recipients; total ABO compatibility and donor-recipient crossmatch; the absence of positivity to hepatitis B virus (HBV), hepatitis C virus (HCV), and bacteriologic cultures; and early death made reuse possible. The shortage of donors in relation to patients on the waiting list and the poor clinical condition of the second recipients made it necessary to adopt the decision to reuse the graft in an attempt to save their lives. The evolution of the patients and the reused grafts was satisfactory, and there were no complications that could be attributed to the fact that the graft had been transplanted before.
Adult↗
Low-risk stress fractures.
Stress fractures can occur in almost any bone in the body, with the lower extremity weightbearing bones, especially the tibia, tarsals, and metatarsals, being affected most frequently. Although the cause of these fractures is multifactoral, repetitive physical forces without adequate rest are the primary culprits. Stress fractures may be broadly classified as low-risk or high-risk injuries. Low-risk stress fractures, the topic of this review article, can be diagnosed through a thorough history, physical examination, and radiographs. Nuclear scintigraphy is occasionally necessary for confirmation, especially for fractures of the spine and pelvis. When diagnosed early and treated with restriction of activity, low-risk stress fractures have a favorable prognosis.
Diagnosis, Differential↗
Use of theophylline to control hematocrit in respiratory polycythemia.
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Adult↗
Role of electron microscopy in head and neck pathology in adults and children.
Diagnostic electron microscopic studies specific to the head and neck region are limited in both children and adults. Even information about the workload created by specimen acquisition from this region in the electron microscopy laboratory is lacking. To address these deficiencies, various specimens gathered from adults (N = 6607) and children (N = 1556), over a 5- and 10-year period, respectively, and blocked in plastic resin were surveyed. Head and neck samples accounted for 16.4% of these samples from adults and 13.5% from children, representing sizable contributions to workload from an anatomic region amounting to less than 10% of body mass. In adults, diagnostic problems posed by metastatic neoplasms account for a considerable proportion of the cases submitted for electron microscopy; in the pediatric age group, undifferentiated primary tumors of the head and neck region frequently require ultrastructural study. In both circumstances, spindle cell, look-alike, neuroendocrine, and small cell tumors can frequently be rapidly assessed and differentiated by ultrastructural details. Problem cases are inevitable given the complexity of this region and the number of different tissues and organs in close proximity. It is advantageous to anticipate the possibility of encountering difficult differential diagnostic problems by sampling lesions of the head and neck for glutaraldehyde fixation more frequently.
Adult↗
Management and outcome of liver recipients with post-transplant lymphoproliferative disease.
BACKGROUND/AIMS: The possibility of development of post-transplant lymphoproliferative disease by patients receiving immunosuppressive therapy is well known. However, elective treatment and outcome remain controversial. We reviewed the management and outcome of our patients with post-transplant lymphoproliferative disease. METHODOLOGY: Records of 457 patients who underwent orthotopic liver transplantation from 1986 to 1997 were analyzed. Patients who developed post-transplant lymphoproliferative disease were reviewed retrospectively. Incidence, clinical presentation, risk factors and outcomes were examined with special emphasis on ductopenic rejection and hilum involvement. RESULTS: Eleven patients developed a post-transplant lymphoproliferative disease (2.4%). These were B-cell non-Hodgkins lymphoma, Epstein-Barr virus-associated in all cases. Five patients (45.5%) received monoclonal antibodies or antithymocyte globulin. Seven patients (63.6%) developed a lymphoproliferative disease before 9 months post-transplant and 4 recipients (36.4%) after 20 months. No late lymphomas regressed after withdrawal from immunosuppression. Six patients (54.5%) were treated with chemotherapy. Eight patients (72.7%) had a tumoral remission. Five patients (45.5%) developed chronic rejection after immunosuppressant discontinuation. Four of them died as a consequence of ductopenic rejection and retransplantation was required in another; 2 died due to graft hilum infiltration. Five patients (45.5%) are alive after a follow-up of 36.5 +/- 32 months (range: 4-77 months). CONCLUSIONS: Patients with post-transplant lymphoproliferative disease require a close follow-up in order to promptly treat conditions that could lead to death. In our series, these were more closely associated with a failing transplanted organ than with the lymphoma itself.
Adolescent↗
Predictive factors in smoking cessation with combined therapy with bupropion and nicotine patches.
UNLABELLED: The association of bupropion and nicotine is a good choice in the treatment of smoking cessation. However, not all patients actually give up smoking. STUDY OBJECTIVES: This work was undertaken with the aim of finding out the functional or clinical variables that could be associated with the success of the cessation therapy. DESIGN: In one year, 88 patients who were treated with bupropion 300 mg/day and nicotine patches were followed-up, for 1 month and 3 months, respectively. They were all questioned about the number of cigarettes per day, the years they have been smoking, the number of quitting attempts, and concurrent pulmonary conditions were sought for. The Fageström Test, forced spirometry (FVC, FEV-1, FEF25-75), and exhaled carbon monoxide (by co-oxymetry) were also assessed. For the statistical analysis, a logistic regression model allowing to predict the response of new subjects to the treatment, with the lowest error possible, was applied. To choose the working model, the highest and lowest value of each variable were found, drawing the correlation matrix between dependent and independent variables, by means of the box-plot procedure. Then, the model's application conditions were analysed: linearity, homoscedasticity, independence of the applications, and normality of the distributions. To assess the discrimination of the model, a ROC curve was used. RESULTS: Showed that at the end of the follow-up year, 59.1% of the patients quitted smoking. The multivariate analysis with logistic regression showed that no previous history of chronic obstructive pulmonary disease (COPD), a FEF25-75 value and effectively quit after the first week of treatment were independent prognostic factors of treatment success. When the diagnosis precision of our model was analysed by means of the ROC curve, it showed a 78% value, with the 95% confidence interval ranging from 68.5% to 86.9%. At the optimal cut-off point of our model, sensitivity and specificity for quitting smoking were found to be 66.7% and 80%, respectively. CONCLUSIONS: We conclude that with a diagnosis precision of 78.8% patients with no history of COPD, who quitted at the first week of therapy with bupropion and with low FEF25-75, will remain non-smokers after one year follow-up. Contrarily, COPD patients who still smoke after one week of therapy, will not achieve quitting smoking.
Adult↗