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Biomedical subjects

J L Rodriguez

Publications and source records attributed to J L Rodriguez.

At least 127 records · Page 7Linked to original sources
PubMed1986

Coincident multiple myeloma and non-Hodgkin's lymphoma with 2 serum monoclonal immunoglobulins.

A case with features of both multiple myeloma and non-Hodgkin's lymphoma at the moment of diagnosis is presented. The patient had lytic bone lesions and biclonal gammopathy, IgM kappa and IgA kappa. In the bone marrow biopsy, there was a diffuse infiltration by atypical plasma cells coexisting with an interstitial and nodular infiltration by poorly differentiated lymphoid cells. Immunofluorescence studies showed positive staining with alpha and kappa antisera in the cytoplasm of plasma cells and with mu and kappa antisera on the surface of lymphoid cells. After the beginning of chemotherapy, the IgA kappa monoclonal protein disappeared and the IgM kappa monoclonal protein remained constant.

Aged↗
PubMed1986

Pneumocystis carinii pneumonia presenting as cavitating and noncavitating solitary pulmonary nodules in patients with the acquired immunodeficiency syndrome.

Among 150 cases of microscopically proved Pneumocystis carinii pneumonia secondary to the acquired immunodeficiency syndrome (AIDS) seen by our pulmonary service from January 1982 to January 1986, P. carinii presented roentgenographically as a solitary pulmonary nodule in 2 patients (1.3%). It was the sole cause of the nodules as determined by clinical and roentgenographic response to specific drug therapy, examination of specimens obtained at fiberoptic bronchoscopy, and examination of lung specimens obtained at autopsy. In one of the patients, the nodule appeared to develop a large central cavity, which was confirmed at autopsy. In patients with AIDS, a solitary pulmonary nodule with or without cavitation may rarely represent P. carinii pneumonia.

Acquired Immunodeficiency Syndrome↗
PubMed1986

Pulmonary nocardiosis in the acquired immunodeficiency syndrome. Diagnosis with bronchoalveolar lavage and treatment with non-sulphur containing drugs.

A patient with the acquired immunodeficiency syndrome (AIDS) presented with Pneumocystis carinii pneumonia and pulmonary nocardiosis. The nocardial lesions appeared small and localized on chest radiograph. On two separate occasions, nocardial organisms were absent in transbronchial lung biopsy specimens, but were identified in bronchoalveolar lavage fluid probably because the latter specimen sampled a larger area of lung. The patient was initially treated with trimethoprim-sulfamethoxazole (TMP/SMX) for both infections. When TMP/SMX was discontinued because of an adverse reaction, the nocardiosis promptly exacerbated but was then easily controlled with minocycline and amikacin followed by minocycline and cycloserine. Among patients with AIDS who have sulfamethoxazole hypersensitivity during treatment for nocardiosis, alternative drugs may be efficacious and may be particularly important in this setting because they have a lower incidence of toxicity.

Acquired Immunodeficiency Syndrome↗
PubMed1986

[Malignant melanoma of the penis associated with other types of melanosis. Apropos of an isolated case].

A patient with malignant melanoma of penis also presented a blue nevus, urethral melanosis and zones of malignant lentigo. The patient had a history of melanic lesions since infancy and initial symptoms had developed two months before attending for consultation. This isolated case involved fairly atypical melanic lesions in the urogenital tract. Strict surveillance of patients with mucosal melanic lesions is essential when confronted with any suspicious variation noted clinically.

Aged↗
PubMed1985

Ventilatory and metabolic effects of glucose infusions.

