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Biomedical subjects

F Cruz

Publications and source records attributed to F Cruz.

At least 37 records · Page 2Linked to original sources
PubMed1997

Desensitization of bladder sensory fibers by intravesical capsaicin has long lasting clinical and urodynamic effects in patients with hyperactive or hypersensitive bladder dysfunction.

PURPOSE: Capsaicin was used to treat symptomatic patients with hyperactive or hypersensitive bladders. MATERIALS AND METHODS: Capsaicin solution (1 mM.) was instilled into the bladder of 16 patients with spinal hyperreflexia, bladder instability or hypersensibility. RESULTS: Frequency decreased in 14 patients and continence was achieved in 10 of 14 incontinent cases. Mean first desire to void and maximal cystometric capacity increased significantly. These effects lasted for 6 to 12 months and were renewed following repeat treatment. CONCLUSIONS: Bladder afferent desensitization with capsaicin is promising in patients with motor or sensory bladder dysfunction, although initial pungency might limit its use.

Administration, Intravesical↗
PubMed1997

Effects of heavy water on hepatic intracellular pH and phosphatidylcholine turnover. A 31P NMR study.

The short term effect of heavy water (2H2O) in intracellular pH (pHi) and phosphatidylcholine (PtdCho) turnover have been studied by 31P NMR spectroscopy in the perfused mouse liver metabolizing alanine. Hepatic pHi decreased from 7.19 +/- 0.01 (n = 10) to 7.01 +/- 0.03 (n = 4) after the addition of 6 mM alanine to Krebs Ringer bicarbonate (KRB) perfusion medium. Replacement of 50% of the KRB water with 2H2O during alanine perfusion inhibited the intracellular acidification induced by alanine and caused i) a decrease in the hepatic content of PtdCho, and ii) increases in phosphocholine and glycerophosphocholine, respectively. Amiloride (1 mM) of 5-(N-ethyl-N-isopropyl)-amiloride (10 microM), two previously reported inhibitors of the Na+/H+ exchangers, mimicked the effects produced by 2H2O on pHi and PtdCho turnover. Replacement of 50% of the KRB water with 2H2O or the addition of 1mM amiloride to KRB only, did not modify pHi nor increase the levels of phosphocholine of glycerophosphocholine. Thus, the observed increases are the result of alanine perfusion in the presence of 2H2O or amiloride. These results suggest that 2H2O behaves similarly to previously reported inhibitors of Na+/H+ exchange, disclosing also a novel role for PtdCho metabolism in the regulation on hepatic pHi.

Alanine↗
PubMed1997

[Cytodiagnosis of focal hepatic lesions by image guided fine needle biopsy].

BACKGROUND: Image guided fine needle cytological diagnosis of hepatic lesions has become a routine diagnostic procedure. AIM: To analyze the diagnostic yield of fine needle cytological aspirates of the liver. PATIENTS AND METHODS: Two hundred two aspirates, obtained in 201 patients were studied. Procedures were performed under ultrasound guidance in 77.9% of cases and under CT scan guidance in 22.1%. Cytological diagnosis was compared with definitive pathological diagnosis in 136 patients and with clinical follow up in 66. RESULTS: Cytology was positive for malignant cells in 81.2% of cases, negative for malignant cells in 15.3%, inconclusive in 1% and the sample was inadequate in 2.5%. Cytology was false negative for malignant lesions in 17 cases and there were no false positives. It had a sensitivity of 90.6%, a specificity of 100%, a positive predictive value of 100% and a negative predictive value of 55.3%. The histological types of malignant lesions were adenocarcinoma in 48.2% of cases, hepatocellular carcinoma in 16.5% and non specified carcinoma in 20.7%. The main sites of the primary tumors were the liver in 24.4% of cases, gallbladder and biliary tract in 20.9%, intestine in 15.1%. CONCLUSIONS: Cytological diagnosis of fine needle aspirates of the liver obtained under image guidance are a valuable support in the diagnosis of focal liver lesions.

Adolescent↗
PubMed1997

[Occult gallbladder disease or microlithiasis in patients with acute pancreatitis: a frequent clinical event].

