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Biomedical subjects

J L Ponce

Publications and source records attributed to J L Ponce.

12 recordsLinked to original sources
PubMed2001

Solitary adrenal gland metastasis of a follicular thyroid carcinoma presenting with hyperthyroidism.

Follicular thyroid carcinoma typically manifests under euthyroid conditions, and diagnostic scintigraphy usually identifies a cold nodule. Sometimes, such tumors can appear in the context of hyperthyroidism, which can be caused by a toxic multinodular goitre, a toxic adenoma, or even carcinoma. We report a case of follicular thyroid carcinoma discovered after surgical treatment of a toxic multinodular goiter, in which solitary adrenal gland metastasis was detected five years later. A (131)I whole body scan is the diagnostic method of choice for functioning thyroid metastasis.

Adenocarcinoma, Follicular↗
PubMed2000

Small bowel motility: relationship between smooth muscle contraction and electroenterogram signal.

A study is made to correlate the electrical and mechanical activity of the smooth muscle of the small bowel. Bioelectrical signal recording from the intestinal serosa (electroenterogram) comprises a slow wave (SW) and spike burst (SB), though only the latter reflects intestinal pressure. The electroenterogram and smooth muscle pressure are simultaneously recorded in the canine small bowel. Spectral and time series analysis of the electroenterogram are performed to establish those electrical parameters that best reflect intestinal pressure. The results reveal an underlying correlation between the estimated parameters of electrical activity and smooth muscle pressure. In addition, parameters derived from the spectral techniques were closely correlated to pressure events in the intestine, even more so than the variables directly acquired from the classical time domain analyses. Specifically, spectral energy above 2 Hz and mean frequency (both calculated from the biosignal periodogram), are parameters that identify intestinal pressure. The extrapolation of these spectral parameters to long time periods could serve to define a motility index (MI) from electrical gut activity. In this context, electroenterogram recording and analysis can contribute to solve problems inherent to manometric recording, though the need for surgical intervention restricts electrical methods to experimental or surgical studies.

Animals↗
PubMed1999

[Multiple endocrine neoplasia type 1: genetic study of a large family].

Multiple endocrine neoplasia syndrome type 1 (MEN-1) is an inherited disorder characterised by the predisposition of the cells from parathyroid glands, endocrine pancreas and adenohypophysis to develop neoplasms. We report the genetic study of an extended family with at least 8 affected patients and 10 putative carriers of a mutation in MEN-1 gene. One intragenic (Asp418 GAC-->GAT), and five flanking markers were characterised in the family by PCR amplification and polyachrylamide gel electrophoresis. Association of the disease to MEN-1 gene was confirmed for this family: all the affected members show a haplotype in common. Three patients at risk were diagnosed as non-carriers, since they have not inherited that haplotype. The remaining seven members, presymptomatic carriers, are included in a follow-up protocol. The genetic study of families segregating MEN-1 syndrome are useful in avoiding indiscriminate follow-up determinations to those members who have not received the genetic predisposition to develop any of the manifestations of the syndrome. Segregation analysis with linked markers is useful, under certain circumstances, to perform such type of studies.

Biomarkers, Tumor↗
PubMed1999

The importance of a tumor capsule in columnar cell thyroid carcinoma: a report of two cases and review of the literature.

Two cases of papillary columnar cell thyroid carcinoma are presented. A 49-year-old man presented with lymph node and pulmonary metastases at diagnosis; a 51-year-old woman developed local recurrence and lung and bone metastases 3 years postsurgery. Death occurred after 52 and 57 months, respectively. The first case lacked a tumor capsule, although the second exhibited capsule remains with extensive tumor cell infiltration. A review is made of all similar cases reported to date in the literature, placing emphasis on the epidemiological and prognostic differences observed in terms of circumscribed or noncircumscribed tumor. The presence of a capsule was associated with a higher frequency of female patients and a favorable prognosis. In contrast, tumors profusely infiltrating the thyroid parenchyma or extrathyroid tissues in the absence of a capsule, found in similar proportion of men and women had a fatal prognosis.

Carcinoma, Papillary↗
PubMed1998

Prevention of postoperative pulmonary complications through respiratory rehabilitation: a controlled clinical study.

OBJECTIVE: To investigate the efficacy of respiratory rehabilitation in preventing postoperative pulmonary complications (PPC) and to define which patients can benefit. DESIGN: A randomized clinical trial. SETTING: A public hospital. PATIENTS: Eighty-one patients who had upper abdominal surgery were distributed into two homogeneous groups: control (n = 41) and rehabilitation (n = 40). INTERVENTION: Breathing exercises in the rehabilitation group. MAIN OUTCOME MEASURES: Preoperative and postoperative clinical evaluation, spirometry, arterial gasometry, and simple chest X-rays. RESULTS: The incidence of PPC was 7.5% in the rehabilitation group and 19.5% in the control group; the control group also had more radiologic alterations (p = .01). Stratified PPC analysis did not reveal significant differences between groups. However, high- and moderate-risk patients in the rehabilitation group had fewer PPC. Multivariate analysis showed a greater PPC risk associated with pulmonary history (p = .02) and duration of surgery longer than 120 min (p = .03), while rehabilitation exerted a protective effect (p = .06). Significant postoperative decreases in pulmonary volumes and arterial gas values were recorded in both groups, without significant differences. CONCLUSIONS: Respiratory rehabilitation protects against PPC and is more effective in moderate- and high-risk patients, but does not affect surgery-induced functional alterations.