It has been demonstrated that total parenteral nutrition (TPN) results in increased O2 consumption (VO2), CO2 production (VCO2) and minute ventilation (VE). TPN consists of a mixture of glucose and amino acids. The individual role of each of these nutrients in mediating these changes has not been well established. To examine the effects of the individual nutrients, continuous infusions of glucose in hypo- and hypercaloric amounts were given to four normal volunteer subjects and four acutely ill patients for a six-day period, with three days on each dietary intake. After each three-day period, gas exchange, VO2, VCO2, and ventilatory variables (VE), tidal volume (VT), frequency (f), mean inspiratory flow (VT/TI), inspiratory time (TI) and expiratory time (TE) were measured. With the high carbohydrate diet, CO2 production increased 18 percent (p greater than .05) and 7 percent (p greater than .05) in the normal subjects and the patients, respectively. VO2 did not change, while the RQ rose. VE rose in parallel with VCO2, with no significant change in ventilatory sensitivity to CO2. In light of previous observations, these results suggest that during administration of TPN, the protein component plays a major role in the observed ventilatory changes: a) by bringing about a rise in VO2, which acts to magnify the effect of an increased RQ on VCO2, and b) by increasing ventilatory sensitivity to CO2.

Adult↗
PubMed1983

Morphine and postoperative rewarming in critically ill patients.

Morphine sulfate (MSO4) has been demonstrated to attenuate the stress response. MSO4 might be useful in minimizing the stress associated with the perioperative period, particularly that due to awakening from anesthesia and rewarming. Two groups of critically ill patients who developed hypothermia (35.8 degrees C) during a surgical procedure were studied. The control group was observed during routine medical management. Group II received 1 or 4 mg/kg MSO4 followed by an infusion of 0.2 or 0.5 mg/kg/hr. During the postoperative rewarming period the control group patients demonstrated a major increase in metabolic demand and myocardial work. In group II patients the infusion of MSO4 resulted in a lower metabolic rate. This was associated with a significantly longer rewarming time and a significant reduction in shivering, heat loss, heart rate, mean arterial pressure, and rate-pressure product. Infusion of MSO4 in critically ill patients during the perioperative period suppressed metabolic demands and myocardial work while preserving cardiovascular function.

Aged↗
PubMed1983

The isolated C3 in the 'vascular pole' in patients with primary haematuria.

Among sixty-four patients with primary haematuria, immunofluorescence methods revealed seven cases (11%) with isolated C3 deposits in the 'vascular pole'. Serum complement were normal and the follow-up after 20-41 months indicate a benign course. In patients with C3 deposits in the 'vascular pole' light microscopy was normal. We never observed C3 deposits in specimens of normal kidney which were processed by the same methods using mono-specific antisera confirmed by immunoelectrophoresis. This entity defined by immunofluorescence methods, can be called 'vascular pole disease'.

Adolescent↗
PubMed1983

[Isolated hematurias: histologic and immunologic study].

An immunologic study and a renal biopsy were performed in 64 patients with isolated hematuria. Fifty of them had macroscopic hematuria and 14 microscopic hematuria. The kidney was normal in 66% by light microscopy; in the remaining 34% glomerular lesions were moderate: thickening of the mesangial matrix, diffuse or segmentary mesangial proliferation. Four patterns were observed by immunofluorescence: C3 located either in the mesangium, or at the level of the vascular pole, mesangial IgA, mesangial IgM and lack of deposits. According to our experience IgA nephropathy presenting as isolated hematuria has a better prognosis than the other symptomatic forms of this glomerulonephritis. No patient with the other renal pathological changes so far developed hypertension or renal failure. We prefer to perform biopsies on patients with isolated hematuria, considering the frequency of IgA nephropathy and the possibility of finding mesangial deposits of IgM and C3 whose significance is so far poorly known.

Adolescent↗
PubMed1983

Physiologic requirements during rewarming: suppression of the shivering response.

