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Jerónimo Forteza

Publications and source records attributed to Jerónimo Forteza.

15 recordsLinked to original sources
PubMed2006

Apical suction leads to severe ischemia of the ventricular apex.

OBJECTIVE: Apical suction devices allow displacement of the heart in off-pump coronary artery surgery. However, high vacuum pressure may injure the suctioned myocardium. It has been demonstrated that partial pressure of oxygen in the myocardium (ptiO(2)) is a sensitive and rapid indicator of myocardial ischemia. The purpose of this study is to evaluate the effect of apical suction on the ptiO(2) as an indirect measure of myocardial perfusion of the ventricular apex. METHODS: Twenty-six patients undergoing elective off-pump coronary surgery were studied. Intramyocardial ptiO(2) was continuously measured using a flexible catheter microprobe (Licox GMS mbH, Kiel, Germany). Patients were divided into two groups. In one group (Group A; n=14), the microprobe was intraoperatively inserted into the myocardium of the left ventricular apex. In the second group (Group B; n=12), the probe was inserted in the anterior wall of the left ventricle. Intramyocardial ptiO(2) monitoring was made with the heart in the resting position and after placing the apical suction device. RESULTS: In Group A, basal ptiO(2) was 15.3+/-7.4 mmHg. One minute after placing the apical suction device, the ptiO(2) significantly decreased to 2.3+/-1 mmHg (p<0.001). A progressive increase of ptiO(2) was observed immediately after the Xpose suction device was removed. ptiO(2) was 13.6+/-9.1 mmHg 5 min after releasing the suction cup and increased to 27.2+/-12.6 mmHg 20 min later. In Group B, basal ptiO(2) was 17+/-10.3 mmHg. No significant changes were observed in Group B after placing and removing the suction cup. CONCLUSIONS: Apical suction devices lead to severe ischemia of the suctioned myocardium. Collapse of coronary vessels due to vacuum pressure is a possible mechanism. Reperfusion occurs immediately after removing the suction cup and a significant reactive hyperemia is observed.

Aged↗
PubMed2006

Partial protection against collagen antibody-induced arthritis in PARP-1 deficient mice.

Poly(ADP-ribose) polymerase-1 (PARP-1) is a nuclear DNA-binding protein that participates in the regulation of DNA repair and maintenance of genomic integrity. In addition, PARP-1 has a role in several models of inflammation disease, where its absence or inactivation confers protection. The aim of this study was to analyze the impact of selective PARP-1 suppression in collagen antibody-induced arthritis. We show that PARP-1 deficiency partially reduces the severity of arthritis, although the incidence of disease was similar in control and deficient mice. Decreased clinical scores were accompanied by partial reduction of histopathological findings. Interestingly, quantitative real-time PCR and ELISA analysis revealed that the absence of PARP-1 down-regulated IL-1beta and monocyte chemotactic protein 1 expression in arthritic joints whereas tumor necrosis factor-alpha transcription was not impaired. Our results provide evidence of the contribution of PARP-1 to the progression of arthritis and identify this protein as a potential therapeutic target for the treatment of rheumatoid arthritis.

Animals↗
PubMed2005

Cyclooxygenase-2 in normal, hyperplastic and neoplastic follicular cells of the human thyroid gland.

This study was undertaken to investigate cyclooxygenase-2 (COX-2) expression in follicular cells of the human thyroid. COX-2 expression was studied immunohistochemically in a total of 174 samples. COX-2 immunoreactivity was confined to the cell cytoplasm with the nuclei remaining unlabelled. COX-2 expression was observed in five cases (17.2%) of normal follicular cells and in one case (16.6%) of solid cell nests. Follicular carcinoma expressed COX-2 more frequently than follicular adenoma (93.4% vs 21.1%) (p<or=0.001). A higher percentage of cases of papillary microcarcinomas up-regulated COX-2 in comparison with all papillary carcinomas (p<or=0.05). However, we could not establish any relationships among COX-2, patients' ages or lymph node metastases in papillary carcinomas. COX-2 expression was found in 12 (92.3%) poorly differentiated carcinomas and in 13 (92.8%) undifferentiated carcinomas. We found that COX-2 is not always useful as a marker of malignancy. Our results suggest that COX-2 plays a role in progression of all thyroid carcinomas, but in papillary carcinomas, seems more important only in the early stages. COX-2 expression in the undifferentiated carcinoma deserves special consideration due to its prognosis and to the fact that selective COX-2 inhibitors were found to enhance tumour response to radiation in some studies.

