Biomedical subjects

J C Gonzalez-Vitale

Publications and source records attributed to J C Gonzalez-Vitale.

11 recordsLinked to original sources

PubMed1985

Extrapulmonary silicosis: a clinical, morphologic, and ultrastructural study.

A variety of silicotic lesions derived from thoracic silicosis via lymphohematogenous spread to the liver, spleen, bone marrow, and extrathoracic lymph nodes are described. The morphologic features of these lesions depend on the extent of macrophage aggregation, the occurrence of fibrogenesis, and the development of necrosis and degradative changes in macrophages and adjacent extracellular matrix, presumably caused by lysosomal enzymes released from macrophages. Ultrastructurally, the degenerative alterations of matrix material include longitudinal splitting and breakage of collagen fibrils into segments one and three quarters the length of the original fibrils and deposition of flocculent electron-dense material either focally or diffusely around collagen fibrils. The corresponding changes viewed light microscopically are those of fibrinoid necrosis. The sclerohyaline nodule, the characteristic lesion of silicosis, includes all of these features as it evolves through nodular histiocytic and subsequent fibrohistiocytic phases. Its ultimate morphology appears to be determined by the reassembly of the degraded matrix into non-native, fibrous long-spacing collagen via a spiny collagen intermediary. The sclerohyaline nodule occurs infrequently in the spleen and liver, although less typical lesions caused by silica alone or admixed with other dusts seem to occur more commonly in these organs. These lesions appeared as loose or nodular histiocytic or fibrohistiocytic aggregates. Nonspecific fibrous nodules or more extensive fibrosis, as seen in portal triads, may represent advanced stages of such lesions. Acute or healed focal segmental glomerulonephritis occurred in 40 per cent of the cases, suggesting that it may be an important remote effect of silicosis. Continuous destruction of lymphocytes adjacent to silicotic nodules may be an antigenic source of the high concentration of autoimmune reactants described in silicosis.

Adult↗

PubMed1982

Immunoblastic lymphoma of small intestine complicating late-onset immunodeficiency.

A malignant lymphoma of the small bowel developed in a 75-year-old woman who had severe late-onset hypogammaglobulinemia with intestinal malabsorption and nodular lymphoid hyperplasia. The tumor arose in the midst of the abnormal lymphoid follicles and appeared to be of B-immunoblastic type. Immunoperoxidase staining, however, failed to reveal immunoglobulins in the tumor cells. In vitro immunologic studies showed that immunoglobulin production by the patient's peripheral lymphocytes had decreased and that this decrease was mediated by hydrocortisone-sensitive suppressor cells. These findings suggest that nodular lymphoid hyperplasia of the intestine in the context of severe immunodeficiency is a premalignant condition.

Agammaglobulinemia↗

PubMed1981

Steroid section patterns of a hilus cell tumor of the ovary.

Steroidogenic function of a locally invasive hilus cell tumor of the ovary was studied. Serum levels of testosterone, androstenedione, dihydrotestosterone, 17 alpha-hydroxyprogesterone, progesterone, and estradiol were measured in blood samples from the peripheral and the ovarian vein. The tumor was secreting all but estradiol. Concentrations of progesterone and 17 alpha-hydroxyprogesterone were greatly elevated. Testosterone and dihydrotestosterone were the predominant androgens secreted by the tumor. Estradiol concentrations were elevated but without a significant peripheral-ovarian gradient. Concentrations of all the steroids coming from the tumor were increased paradoxically in the peripheral circulation after administration of dexamethasone, and the tumor was responsive to stimulation by human chorionic gonadotropin.

Androstenedione↗

PubMed1978

Acute renal failure after cis-dichlorodiammineplatinum(II) and gentamicin-cephalothin therapies.

Combined gentamicin-cephalothin therapy in four patients after treatment with cis-dichlorodiammineplatinum(II) (CPDD) for advanced solid tumors was complicated by severe acute renal failure. The total dose of gentamicin varied from 240 to 945 mg and that of cephalothin varied from 28 to 48 g. Low-dose (0.5 mg/kg x 8) CPDD was given to one patient, high-dose (3 mg/kg) CPDD was given to two patients, and very high-dose (5 mg/kg) CPDD was given to one patient. The high and very high doses of CPDD were given with concomitant mannitol diuresis. CPDD therapy was complicated by mild transient azotemia in three patients and by severe acute renal failure in one. In the latter, the azotemia began to improve on Day 7 after CPDD treatment. Following gentamicin-cephalothin therapy, all patients developed severe acute renal failure which persisted until death. At autopsy, all patients had extensive renal tubular necrosis at various stages. These findings indicate that gentamicin-cephalothin therapy after treatment with CPDD can be severely nephrotoxic, and that this antibiotic combination should be given with great caution, if at all, to patients receiving CPDD treatment for malignancy.

Acute Kidney Injury↗

PubMed1976

Meningeal carcinomatosis.

An anatomopathologic study of 18 cases of pure meningeal carcinomatosis is presented. In five of these cases, the brain, spinal cord, choroid plexuses, cerebral vessels, and prevertebral soft tissues, including the lumbosacral nerve plexuses and ganglia, were examined microscopically in an attmept to determine the routes of tumor spread. Our results suggest that the malignant cells reach the cerebrospinal leptomeninges via perineural, endoneural, and perivascular lymphatics and sheaths through the intervertebral and possibly cranial foramina. Involvement of the choroid plexuses appears to be secondary to, rather than the avenue for, leptomeningeal carcinomatosis, with the tumor cells reaching the choroid plexuses via the perivascular sheaths of choroidal vessels. Leptomeningeal carcinomatosis was the only manifestation of metastatic spread beyond regional lymph nodes in about 40% of all reported cases in which this information is available. This implies that radiation or other forms of local therapy to the cerebrospinal leptomeninges may provide an effective means of palliation in many of these cases.

