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G Plasencia

Publications and source records attributed to G Plasencia.

16 recordsLinked to original sources
PubMed2001

Localization of an exonic splicing enhancer responsible for mammalian natural trans-splicing.

Carnitine octanoyltransferase (COT) produces three different transcripts in rat through cis- and trans-splicing reactions, which may lead to the synthesis of two proteins. Generation of the three COT transcripts in rat does not depend on sex, development, fat feeding, the inclusion of the peroxisome proliferator diethylhexyl phthalate in the diet or hyperinsulinemia. In addition, trans-splicing was not detected in COT of other mammals, such as human, pig, cow and mouse, or in Cos7 cells from monkey. Rat COT exon 2 contains two purine-rich sequences. Mutation of the rat COT exon 2 upstream box does not affect the trans-splicing in vitro between two truncated constructs containing exon 2 and its adjacent intron boundaries. In contrast, mutation of the downstream box from the rat sequence (GAAGAAG) to a random sequence or the sequence observed in the other mammals (AAAAAAA) decreased trans-splicing in vitro. In contrast, mutation of the AAAAAAA box of human COT exon 2 to GAAGAAG increases trans-splicing. Heterologous reactions between COT exon 2 from rat and human do not produce trans-splicing. HeLa cells transfected with minigenes of rat COT sequences produced cis- and trans-spliced bands. Mutation of the GAAGAAG box to AAAAAAA abolished trans-splicing and decreased cis-splicing in vivo. We conclude that GAAGAAG is an exonic splicing enhancer that could induce natural trans-splicing in rat COT.

Alternative Splicing↗
PubMed1997

Is laparoscopic surgery applicable to complicated colonic diverticular disease?

BACKGROUND: Expanding upon our experience with laparoscopic surgery for colonic benign and malignant processes and for bowel obstruction, we have reviewed our experience with minimal access laparoscopic surgery for complicated diverticular disease. We propose an approach of surgical care incorporating diagnostic laparoscopy in those not responding to medical therapy alone. METHODS: Our study includes data from two different surgical teams working in separate hospital-and-patient environments. Our theory that laparoscopy could be widely applicable to this complex disease process is borne out by experience in both locations. One hundred forty-eight patients were managed by laparoscopic or laparoscopically assisted methods with 18 patients requiring drainage only without resection. RESULTS: Our management of 148 of 164 patients (90%) by laparoscopic approach was successful, with a very acceptable morbidity of 5% in the elective cases and decreased ileus (20% of open vs 7% laparoscopic) in acute complicated cases. Elective resections required hospitalization of 4-5 days, demonstrating the benefits of incorporating laparoscopy in the care of these cases, particularly when compared to standard open procedures requiring 8 days' hospitalization. CONCLUSIONS: We believe complications of diverticular disease including abscess, perforation, fistula, and bleeding can potentially be managed in this way by minimal access procedures, decreasing postoperative wound problems, decreasing length of hospitalization and overall morbidity, and improving patient care.

Adult↗
PubMed1994

Sequential psychomotor skills development in laparoscopic colon surgery.

OBJECTIVES: To quantify the complexity of each of three skills used in laparoscopic colon surgery and to quantify the relative complexity of seven laparoscopic colon procedures on a graduated complexity scale. DESIGN: Five surgeons used a scale of 1 through 6 to measure the relative complexity of three laparoscopic skills (intracorporeal mobilization, intracorporeal devascularization, and intracorporeal anastomosis) to assess the relative difficulty of seven laparoscopic procedures (right colon resection, sigmoid colon resection, low anterior resection, Hartmann's procedure, left colon resection, abdominoperineal resection, and transverse colon resection) using detailed evaluation of their first 100 laparoscopic colon resections. SETTING: Three private community hospitals. MAIN OUTCOME MEASURES: The complexities of intracorporeal mobilization, intracorporeal devascularization, and intracoporeal anastomosis were recorded for seven laparoscopic colon procedures. RESULTS: The least complex procedure was right colon resection, followed in increasing complexity by sigmoid colon, Hartmann's procedure, low anterior resection, abdominoperineal resection, left colon resection, and transverse colon resection. The addition of each laparoscopic skill increased the complexity during each procedure. All three skills were not required for every procedure. CONCLUSIONS: Since all procedures do not require all three skills, skills can be learned sequentially if patients are chosen judiciously. A sequence of laparoscopic procedures performed by surgeons is recommended. The relative complexities for each procedure suggest an outline (map) for surgeons to use during laparoscopic colon surgery.

Abdomen↗
PubMed1994

Laparoscopic-assisted sigmoid colectomy and low anterior resection.

Laparoscopic-assisted sigmoid colectomy or low anterior resection was undertaken in 30 selected patients. The median age was 51 (range, 30-85) years. Eight patients had previous abdominal surgery: four hysterectomies, two appendectomies, and two cholecystectomies. There was no mortality. Complications occurred in three patients. One patient developed a wound infection, there was one iliac artery injury, and one postoperative bleed, which did not require transfusion. Eighteen patients were operated on for primary cancer of the colon and 12 patients for benign disease. Technical aspects are described in detail. The average hospital stay was four days with most patients receiving oral analgesics by the second postoperative day. Laparoscopic colon resection can be an alternative to open surgery.