BACKGROUND: Patients with acute pancreatitis (AP) and a normal gallbladder by standard echographic evaluation may have "occult" gallbladder disease or microlithiasis with recurrent episodes of AP. AIM: To conduct a prospective evaluation of patients with the diagnosis of non-biliary AP in order to detect "occult" gallbladder disease and to compare its clinical presentation with that of biliary AP. PATIENTS AND METHODS: Patients admitted with the diagnosis of AP to a clinical hospital were included in the study. According to an abdominal ultrasound study, patients were classified as having or not cholelithiasis. A duodenal biliary drainage was performed in 15 patients with AP and without gallbladder stones. RESULTS: Patients without cholelithiasis had recurrent AP more often than patients with biliary AP (53 and 3.3% respectively). Excessive alcohol ingestion did not rule out the possibility of biliary etiology. In 6 patients, the analysis of duodenal bile showed cholesterol crystals, and cholecystectomy confirmed the existence of gallbladder disease in 5. All of them remained asymptomatic during a follow-up period of four years. One patient refused surgery, with subsequent development of gallstones and recurrent episodes of AP. In other 4 patients, gallbladder disease was confirmed by percutaneous gallbladder puncture or during cholecystectomy. No recurrence of AP were observed during the follow-up CONCLUSIONS: Microlithiasis or "occult" gallbladder disease accounts for at least 67% of the original "non-biliary" AP. Duodenal bile analysis is a useful and necessary technique for the evaluation of patients with "non-biliary" acute pancreatitis. Careful clinical and echographic follow-up of this subgroup of patients with AP is mandatory.

Acute Disease↗
PubMed1996

Long tracheobronchial and esophageal rupture after blunt chest trauma: injury by airway bursting.

Tracheobronchial rupture can be associated with blunt thoracic trauma. An important factor in the physiopathology of these lesions is reflex closure of the glottis, which can be related to closed chest trauma. We report a case of nonpenetrating thoracic trauma that caused a long membranous tracheal rupture from the subcricoid area to the main carina, extending to both main bronchi. In addition, a complex esophageal rupture occurred due to the great energy liberated by the airway rupture acting as a real tracheal burst. Both lesions were diagnosed by flexible bronchoscopy. The postoperative period was without serious complications.

Adolescent↗
PubMed1995

[Diagnostic role of the combination of computerized tomography and angiography in traumatic injuries of the thoracic aorta].

AIM: To assess the diagnostic value of the combination of computed tomography and angiography in patients with blunt thoracic trauma and suspicion of aortic injury. PATIENTS AND METHODS: Retrospective analysis of six patients, aged 22 to 72 years old, with traumatic thoracic aorta injury secondary to severe trauma, specially car accidents, seen between 1985 and 1994. RESULTS: An early diagnosis was done in three patients. One patient, in whom diagnosis was delayed, died before surgery. In three cases, CAT scan showed indirect evidence of aortic rupture, consisting in alterations of aortic outline. In other three patients, it showed hemomediastinum, associated to a left hemothorax in one case. Angiography confirmed the diagnosis, localized and characterized the injury in all patients. CONCLUSIONS: The delay in the diagnosis of aortic injury may be fatal. The combination of CAT scan and angiography has a high sensitivity and specificity to localize and characterize lesions of the aorta or its branches or associated organs, essential step for surgical planning. CAT scan restricts the use of angiography, avoiding false negative studies, but cannot be used as the sole diagnostic procedure.

Adult↗
PubMed1994

Bronchobiliary fistula secondary to biliary lithiasis. Treatment by endoscopic sphincterotomy.

Bronchobiliary fistula is a rare condition, defined by the presence of a passage between the biliary tract and the bronchial tree. Many conditions can give rise to the development of such a communication. Biliary lithiasis is one of those and is perhaps the one most amenable to endoscopic management. We describe a case of bronchobiliary fistula secondary to the development of choledocholithiasis in a cholecystectomized patient. The clinical suspicion was raised by the presence of bilioptosis (bile-stained sputum), and the diagnosis established by endoscopic retrograde cholangiopancreatography. The patient was submitted to endoscopic sphincterotomy and stone extraction, achieving frank clinical alleviation. This case gives us the chance to review bronchobiliary fistulas secondary to biliary lithiasis, placing particular emphasis on the opportunities of endoscopic management.

Biliary Fistula↗
PubMed1994

Alkyl glycerol monoethers in the marine sponge Desmapsamma anchorata.

1-O-Hexadecylglycerol (chimyl alcohol), 1-O-heptadecylglycerol and 1-O-octadecylglycerol (batyl alcohol) have been identified as the major native constituents of a mixture of free alkyl glycerol ethers isolated from the contained water and the methanolic extract of the sponge Desmapsamma anchorata. Minor components were the free C14, C15, C19, C20 and C21 alkyl glycerol monoethers. The alkyl glycerol monoethers were analyzed and identified by gas chromatography/mass spectrometry of their isopropylidene derivatives. This is the first report on the occurrence of free C15, C19, C20 and C21 alkyl glycerol monoethers in a sponge.