Adult↗

PubMed1976

Radiation-induced intracranial malignant fibrous histiocytoma.

An autopsy case of radiation-induced intracranial malignant fibrous histiocytoma (fibroxanthosarcoma) is reported. The tumor developed in the region of the sella turcica 11 years after high dose radiotherapy of a chromophobe adenoma of the pituitary. The tumor had infiltrated the base of the brain as well as the base of the skull. Metastases were not found. The tumor was composed of an admixture of bizarre fibroblasts, histiocytes and giant cells, xanthoma cells and siderophages, with a storiform fibrous stroma. This appears to be the first documented instance of a malignant fibrous histiocytoma occurring intracranially after local x-irradiation.

Adenoma, Chromophobe↗

PubMed1976

Pulmonary tumor emboli and cor pulmonale in primary carcinoma of the lung.

Tumor embolization was found at autopsy in the pulmonary arteries of 33 of 331 patients dying with primary carcinoma of the lung (other than oat cell carcinoma). Venous or lymphatic vascular involvement, or both, was greater frequency of tumor embolization htan epidermoid carcinomas (16.5% vs. 5.8%). In 16 of the 33 cases, diffuse, obliterative intimal fibrosis was found in small arteries affected by the tumor embolization. Enlargement of the right cardiac ventricle was present in 26 of the 33 cases. Dyspnea as the initial symptom or as one of the major symptoms, occurred in 21 patients. The average interval between onset of dyspnea and death was 4 weeks. It is concluded that pulmonary arterial embolization is a relatively frequent complication of primary lung carcinoma, particularly adenocarcinoma, which may lead to the developemnt of pulmonary hypertension and cor pulmonale Dyspnea, occurring de novo in patients with primary lung carcinoma is an ominous sign and should alert the clinician to the possibility of arterial pulmonary tumor embolization.

Adult↗

PubMed1976

Cis-dichlorodiammineplatinum(II) in advanced bladder cancer.

Cis-dichlorodiammineplatinum(II) (DDP) was given at a dose of 1.25 or 1.6 mg/kg to 24 patients with advanced measurable, urinary tract cancer. Eight patients (35%) achieved a partial remission and four additional patients had a minor response. There were 14 patients with epidermoid (transitional cell) bladder cancer who had had no prior chemotherapy and all eight partial responders were in this group. DDP appears to be one of the more active antineoplastic agents in bladder cancer.

Aged↗

PubMed1976

Segmental mediolytic arteritis: a clinical pathologic study.

A distinct arterial lesion was observed in the large abdominal muscular arteries in three autopsied patients. The salient histopathologic feature of this arterial lesion was either partial or total mediolysis. This was accompanied by a linear fibrin deposit between the media and adventitia and a variable nonpleomorphic inflammatory infiltrate. Total mediolysis led to the formation of arterial gaps. Disecting aneurysms frequently occurred and began either adjacent to arterial gaps or as a result of capillary hemorrhages in areas of partial mediolysis. Ruptured aneurysms led to massive intraabdominal hemorrhages. Arterial luminal occlusion, either by thrombi or dissection, resulted in ischemic bowel changes and renal infarcts. In addition, the arteries affected by mediolysis also showed medial degenerative changes, akin to cystic medial necrosis. Concomitant changes in the kidney showed mesangial hyperplasia; the heart exhibited histiocytic infiltrates and rare Aschoff-like bodies and capsular inflammation were seen in the spleen. The pathogenesis of the arterial lesions is unknown. A possible explanation is that this arteritis may have been induced by immune complexes and that local arterial medial degenerative changes predispose the involved arteries to immunologic injury.

Aged↗

PubMedDate not supplied

Polycystic liver disease: a study of cyst fluid constituents.

Cyst fluid from a patient with polycystic liver disease was obtained by needle aspiration using ultrasound guidance. The constituents of the fluid resembled the "bile salt-independent" fraction of human bile and supports the hypothesis that such cysts are lined by a functioning, secretory bile duct epithelium.

Amino Acids↗

PubMedDate not supplied

Atheromatous emboli to the lumbosacral spinal cord.

The lumbosacral spinal cords of 28 patients with atheromatous emboli to abdominal viscera and/or grafts to the abdominal aorta were examined by serial sections. In 12 patients, atheromatous emboli were found in spinal arteries, most commonly in the sacral cord, and most frequently in the anterior spinal artery. The general absence of spinal cord infarctions was attributed to the nature of the emboli, apparent good collateral circulation, and the absence of diffuse atherosclerosis. However, 38% of the patients had arteriosclerosis; this was generally focal and not associated with significant luminal narrowing. Only one patient had infarction, which was limited primarily to the gray matter. It would appear that hypoperfusion must exist in conjunction with atheromatous emboli in order for infarction to develop. Organized atheromatous emboli also caused focal ischemic atrophy of neurons. It is postulated that this change may be the morphological basis for some of the atypical lower motor neuron diseases found in the elderly.

Arteriosclerosis↗