Colectomy↗
PubMed1988

A new silicone-prosthesis in the modified Thiersch operation.

Experience with a new silicone prosthesis in the modified Thiersch operation for rectal procidentia in 16 extremely poor-risk patients is presented. The technique of implantation, structural details of the prosthesis, and the clinical results are described. The use of a new silicone prosthesis in the modified Thiersch procedure is a viable alternative in this group of patients. Surgical technique is a primary determining factor in preventing complications.

Humans↗
PubMed1987

Diagnostic peritoneal lavage in the management of blunt abdominal trauma: a reassessment.

In order to reassess the value of diagnostic peritoneal lavage (DPL) in patients with blunt abdominal trauma, we conducted a prospective study over a 15-month period involving 138 patients. There were 29 (28.3%) patients with positive DPL and 103 (71.7%) with negative DPL in this series. Of the 29 patients with positive DPL, 28 (96.5%) were found to have significant intra-abdominal injuries; 27 by exploratory laparotomy and in one case at autopsy. One patient with a grossly positive DPL had a negative exploratory laparotomy (3.4% false positive rate). All 109 patients with negative DPL were admitted. In only one case a significant intra-abdominal injury was demonstrated (0.9% false negative rate). The overall mortality in this series was 11.6% and there were no complications related to the DPL. Our results suggest that DPL is indeed an accurate indicator of significant intra-abdominal injuries in patients with blunt abdominal trauma.

Abdominal Injuries↗
PubMed1987

The role of splenorrhaphy in splenic trauma.

Eighty-five cases of splenic trauma that were treated surgically from 1981 to 1983 were reviewed to define the exact role of splenorrhaphy. There were 73 male and 12 female patients with a mean age of 34 years. The mechanism of injury was blunt trauma in 51 and penetrating trauma in 34. The incidence of associated intraabdominal injury was 31 per cent and 79 per cent in blunt and penetrating trauma, respectively. Splenectomy was performed in 43 (51%) and splenorrhaphy in 42 (49%). Splenorrhaphy was performed in 19 (37%) who had blunt trauma and 23 (67%) who had penetrating trauma (P less than 0.01). Overall six patients died, three in the splenorrhaphy group (7.1%). Only one patient who had splenorrhaphy required reoperation for splenic hemorrhage. The authors conclude that about 50 per cent of all injured spleens in the patient population studied can be salvaged during laparotomy for splenic trauma, the splenic salvage rate is higher in penetrating trauma, and splenorrhaphy is a safe operation.

Adolescent↗
PubMed1986

Preventable trauma deaths: Dade County, Florida.

We reviewed 1,201 trauma deaths that occurred in Dade County, Florida, in 1982 in order to evaluate the need for an organized trauma network. There were 715 deaths (59.5%) at the scene. Of the remaining 486 patients who were transported to hospitals for treatment there were 240 central nervous system (CNS) deaths and 246 non-CNS deaths. Fifty-two (21.1%) preventable non-CNS trauma deaths were identified out of the 246 non-CNS deaths. The lack of an appropriate surgical procedure or a delay to surgery accounted for 82.7% of the preventable deaths. The preventable non-CNS death rate was 12.1% at the then functional Level I hospital and 26.4% at the other 22 hospitals (p less than 0.01). The ISS scores were similar for both the functional Level I hospital and the other hospitals. A trauma network involving seven hospitals is currently being established in Dade County, Florida. Applying the 1982 data to these hospitals reveals a preventable non-CNS death rate of 12.1% for the Level I hospital, 21.5% for the six planned Level II hospitals, and 30.0% for the other 16 hospitals. We conclude that: the severely injured should be triaged directly to trauma centers, and there is a need in Dade County, Florida, for an organized trauma system.

Adolescent↗
PubMed1986

A prospective randomized study of moxalactam versus gentamicin and clindamycin in penetrating abdominal trauma.