Animals↗
PubMed1994

Imidazol-1-ylalkanoic acids as extrinsic 1H NMR probes for the determination of intracellular pH, extracellular pH and cell volume.

The synthesis and biological evaluation of a novel series of extrinsic probes for intracellular pH (pHi), extracellular pH (pHo) and cell volume determination by 1H NMR is described. Imidazol-1-ylacetate, malonate, 3-glutarate and 2-succinate esters were synthesized by reaction of imidazole with alpha-bromo esters or with alpha, beta-unsaturated esters. The corresponding acids were prepared by hydrolysis. Rat erythrocytes were readily permeable to methyl imidazol-1-ylacetate, moderately permeable to diethyl 2-imidazol-1-ylsuccinate and impermeable to diethyl 3-imidazol-1-yl-glutarate esters. Imidazol-1-ylacetic acid was the only acid derivative which penetrated the erythrocyte interior when added directly to the incubation medium. Transport of the permeable compounds to the erythrocyte interior was non-saturable up to 200 mM added compound. Addition of methyl imidazol-1-ylacetate or diethyl 2-imidazol-1-ylsuccinate esters to erythrocyte suspensions, resulted in hydrolysis to imidazol-1-ylacetic acid and 2-imidazol-1-ylsuccinic acid mono-ethyl ester in the intracellular and extracellular spaces, respectively. pHi and pHo were determined from the different chemical shifts of the H-2 proton of the acid derivatives in the intracellular (H-2i) and extracellular (H-2o) compartments. In addition, the relative intracellular and extracellular volumes could be calculated from the areas of the intracellular and extracellular H-2 resonances.

Animals↗
PubMed1994

Unilateral adrenal hyperplasia.

A case of unilateral primary adrenal hyperplasia, without concomitant hypokalemia, is presented. After surgical removal of the gland, a complete remission occurred. This rare condition may, in fact, be more frequent than thought as it can coexist with normokalemia. We postulate that it is probably a new phase of the transformation between hyperplasia and adenomas that can also occur in the adrenal cortex similar to such transformations in other endocrine organs.

Adenoma↗
PubMed1994

Activation of the c-fos proto-oncogene in the spinal cord following noxious stimulation of the urinary bladder.

Activation of the c-fos proto-oncogene following mechanical or chemical noxious stimulation of the urinary bladder was studied at T12-L2 and L5-S1, the spinal cord segments of projection of the hypogastric nerve (HGN) and pelvic nerve (PN) fibers, respectively. In intact adult rats, c-fos expression was found at T12-L2 only in lamina I. At L5-S1, Fos cells occurred in lamina I, the intermediolateral gray matter (ILG), and the dorsal commissure (DCM). These two areas contained the highest number of immunoreactive cells. Although more Fos cells were induced by mechanical than by chemical stimulation, the distribution of the reactive neurons was similar after both types of stimuli. In adult rats that had been treated neonatally with capsaicin, there was a marked fall in c-fos activation by mechanical or chemical noxious stimuli in all immunoreactive areas. The loss of Fos cells was more pronounced in ILG and DCM at L5-S1 (95%) than in lamina I at the two spinal domains (70%). The confinement of c-fos activation to lamina I at T12-L2, the spinal cord domain of the HGN, suggests that the input carried from the bladder by this nerve is preferentially used for pain perception. The same function is expected for noxious input reaching lamina I at L5-S1, the spinal cord territory of termination of the PN. However, the striking number of Fos cells in ILG and DCM supports the important role played by this nerve in the control of the micturition reflex.(ABSTRACT TRUNCATED AT 250 WORDS)

Afferent Pathways↗
PubMed1993

Periterminal synaptic organization of primary afferents in laminae I and IIo of the rat spinal cord, as shown after anterograde HRP labelling.

The fine structure and periterminal synaptology of the primary afferent terminations in laminae I and IIo are examined in the rat, following anterograde labelling with horseradish peroxidase applied to the right C5-dorsal root. Labelled varicosities observed along the terminal arbors in parasagittal thick sections were relocated in ultrathin sections by electron microscopy. The labelled terminal profiles generated by the three primary afferent plexuses which can be identified by light microscopy in laminae I-IIo had similar fine structural features, except that axo-axonal contacts, although rare, were more frequent in the medial network plexus. Primary boutons were packed with agranular spherical vesicles and some large granular vesicles, and were mostly presynaptic to profiles of dendritic trunks of marginal cells. Unlabelled axonal profiles, either light with some flattened vesicles, or dense with round vesicles, were also presynaptic at symmetrical or asymmetrical contacts, respectively, to those dendritic profiles. It is suggested that such knobs of intrinsic origin are responsible for postsynaptic modulation of the primary noxious input. Although the 20 microns wide lamina IIo belongs cytoarchitectonically to lamina II and can be distinguished from lamina I by a decreased amount of myelinated fibres and large dendritic profiles, the periterminal synaptology was here found to be the same as in lamina I.