Adolescent↗
PubMed1998

Pulmonary function and complications after laparoscopic cholecystectomy.

OBJECTIVE: To investigate the impairment of pulmonary function and complications after laparoscopic compared with open cholecystectomy through an upper midline incision. DESIGN: Prospective randomised trial. SETTING: Teaching hospital, Spain. SUBJECTS: 40 patients, 20 in each group. INTERVENTIONS: Clinical examination, spirometry, arterial blood gas analysis, and chest radiographs before and after operation. RESULTS: 48 hours postoperatively FVC and FEV1 had decreased to 56.7% and 53%, respectively, in the patients who had had open cholecystectomy, compared with 85.3% and 84.8% in the laparoscopic group (p < 0.0001). The mean (SD) postoperative percentage reductions in both PaO2 (86.1 (11.1) compared with 98.3 (11.3)) and SatO2 (98.6 (1.3) compared with 100 (1.5)) were also greater in the open group (p < 0.005 in both cases). CONCLUSIONS: Laparoscopic cholecystectomy causes less impairment of lung function than cholecystectomy through an upper midline incision.

Cholecystectomy↗
PubMed1995

[Digestive hemorrhage and hemoperitoneum as complications of visceral aneurysms].

Two cases of visceral aneurysm are reported, one of the splenic artery and another of the gastroepiploic artery. The reason for the publication is the rarity, especially of aneurysms of the gastroepiploic artery, and because of the unusual presentations as upper gastrointestinal hemorrhage and hemoperitoneum respectively. The splenic artery aneurysm was diagnosed by CAT scan and the gastroepiploic one during emergency laparotomy because of the hemodynamic disturbance.

Aged↗
PubMed1992

[Multiple endocrine neoplasia II A syndrome: relationship between age of the patient, levels of basal calcitonin and size of the thyroid tumor].

This paper presents our experience in four families having the multiple endocrine neoplasia (MEN) II-A syndrome, with a total of 19 affected patients. All had medullary thyroid carcinoma (MTC), 6 also had pheochromocytoma (PH) and 3 had hyperparathyroidism. The screening of the members of the families to measure basal and pentagastrin response calcitonin (CT) serum levels allowed an early diagnosis of medullary thyroid carcinoma, when lesions were only 1 mm in diameter. Measurement of vanillymandelic acid, catecholamines and metanephrines in 24-hour urine collections allowed the diagnosis of pheochromocytoma in patients, some of whom were asymptomatic. A clear relationship was found between the age of the patients, the basal serum calcitonin level and size of the MTC.

Adolescent↗
PubMed1990

Changes in small intestinal motility in acute physical stress--an experimental study.

The objectives of the present study were: 1) to describe the modifications in motility of the small intestine in response to situations of acute physical stress during fasting and post-prandial periods. 2) To analyse the possible involvement of the adrenergic and beta-endorphinergic systems in these modifications. For this we used a total of 60 dogs. The motility of the small intestine was recorded using electromyography techniques (monopolar electrodes) and manometric techniques (submucous microballoons). Plasma levels of beta-endorphin and catecholamines were determined before and after the stimulus. We show that physical stress applied in phases I or II of the fasting period induced a significant increase in the percentage of slow waves followed by the action potential for 1 minute in the three locations of the intestine studied (duodenum, angle of Treitz and proximal part of the jejunum), lasting from 8 to 12 minutes (p less than 0.001). When it is applied during the early post-prandial period it is responsible for a significant decrease in the percentage of slow waves followed by the action potential for 1 minute for a period of 6 to 11 minutes (p less than 0.001). The administration of adrenergic blockers prevents the effect of hypomotility caused by acute physical stress (p less than 0.001), whereas the administration of naloxone favors this hypomotility effect (p less than 0.001). Acute physical stress, on being applied during the late post-prandial period increases the percentage of slow waves followed by the action potential for 1 minute for a period of 8 minutes (p less than 0.001).(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMed1981

Persistent Müllerian structures in a genotypic male.

A case report of a male with persistent Müllerian structures is presented. The patient was 34 yr old and had a left inguinal hernia, bilateral cryptorchidism and azoospermia. His karyotype was 46 XY. At operation a uterus with vestigial Fallopian tubes and a hypoplastic testis were found inside the hernial sac. Histological studies confirmed the persistence of Müllerian structures. The clinical implications of anti-Müllerian hormone dysfunction are discussed.

Adult↗