We conducted a randomized, prospective study of moxalactam versus gentamicin plus clindamycin in 42 patients with penetrating abdominal trauma. Patients were randomized to receive intravenously either 2 grams of moxalactam every 12 hours or 80 milligrams of gentamicin every eight hours and 600 milligrams of clindamycin every six hours. Antibiotics were administered preoperatively and continued for a minimum of five days if hollow viscus injury occurred. For those without hollow viscus injury, only those patients receiving a minimum of three days of antibiotics were evaluated. A single intramuscular dose of 10 milligrams of vitamin K was also administered to all patients in the moxalactam group. There were 39 males and three females with a mean age of 33 years. Twenty patients received moxalactam and 22 received gentamicin plus clindamycin. The mechanism of injury was gunshot wound in 32 patients and stab wounds in ten patients. Eight patients in each group sustained injuries to the small intestine or colon, or both. The mean injury severity score was 22.6 and 21.2 in the single and double antibiotic regimen, respectively. The mean duration of antibiotic therapy was 5.8 and 7.0 days in the single and double antibiotic group, respectively. No infectious complications occurred in the moxalactam group whereas five infections occurred in four patients in the gentamicin plus clindamycin group (p less than 0.05). These infections included one intra-abdominal abscess, two wound infections and two episodes of necrotizing fasciitis of the wound and abdominal wall. There were no complications attributable to moxalactam therapy. The over-all mortality rate was zero per cent. The total pharmacy cost of a five day course of moxalactam plus a single dose of vitamin K is $204.67 compared with $226.00 for a similar course of gentamicin plus clindamycin. We conclude that: moxalactam is at least, if not more, effective in preventing infectious complications after penetrating abdominal trauma compared with gentamicin plus clindamycin; moxalactam is safe in the doses used when combined with vitamin K, and 3, moxalactam is more cost-effective than gentamicin plus clindamycin dual antibiotic therapy.

Abdominal Injuries↗
PubMed1985

Mucosal advancement in the treatment of anal fistula.

One hundred eighty-nine patients with anal fistula treated within an eight-month to seven-year period by anal fistulectomy and rectal mucosal advancement are presented. An 80 percent follow-up revealed a 90 percent asymptomatic group and a ten percent group who had minor symptoms. Eight percent of the symptomatic patients had minor soiling; 7 percent were incontinent for gas, and 6 percent were incontinent for loose stools. No patient was incontinent for solid feces. There was a 1.5 percent rate of recurrent anal fistula comparable to other techniques.

Adolescent↗
PubMed1984

Adult intussusception with autoamputation and preservation of bowel continuity.

We present a case of adult intussusception with autoamputation and preservation of bowel continuity. Our patient, a 65-year-old man, passed a 65-cm segment of large bowel per anus with spontaneous recovery and with a two-month follow-up free of symptoms secondary to the intussusception. Mesenteric ischemia secondary to angiography with distal embolization two weeks prior to the event may have been a precipitating factor in this unusual form of intussusception.

History, 19th Century↗
PubMed1981

Exercise duration to angina at two and twelve hours after timolol.

Eight patients who improved their exercise duration to angina or marked fatigue (greater than or equal to 25%) on timolol 10 to 30 mg twice daily over that on placebo 8 to 14 mo previously were subjects in a double-blind, randomized, crossover 4-wk study of the effect of timolol on exercise duration 2 and 12 hr after medication. One patient was discontinued from the study because unstable angina developed on placebo. Mean exercise duration on timolol over control was increased at 12 hr (p less than 0.02) and at 2 hr ( p less than 0.001) after drug. There was an increase in exercise duration greater than or equal to 25% on timolol over control compared with placebo in three of seven patients (43%) 12 hr after drug and in seven of seven (100%) 2 hr after drug. Timolol 10 to 30 mg twice daily prolongs exercise duration to angina or marked fatigue at 2 hr after drug and in some responders at 12 hr after drug.

Angina Pectoris↗
PubMed1980

Effect of acebutolol and propranolol on premature ventricular complexes.

A double-blind, randomized study comparing the efficacy of intravenous acebutolol with propranolol on frequent premature ventricular complexes (PVCs) in 24 patients is reported. Frequent PVCs were abolished or reduced by 75% or more in 10 of 12 patients (83%) given acebutolol and in 10 of 12 patients (83%) given propranolol. The therapeutic effect of acebutolol lasted for at least 1 hr in 4 of 12 patients (33%), for at least 3.5 hr in 3 of 12 patients (25%), and for at least 4 hr in 2 of 12 patients (17%). The effect of propranolol lasted for at least 1 hr in 6 of 12 patients (50%), for at least 3.5 hr in 4 of 12 patients (33%), and for at least 4 hr in 4 of 12 patients (33%). Hence, intravenous acebutolol and propranolol were equally effective.

Acebutolol↗
PubMed1979

Verapamil in atrial fibrillation and atrial flutter.

A double-blind randomized study was performed to compare the efficacy of intravenous verapamil with saline in 28 patients with a rapid ventricular rate and atrial fibrillation or atrial flutter. Conversion of atrial fibrillation to sinus rhythm occurred in none of 14 patients after saline and in 3 of 20 patients (15%) 7 to 160 min after verapamil. The ventricular rate in atrial fibrillation was slowed greater than or equal to 15% in 2 of 14 patients (14%) by saline, in 17 of 20 patients (85%) by 1 dose of verapamil (p less than 0.001), and in 19 of 20 patients (95%) by 1 or 2 doses of verapamil (p less than 0.001). Conversion of atrial flutter to sinus rhythm occurred in none of 4 patients after saline and in 1 of 7 patients (14%) 105 min after verapamil. The ventricular rate in atrial flutter was slowed greater than or equal to 15% in none of 4 patients by saline, in 4 of 7 patients (57%) by 1 dose of verapamil, and in 7 of 7 patients (100%) by 1 or 2 doses of verapamil (p less than 0.001).

Adult↗