Afferent Pathways↗
PubMed1993

[Percutaneous biliary endoprostheses. Clinical experience of 6 years].

The aim of this study was to assess the effectiveness and long term permeability of percutaneous biliary endoprostheses. Seventy three patients with biliary tract obstruction due to a primary malignant tumor (n = 60), lymph node metastases at the porta hepatis (n = 10) and benign stenosis of a biliary-enteric anastomosis (n = 3), were treated between 1985 and 1990. Plastic prostheses were installed in 63 patients and metallic in 10. The procedure had a 30% incidence of complications. Thirty three percent of the prostheses remained patent until patient's death. In 15 and 40% of patients, signs of prosthesis obstruction were observed three and six months after installation respectively, bearing in mind a mean survival of 24 weeks. In 90% of patients there was a clinical and laboratory improvement. Mortality was 30% at 30 days in the group of patients with malignant diseases. It is concluded that the installation of percutaneous biliary endoprostheses is a relatively safe and well tolerated procedure, with a low incidence of complications or mortality and that allows an effective biliary decompression.

Adult↗
PubMed1993

Pregnancy and cholelithiasis: pathogenesis and natural course of gallstones diagnosed in early puerperium.

Several recent reports have indicated an increased prevalence of gallstones in association with pregnancy. If these reports are true, the early puerperium should be a favorable time to detect the disease in its initial stages and follow its natural course. Accordingly, the gallbladder was examined by ultrasound in 980 women during the immediate postpartum period and in 150 nulliparous, age-matched healthy volunteers. Gallstones were detected in 12.2% of the puerperal women and in 1.3% of the control group. In 70 patients who had stones in a functioning gallbladder, 22 (31%) had had attacks of biliary colic. The history of pain was more common in patients with stones greater than 10 mm in diameter. Forty-one women with small stones (< 10 mm) were followed clinically and ultrasonographically for between 6 and 24 (mean = 8.7) mo. All remained pain-free, and in twelve subjects (29%) the stones disappeared. Gallbladder bile was examined in 11 normal volunteers (controls) immediately after delivery and in 19 women with small stones 39 +/- 6 days postpartum. Bile was saturated with cholesterol in the controls and was unsaturated in patients with gallstones. We conclude that in our population pregnancy is a very important pathogenetic factor favoring gallstone formation. Attacks of biliary colic appear early and frequently in young Chilean women with this disease. Unexplained disappearance of small stones frequently occurs: in some cases it is likely to be the result of spontaneous dissolution because bile becomes unsaturated within a few weeks of delivery.

Abdominal Pain↗
PubMed1992

Immunocytochemical staining of neuropeptides in terminal arborization of primary afferent fibers anterogradely labeled and identified at light and electron microscopic levels.

A method is described to combine, at the ultrastructural level, horseradish peroxidase (HRP) anterograde tracing of primary afferents and peptide immunocytochemistry, using the lateral plexus of primary afferent fibers in laminae I-IIo of the rat dorsal horn as a model system. Free HRP was crushed against the dorsal roots. After a 14-h survival, animals were perfused, and the spinal cord was sliced at 50 microns with a Vibratome in a parasagittal plane. From these thick sections, camera lucida drawings of HRP-labeled fibers were obtained. Following osmication and Epon flat embedding, thick sections were re-cut at 5 microns and the labeled arbors matched with those previously drawn from the 50-microns sections. Ultrathin sections were cut from the 5-microns semithin sections and directly stained on grids using a post-embedding immunogold labeling procedure. Single and/or double immunocytochemical staining was performed using a rat monoclonal antibody against substance P and a rabbit polyclonal antiserum against calcitonin gene-related peptide (CGRP). Immunocytochemical reactions were visualized using appropriate immunoglobulin G-gold conjugates and the double-labeled synaptic boutons were matched with the varicosities previously visualized at the light level in the thick and semi-thin sections. The major advantages of this method are: (i) correlative studies at light and electron microscope level are made possible; (ii) tissue ultrastructure and antigenicity are adequately preserved so that a reliable subcellular localization of antigens under study is obtained; (iii) the markers used for tracing and immunocytochemistry are clearly distinguishable, even when present in the same nerve profile; and (iv) anterograde tracing can easily be combined with multiple immunolabeling.

Animals↗