Adenoma↗
PubMed2004

Mesenchymal hamartoma of the liver; Clinicopathological, immunohistochemical and flow cytometric study of two cases.

Mesenchymal hamartoma (MH) is a rare liver lesion of infancy. Due to its rapid increase in size, it is often misdiagnosed clinically as a malignant tumour or as a hepatic cyst because of its cystic appearance. We present the clinicopathological, immunohistochemical and flow cytometric features of two cases, involving an 11-month-old boy and a 13-month-old girl. In both cases, the histological appearance and the immunohistochemical findings were identical. Bile ducts and blood vessels showed the expected immunohistochemical profile, whereas the mesenchymal component showed immunoreactivity not only for vimentin but also for muscular markers. Flow cytometry disclosed an aneuploid population in one case, thus favouring the interpretation of MH as a neoplastic lesion. Unlike the characteristically continuous and rapid growth of MH before or shortly after birth, these two cases showed low proliferative and apoptotic indexes and a high immunohistochemical expression of bcl-2 protein. This prompted us to hypothesize that MH might undergo a brief initial proliferative phase, but the cells would later become 'immortalized' by bcl-2 overexpression.

Journal Article↗
PubMed2004

Telomerase expression and proliferative activity suggest a stem cell role for thyroid solid cell nests.

Solid cell nests of the human thyroid gland are composed of main cells and C cells. In order to investigate the putative stem cell nature of the role for solid cell nests, we evaluated the histological features, and the immunohistochemical expression of p63, bcl-2, telomerase catalytic subunit, and two proliferative markers (Ki-67 and minichromosome maintenance protein 2), in a series of 24 cases of solid cell nests. Proliferative indices were determined in (a) solid cell nests, (b) thyroid follicular cells in the vicinity of solid cell nests within a low-power field, and (c) distant thyroid tissue, at a distance of at least three low-power fields from solid cell nests. In 15 cases of solid cell nests (62.5%), mixed follicles were observed; papillary formations were observed in four cases (16.6%), and ciliated cells were observed in the lining of microcysts associated with two cases (8.3%). Salivary gland-type tissue, cartilage islands, adipose and fibrous tissues, and small nerves were also associated with some cases of solid cell nests. We observed that the main cells of the solid cell nests express consistently telomerase, although at lower levels than p63, and show strong cytoplasmic immunoreactivity for bcl-2, which is associated with an increased differentiation potential. We also observed that despite their relative low proliferative index, main cells of the solid cell nests display higher proliferation than follicular cells in the vicinity and follicular cells in more distant thyroid tissue. We conclude that main cells of the solid cell nests apparently harbor the minimal properties of a stem cell phenotype (capacity for both self-renewal, conferred by telomerase activity, and differentiation to one or more than one type of specialized cells, given by the high expression of p63 and bcl-2) and may thus represent a pool of stem cells of the adult thyroid.

Adult↗
PubMed2002

Cellular localization of orexin receptors in human adrenal gland, adrenocortical adenomas and pheochromocytomas.

Orexin-A and -B are hypothalamic peptides derived from a precursor called prepro-orexin and related with the regulation of the energy balance and arousal. They act on G protein receptors named orexin receptor 1 (OX1R) and orexin receptor 2 (OX2R). In the present study, we used immunohistochemical techniques to detect the distribution of OXR in normal human adrenal gland and adrenal tumours (adrenocortical adenomas and pheochromocytomas). OX1R was expressed in the cortex of the normal human adrenal gland (glomerulosa, fasciculata and reticular zones) and OX2R was located in the medulla (epinephrine and norepinephrine cells). By the double immunofluorescence techniques, we demonstrated that virtually all medullar cells (epinephrine and norepinephrine cells) expressed OX2R. As was expected, according to the results obtained in normal tissues, cortical tumours (adrenocortical adenomas) were positive for OX1R but not for OX2R and conversely, medullar tumours (pheochromocytomas) expressed only OX2R.