Intraoperative hypothermia has become a common occurrence. Postoperative rewarming often is accompanied by shivering and results in increased metabolic and circulatory demands. We examined the metabolic, hemodynamic, and biochemical variables in 2 groups of hypothermic (greater than 35.8 degrees C) patients requiring mechanical ventilation after a major operation. One was observed during routine medical management whereas the other group received 40 mg of metocurine iodide and then observed during routine medical management. All patients were allowed to rewarm passively. O2 consumption (VO2, ml/min, STPD), CO2 production (VCO2, ml/min, STPD) and respiratory quotient (RQ) measurements were made every 15 min using a Beckman Metabolic Measurement Cart. Esophageal temperature, arterial blood pressure, heart rate (HR), rate pressure product, CVP, arterial blood gases, serum lactate concentration, and duration of shivering also were recorded. Suppression of the shivering by metocurine increased rewarming time significantly and decreased VCO2, VO2, HR, rate pressure product, mean arterial pressure (MAP), and the O2 cost of rewarming. Thus, the elimination of shivering during postoperative rewarming is associated with a decrease in caloric, metabolic demands and myocardial work (as assessed by the rate pressure product) while rewarming time is prolonged. In the postoperative, hypothermic, critically ill patient, suppression of the shivering response in selected patients may be indicated.

Adult↗
PubMed1982

Oral rehydration therapy of infantile diarrhea: a controlled study of well-nourished children hospitalized in the United States and Panama.

Although oral glucose-electrolyte solutions containing 90 mmol of sodium per liter have been widely used in the treatment of acute diarrhea among under-nourished children in the developing world, they have rarely been studied in well-nourished children. We therefore conducted a controlled randomized study among well-nourished children three months to two years who were hospitalized with acute diarrhea (52 in the United States, and 94 in Panama), to compare the efficacy of this solution with that of one containing 50 mmol of sodium per liter and with standard intravenous therapy. Oral rehydration with both solutions according to protocol was successful in 97 of 98 children (one required unscheduled intravenous therapy), and in 87 (89 per cent) no intravenous therapy was required. All of six children admitted with hypernatremia were successfully treated with oral therapy alone. We conclude that glucose-electrolyte oral solutions containing either 50 or 90 mmol of sodium per liter are effective and safe in the treatment of well-nourished children hospitalized with acute diarrhea, and that they may completely replace the intravenous fluids in the majority of such children.

Child, Preschool↗
PubMedDate not supplied

Very low density lipoproteins in normal and cholesterol-fed rabbits: lipid and protein composition and metabolism. Part 1. Chemical composition of very low density lipoproteins in rabbits.

The lipid and apoprotein composition of very low density lipoproteins (VLDL) (d less than 1.019 g/ml) from normal and hypercholesteremic (h.c.) rabbits are compared. Significant changes are observed in the apoproteins, as well as in the fatty acid composition of cholesterol esters, and in the relative distribution of phospholipids. Apoproteins show a marked increase of peptides with slow mobility (R2 and R3), corresponding to arginine-rich proteins, both in the rabbit and in some types of human hyperlipoproteinemias (hypothyroidism and Fredrickson Type III). VLDL were separated into the two fractions, VLDL-1 and VLDL-2. Peptides of slow mobility were shown to be present in a higher concentration in VLDL-1. Cholesterol esters of h.c. VLDL have a very high content of oleic acid, the 18:1/18:2 ratio being about three times higher than in normal VLDL. Phospholipid distribution in h.c. VLDL is characterized by an increase of sphingomyelin and decrease of phosphatidylethanolamine. The PC/Sph ratio is about one fifth that of normal. These changes in VLDL lipids are very similar to those occurring in the lipid composition of the atherosclerotic plaques in mammals.

Animals↗
PubMedDate not supplied

Very low density lipoproteins in normal and cholesterol-fed rabbits: lipid and protein composition and metabolism. Part 2. Metabolism of very low density lipoproteins in rabbits.

The metabolic fate of very low density lipoproteins (VLDL) in normal and hypercholesteremic (h.c.) rabbits has been investigated. VLDL were labelled with 125I in the protein moieties and injected into normal and h.c. animals. The turnover of h.c. VLDL is markedly delayed as compared to that of normal VLDL, and conversion into lipoprotein classes of higher density is considerably decreased. This is observed when h.c. VLDL are injected either into h.c., or into normal rabbits. Arterial uptake of radioactivity is much higher with h.c. VLDL than with the normal lipoproteins, and it is highest when h.c. VLDL are injected into normal recipients. These data, together with those reported in the previous study, support the hypothesis that h.c. VLDL have an inherent atherogenicity. Injection of h.c. VLDL into normal animals also offers an experimental model for testing drugs or diets against atherosclerosis, using untreated animals.

