Metabolic effects of liver replacement in homozygous familial hypercholesterolemia.
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Biomedical subjects
Publications and source records attributed to J Ardaiz.
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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.
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Two cases of adrenal pseudocysts are presented, one secondary to the necrosis of an adenoma and the other a hemorrhagic pseudocyst. The diagnosis of these tumors is usually made radiologically owing to the vagueness of symptoms and nonexistent specific laboratory examinations, so that preoperative diagnosis is uncommon. We present a radiologic technique, intravenous viscerogram, which may be useful in the diagnosis of adrenal cysts. This procedure is easy to carry out and has almost no complications for the patient. The classification, clinical findings, and surgical treatment of adrenal cysts are discussed.
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A 12-year-old child with terminal ischemic heart disease as a result of homozygotous familial type IIa hypercholesterolemia received an orthotopic heart transplant and, 21 days later, an orthotopic liver transplant. Six months after heart transplantation, the patient is asymptomatic and evidences normal liver function and cholesterol levels; there are no signs of heart rejection. To our knowledge, this is the first instance of two-step heart-liver transplantation with organs from different donors.