Adolescent↗
PubMed2002

Predictors of malignant behaviour in gastrointestinal stromal tumours: a clinicopathological study of 34 cases.

OBJECTIVE: The clinicopathological features of gastrointestinal (GI) stromal tumours were analysed to find out the features that influence prognosis in these neoplasms. DESIGN: Retrospective study. SETTING: University Hospital, Spain. SUBJECTS: Review of clinical records and analysis of a series of GI stromal tumours classified in three groups: benign = 7 leiomyomas, malignant or potentially malignant = 16 combined smooth muscle-neural tumours, and 2 miscellaneous, and definitely malignant = 1 leiomyosarcoma and 8 gastrointestinal autonomic nerve tumours. MAIN OUTCOME MEASURES: Electron microscopy and immunohistochemical staining for vimentin, smooth muscle actin, muscle specific actin, desmin, S-100 protein, neuronal specific enolase, chromogranin A, synaptophysin, CD34, CD117 (c-kit), Bcl-2, and Ki-67. RESULTS: We found significant differences (p < 0.0001) between the median (P25, P75) size of tumours in the benign group 2.0 (1.2, 3.5) and in the potentially 7.5 (4.0, 13.0) and definitely 5.0 (4.0,6.5) malignant groups. The percentage of mitoses was lower (p = 0.003) in the benign group 0.4 (0.5) than in the other groups 2.0 (1.0, 5.0). Immunoreactivity for CD117 in leiomyomas was an unexpected finding; this showed a different staining pattern from the diffuse and homogeneous staining in GI stromal tumours. In addition, the MIB-1 proliferation index differentiated (p = 0.002) between the benign group 1.5 (1.0, 2.5) and the other two groups 7.0 (3.0, 11.0). CONCLUSIONS: These findings support the idea that GI stromal tumours form a heterogeneous group of neoplasms in which large size, presence of necrosis, and a high proliferative index (mitotic rate or MIB-1 index, or both) are good predictors of malignant behaviour.

Adult↗
PubMed2002

Influence of superimposed alcoholic hepatitis on the outcome of liver transplantation for end-stage alcoholic liver disease.

BACKGROUND/AIMS: Alcoholic cirrhosis is a common indication for liver transplantation. The present study was aimed to assess the influence of superimposed alcoholic hepatitis on the outcome of liver transplantation in patients with alcoholic cirrhosis. METHODS: Survival rates of 68 patients transplanted for alcoholic cirrhosis were compared with those of 101 patients transplanted for miscellaneous causes. Within the alcoholic group, explanted livers were searched for data of acute alcoholic hepatitis. The survival rate of patients with alcoholic hepatitis superimposed on liver cirrhosis was compared to that of patients with liver cirrhosis alone. Clinical severity of alcoholic hepatitis was assessed with Maddrey's score. RESULTS: Survival was similar in alcoholics and patients with other causes of liver disease. Among patients transplanted for alcoholic cirrhosis, survival was similar in patients with superimposed alcoholic hepatitis (n=36) and in cases with liver cirrhosis alone (n=32). There was no difference in survival between patients with mild (n=26) and severe (n=10) alcoholic hepatitis. Seven alcoholics (10%) returned to ethanol consumption. Recidivism was not associated with either alcoholic hepatitis in the explanted liver or graft loss. CONCLUSIONS: Survival after liver transplantation in patients with alcoholic cirrhosis plus alcoholic hepatitis detected in the explanted liver is similar to that of patients transplanted for other reasons. Even the presence of severe alcoholic hepatitis does not worsen the outcome of liver transplantation for end-stage alcoholic liver disease.

Adult↗
PubMed2002

DNA ploidy and cytonuclear area of peritumoral and paratumoral samples of mastectomy specimens: a useful prognostic marker?

