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J Abascal

Publications and source records attributed to J Abascal.

At least 19 recordsLinked to original sources
PubMed1999

Clinical outcome of cotransplantation of peripheral nerve and adrenal medulla in patients with Parkinson's disease. Clínica Puerta de Hierro Neural Transplantation Group.

OBJECT: Transplants of adrenal medulla (AM) and fetal ventral mesencephalon (FVM) are currently being tested as therapeutic alternatives in patients with Parkinson's disease (PD). At the Clínica Puerta de Hierro in Madrid, a controlled clinical trial is underway to establish which donor tissue, if any, is the best for open surgical implantation in patients with PD. METHODS: Since 1987, varying degrees of clinical improvement have been achieved in Grade IV and V parkinsonian patients by implanting perfused AM and FVM into the right caudate nucleus. To investigate further whether implantation of different types of donor tissues results in qualitatively and quantitatively different degrees of recovery, four patients with Grade IV or V PD received implants of pre-coincubated autologous AM and intercostal nerve in the caudate nucleus. Four nonsurgically treated patients served as a control group. Three years posttransplantation, longer on phases (46.2%+/-10.4% of the day presurgery to 87.5%+/-10.4% of the day 36 months postsurgery) and improved symptoms in on and off phases persist in all four cases, with reduced dyskinesias (67.1%+/-9.2% of the day in on phases presurgery to 17%+/-13.8% of the day in on phases 36 months postsurgery). Progress appears to be stepwise, starting within weeks of tranplantation and becoming clinically significant in the 2nd and 3rd months (similar to our AM- and sooner than in our FVM-implanted patients), followed by a period of stability and, after a second wave of improvement 12 to 18 months posttransplantation (similar to FVM implants), has continued (87.5+/-7 points presurgery to 46+/-5.6 points 36 months postsurgery). In the experimental group, doses of levodopa have been reduced by more than 60% and dopamine agonist use has not resumed. In contrast, there have been no significant clinical changes in the control group. CONCLUSIONS: Implantation of tissue other than fetal tissue can promote a long-term improvement in the clinical symptomatology of seriously disabled parkinsonian patients. This finding is supported by the autopsy report of a patient with PD who had undergone grafting of AM plus peripheral nerve in which it was demonstrated that a large number of tyrosine hydroxylase-positive cells survive 1 year after implantation. In addition, there was a dense network of host dopaminergic fibers around the graft.

Adrenal Medulla↗
PubMed1996

Clinical experience with cotransplantation of peripheral nerve and adrenal medulla in patients with Parkinson's disease.

Coimplants of adrenal medulla (AM) and peripheral nerve (PN) in animal models of Parkinson's disease (PD) have shown that AM cells survive longer, tend to show neuronal phenotype, and enhance sprouting of host fibers. Since 1987, our implants of perfused AM and fetal ventral mesencephalon (FVM) in PD patients have achieved varying degrees of clinical improvement. If the donor tissue determines the improvement, different types of implants should result in qualitatively and quantitatively different degrees of improvement. The purpose of this study is to determine whether or not the clinical course, improvement slope, and reduction of medication observed in PD patients who undergo tissue transplantation (Tx) depend on the donor tissue type. In a pilot study, four grade IV-V PD patients received implants of precoincubated autologous AM and intercostal nerve in the caudate nucleus (open surgery). Clinical assessment was based on international scales (UPD) as reported for Tx of FVM and perfused AM. There were no systemic or neurologic complications. Four years post-Tx, longer On phases and improved PD symptoms (ADL and motor-UPD) in On and Off persist in four cases, with reduced dyskinesias. Progress appears to be stepwise, starting within weeks of Tx (similar to AM and sooner than our FVM implants), followed by a period of stability and, after a second wave of improvement 12-18 months post-Tx (similar to FVM implants), continues to date. L-dopa medication has been reduced by more than 60% and dopamine agonist use has not resumed. We conclude that our recipients continue to be clinically better than prior to Tx. The course of recovery after co-Tx of AM and PN differs from that of FVM or AM implants. This fact may be related to the etiological factors that produce the improvement.

Adrenal Medulla↗
PubMed1991

Grafting of perfused adrenal medullary tissue into the caudate nucleus of patients with Parkinson's disease. Clinica Puerta de Hierro Neural Transplantation Group.

The authors report results obtained in 20 severely affected patients with Parkinson's disease (Grade IV or V) who received an autotransplant of perfused adrenal medullary tissue. This study seems to indicate that these autoimplants can improve the parkinsonian symptomatology and induce amelioration in the patients' performance of routine activities. All the symptoms analyzed showed improvement, although it differed in intensity and time of onset. Moreover, this improvement was accompanied by a reduction in the daily intake of L-dopa, with discontinuance of dopamine agonists and amantadine. A number of medical complications were encountered, including three deaths, probably related to performing abdominal surgery in seriously affected parkinsonian patients who were unable to tolerate the discontinuance of their medication. The transient psychiatric disorders observed appeared to be related to the postoperative dose of L-dopa and/or anticholinergic agents administered, and diminished or disappeared when the doses were reduced. The reasons for improvement, which was bilateral, remain unknown, although one cause may be the surgical trauma (minicaudotomy) together with the implantation of adrenal medullary tissue, which may promote the sprouting of surviving dopaminergic fibers. Moreover, in this series, perfusion of adrenal medulla increased the capacity for revascularization of the tissue and may have reduced the damaging effects of warm ischemia on the cells. This, together with the existence of fenestrated vessels, could hypothetically have served as an access point for drugs, and if the implanted cells were viable, they might have served to store and manufacture different factors and/or transmitters. These results as well as those of other groups justify the development of a controlled international clinical trial.