Animals↗
PubMedDate not supplied

Poly(ethylene glycol)-doxorubicin conjugates containing beta-lactamase-sensitive linkers.

7-Aminocephalosporin doxorubicin (AC-Dox) was condensed with monomethoxypoly(ethylene glycol)-propionic acid N-hydroxysuccinimide ester (5 kDa) or with a branched form of poly(ethylene glycol)-propionic acid N-hydroxysuccinimide ester (10 kDa), forming M-PEG-AC-Dox and B-PEG-AC-Dox, respectively. These polymer drug derivatives were designed such that doxorubicin would be released upon Enterobacter cloacae beta-lactamase (bL)-catalyzed hydrolysis. Both M-PEG-AC-Dox (IC50 = 80 microM) and B-PEG-AC-Dox (IC50 = 8 microM) were less toxic to H2981 human lung adenocarcinoma cells than doxorubicin (IC50 = 0.1-0.2 microM) and could be activated in an immunologically specific manner by L6-bL, a monoclonal antibody-bL conjugate that bound to H2981 cell surface antigens. In addition, the polymers were relatively stable in mouse plasma (< 26% hydrolysis after 24 h at 37 degrees C) and were less toxic to mice (maximum tolerated dose > 52 mumol/kg) than doxorubicin (maximum tolerated dose = 13.8 mumol/kg). Pharmacokientic studies were performed in mice bearing subcutaneous 3677 melanoma tumors. B-PEG-AC-Dox cleared from the blood more slowly than M-PEG-AC-Dox and was retained to a 2.1-fold greater extent in human 3677 melanoma tumor xenografts over a 4 h period. The intratumoral concentrations of both polymers far exceeded that of doxorubicin. Thus, the PEG-AC-Dox polymers offer the possibility of generating large intratumoral doxorubicin concentrations owing to their reduced toxicities, the amounts that accumulate in tumors, and the fact that doxorubicin is released upon beta-lactam ring hydrolysis.

Adenocarcinoma↗
PubMedDate not supplied

Hypertrophic scar fibroblasts accelerate collagen gel contraction.

Excessive contraction of hypertrophic scar and subsequent contracture formation are a formidable problem after thermal injury. A comparison between fibroblasts from hypertrophic scar and normal skin was made with the use of fibroblast-populated collagen lattices as a measure of cellular generated contractile forces. Hypertrophic scar and normal skin fibroblasts were mixed with soluble tendon collagen and Dulbecco's modified Eagle medium supplemented with 10% serum, and contraction was measured by serial area measurements. Parallel experiments in the presence of transforming growth factor-beta or anti-transforming growth factor-beta antibody examined the role of this cytokine on lattice contraction. Transforming growth factor-beta activity was measured in an additional set of 10 biopsy specimens. Hypertrophic scar fibroblasts contract lattices at a significantly faster rate than do normal skin fibroblasts. Exogenous transforming growth factor-beta increased lattice contraction by normal skin fibroblasts but had little effect on hypertrophic scar cell-populated lattices. The addition of anti-transforming growth factor-beta antibody decreased lattice contraction by both cell types. Transforming growth factor-beta activity was significantly increased in the hypertrophic scar biopsy specimens. Excessive scar contraction and post-burn scar contracture result from increased contraction forces generated by hypertrophic scar cells. This increased contractility appears to be mediated by increased endogenous presence of transforming growth factor-beta.

Journal Article↗
PubMedDate not supplied

The effects of burn blister fluid on keratinocyte replication and differentiation.

The optimal clinical care of burn blisters has not been determined. The effects of burn blister fluid and control serum on epidermal cell proliferation and differentiation were determined. Both burn blister fluid and serum decreased the cell responses necessary for healing of the burn wound by approximately 40%. The degree of suppression varied from 81% to 28% dependency on the specific burn blister fluid and cell tested. These data suggest that reepithelialization may be inhibited beneath burn blisters. We conclude that in most cases burn blisters should be debrided.

Adult↗