OBJECTIVE: To investigate a possible relationship between DNA alterations in the "normal" residual mammary tissue of patients with breast cancer and survival. DESIGN: Prospective study. SETTING: University hospital, Spain. SUBJECTS: 162 patients operated on for breast cancer between 1991 and 1995. MAIN OUTCOME MEASURES: Cytology, histopathology, optic karyometry, DNA ploidy, and S-phase fraction measured by flow cytometry in peritumoral and paratumoral tissue. Mortality, and univariate analysis. RESULTS: DNA ploidy in peritumoral tissue was altered in 42 patients (26%), in 41 of whom the mean cytonuclear area was also altered. Of the 19 patients whose death within the study period was attributed to their cancer, 13 had peritumoral tissue in which both DNA ploidy and mean cytonuclear area were altered. On univariate analysis, there was significantly worse survival among the patients in whom both tumoral and peritumoral tissues were DNA aneuploid than among those in whom only tumoural tissue was DNA aneuploid (p < 0.0001). CONCLUSIONS: The presence of peritumoral or paratumoral tissue or both, with anomalous DNA content is associated with a reduced survival among women whose breast cancer has been treated by mastectomy. Additional studies including multivariate analysis are necessary to confirm our findings.

Biomarkers, Tumor↗
PubMed2002

Predictive value of P53, BCL-2, and BAX in advanced head and neck carcinoma.

Because the apoptotic process appears to be involved in the response-to-treatment of chemotherapy and radiotherapy, we investigated the prognostic value of the expression of three apoptosis-associated genes (p53, Bax, and Bcl-2) in tumor biopsies from patients with locally advanced head and neck carcinoma. Using specific monoclonal antibodies, immunohistochemical staining for p53, Bax, and Bcl-2 was performed on tumor material from 43 patients before their scheduled adjuvant chemoradiotherapy. Results indicated that the response to treatment was 83.7% (36 of 43 patients). Bax staining was positive in 8 cases (19.5%), p53 in 19 (47.5%), and Bcl-2 in 4 patients (10.8%). There were no statistically significant correlations between any of the apoptosis genes assayed and the patients' response to treatment or to overall survival. In the univariate statistical analysis, response-to-treatment was the only significant variable (p = 0.013) predictive of survival rate. These results suggest that p53, Bax, and Bcl-2 expression are not significant predictive factors of response to induction treatment in locally advanced head and neck carcinoma and that their routine use as prognostic markers cannot be recommended.

Adult↗
PubMed2002

Sclerosing epithelioid fibrosarcoma primary of the bone.

Sclerosing epithelioid fibrosarcoma (SEF) is an uncommon tumor originally described in soft tissues. We report a case of SEF primary of the left iliac bone in a 42-year-old woman. The tumor was grossly well circumscribed. The histologic examination disclosed a hypocellular neoplasm with densely hyalinized stroma. It was composed predominantly of small-to-moderate-sized round-to-ovoid cells, relatively uniform, often with clear cytoplasm, and arranged in nest, cord, and strand patterns. Because the distinctive morphologic patterns and the immunohistochemical profile of this entity may be mistaken for many different tumors, we here emphasize the differential diagnostic problems of this variant of fibrosarcoma. To our knowledge, this is the first tumor of this kind described in the bone.

Adult↗
PubMedDate not supplied

Bilateral adrenal metastases from hepatocellular carcinoma after liver transplantation.

Therapeutic management of hepatocellular carcinoma is a controversial issue. Orthotopic liver transplantation is an alternative for the treatment of hepatocellular carcinoma in a selected group of patients, but recurrence is possible. A 51-year-old patient with liver transplantation due to hepatocellular carcinoma presented bilateral adrenal metastases in a successive manner. A left adrenal gland metastasis was diagnosed five months after liver transplantation, and a left adrenalectomy was carried out. Eight months later, a right adrenal gland metastasis was diagnosed, and a right adrenalectomy was performed. Pathological examination confirmed the diagnosis of a well-differentiated hepatocellular carcinoma. At present, there is no evidence of recurrence 35 months after the second adrenalectomy. Bilateral adrenal gland metastases from hepatocellular carcinoma after liver transplantation have not been previously reported in English literature. Surgical resection of metastases may be indicated in similar patients with successful treatment of the primary tumor, absence of additional metastasic disease, and good performance status.

Adrenal Gland Neoplasms↗