Adrenal Medulla↗
PubMed1989

Preparation of adrenal medullary tissue for transplantation in Parkinson's disease: a new procedure. Technical note.

The authors describe a technique by which adrenal medullary tissue can be easily dissected from the adrenal cortex. The method involves perfusion with Locke's modified buffer, dissection of adrenal gland in buffer free of calcium or magnesium, and storage in a culture medium before implantation into the caudate nucleus of patients with Parkinson's disease. This method seems to increase the viability and purity of adrenal medullary tissue. The results obtained in 15 parkinsonian patients implanted with perfused adrenal medulla indicate the potential value of this technique.

Adrenal Medulla↗
PubMed1988

Atypical hepatic tuberculosis presenting as obstructive jaundice.

A 78-yr-old female with a short history of malaise, anorexia, mild pyrexia, and obstructive jaundice is presented. A diagnosis of tuberculosis of the liver and gallbladder was established at laparotomy. In spite of anti-tuberculous therapy, the patient died on the 5th postoperative day. Widespread miliary tuberculosis affecting the lung, kidneys, spleen, and mesenteric lymph nodes was observed in postmortem studies, with strikingly severe involvement of the intrahepatic bile ducts. Saccular dilatation of the bile ducts alternating with areas of stenosis and narrowed intrahepatic bile ducts was seen. A correlation of the radiological and hepatic postmortem findings is discussed. The atypical presentation of tuberculosis in present times and the causes of jaundice in atypical cases of hepatic tuberculosis are discussed. The rarity of gallbladder tuberculosis is pointed out.

Aged↗
PubMed1985

Another test of the effect of group composition on member behavior change.

Three-person groups (N = 24) dedicated to addressing assertion deficits common to their (female) members were so composed that one member (a confederate) consistently enacted one of four prescribed conditions: (1) personal warmth/success in changing; (2) personal warmth/failure to change; (3) lack of warmth/success in changing; and (4) lack of warmth/failure to change. Both confederate warmth and success modeling influenced the level of assertion change behavior reported by group members. These results confirm propositions based on clinical observations that therapeutic groups benefit measurably by the presence of one or more "warmth generators" and "success models." The results also suggest that while group members are influenced to effect change by success modeling, they tend to attribute this influence to confederate warmth. In addition, they tend to attribute success in changing to warm persons and failure to change to persons who are lacking in warmth.

Affect↗
PubMed1982

Alleviation of diabetic microangiopathy in rats by pancreatic islet cell transplantation.

Diabetes was induced in female WAG rats by an injection of streptozotocin. The resultant diabetic microangiopathy was studied in the kidney and other organs and the effectiveness of pancreatic islet cell transplantation in preventing and reversing the microvascular complications was assessed. It was found that intraportal transplants of more than 1000 islets produced metabolic normality in most animals and successful transplants prevented the development of diabetic microangiopathy. Very early lesions could be completely restored to normal. The findings strongly support the necessity of good metabolic control of human diabetic patients to prevent microangiopathic damage.

Animals↗
PubMed1981

Liver tumours following streptozotocin administration in rats and the effects of pancreatic islet cell transplantation.

The effects of a single injection of streptozotocin, at a dosage of 50 mg/kg body weight, have been studied in female inbred WAG rats. The resultant diabetes in the streptozotocin treated animals was treated in one group of animals by an intraportal pancreatic islet cell transplantation whilst another group received no transplant or insulin treatment. The incidence of tumours were determined at autopsy in animals sacrificed at regular intervals. Tumours, apart from one renal adenocarcinoma, were seen only in the liver and only in streptozotocin treated animals. Liver nodules and cysts were most common in animals which had received both streptozotocin and an islet cell transplant.

Adenocarcinoma↗
PubMed1979

Feminizing adrenocortical carcinoma in a postmenopausal woman.

The successful surgical removal of a feminizing adrenal tumour in a postmenopausal woman is described. Most of these tumours are malignant and the pathological findings and the biological behaviour of the tumour frequently do not correlate, so that a careful follow-up is necessary. In the presence of vaginal bleeding in a postmenopausal woman endometrial carcinoma should be considered. If this has been ruled out and if oestrogens are elevated with low plasma gonadotrophins, a feminizing ovarian or adrenal tumour should be considered.

Adrenal Cortex Neoplasms↗