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Biomedical subjects

L Alvarez

Publications and source records attributed to L Alvarez.

At least 37 records · Page 2Linked to original sources
PubMed2002

Usefulness of contrast agents in the diagnosis of left ventricular pseudoaneurysm after acute myocardial infarction.

BACKGROUND AND OBJECTIVE: The diagnosis of left ventricular pseudoaneurysm after acute myocardial infarction is usually based on echocardiography. However, this technique may have limitations in some patients, especially in cases with suboptimal acoustic window. The objective of this study was to evaluate the usefulness of contrast echocardiography in the diagnosis of left ventricular pseudoaneurysm after myocardial infarction. METHODS AND RESULTS: The study population comprises six patients in whom a two-dimensional echocardiography showed an image consistent with left ventricular pseudoaneurysm. Levovist (Schering) 4gr was administered i.v. to more clearly visualize the blood flow from the left ventricle to the left ventricular pseudoaneurysm cavity in all patients. Infarct location was anterior in five patients, and posterolateral in one. No patient had received thrombolysis or primary angioplasty during the acute phase. The transthoracic echocardiographic study showed an echo-free space adjacent to left ventricle in all patients. In four cases, the diagnosis of left ventricular pseudoaneurysm was made before contrast administration. In the remaining two patients, the definite diagnosis was made only after Levovist administration. CONCLUSION: In the diagnosis of postinfarction left ventricular pseudoaneurysm, the administration of contrast agents may be of help in the correct visualization of the blood flow from the left ventricle to the left ventricular pseudoaneurysm cavity, and may allow a definite diagnosis to be obtained in some patients.

Aged↗
PubMed2002

Weak concordance between wall motion and microvasculature status after acute myocardial infarction: study with myocardial contrast echocardiography in real time with power modulation.

AIMS: The microvasculature damage after myocardial infarction has important implications. The hypothesis of the study was that wall motion abnormalities and microcirculation status do not necessarily match after myocardial infarction, and therefore the study of only myocardial wall motion could offer an incomplete evaluation in these patients. METHODS: Wall motion and myocardial perfusion assessed by contrast echocardiography were evaluated by two different blinded investigators in 29 patients with recent (<1 week) myocardial infarction. Myocardial perfusion was assessed in real-time using power modulation after Optison (1.5-3.0 ml) intravenous administration. RESULTS: One hundred and ninety-nine segments could be adequately evaluated. Of these, 54 (27%) were akinetic. Regarding contrast opacification, 134 segments (67%) had a normal perfusion, whereas the remaining 65 (33%) had an impaired (n=37, 19%) or absent (n= 28, 14.1%) perfusion. Concordance between presence of akinesia and abnormal contrast opacification was only moderate (kappa index 0.42) and agreement only occurred in 116 segments (58%). Fourteen per cent of normoquinetic segments had an impaired perfusion, whereas 35% of akinetic segments had a preserved perfusion. Correlation between the proportion of segments with akinesia and the proportion of segments with impaired perfusion was moderate (r=0.41), and there was no correlation between the proportion of segments with akinesia and the percentage of segments with absent perfusion. CONCLUSION: There is a weak association between regional systolic function and myocardial perfusion after myocardial infarction, as assessed by real-time contrast myocardial echocardiography using power modulation.

Aged↗
PubMed2002

Effect of microcrystalline cellulose grade and process variables on pellets prepared by extrusion-spheronization.

This study evaluated the effects of spheronizer load and speed on the size, circularity, microporosity, compressibility, and friability of pellets prepared by extrusion-spheronization of wet microcrystalline cellulose (MCC) masses with a water content shown by mixer torque rheometry to ensure maximum consistency. Two MCC grades with different mean particle size were used. Both gave pellets with good particle size, sphericity, and compressibility, under a wide range of spheronization conditions. Modification of pellet properties of interest (including size and porosity) was possible by adjustment of spheronization conditions and MCC grade; in particular, pellet porosity was greater with MCC of larger particle size.

Cellulose↗
PubMed2002

[Mycophenolate mofetil in lupus nephritis].

The treatment of severe lupus nephritis is based on the combination of steroids and cytotoxic drugs. Intravenous cyclophosphamide administered in "pulses" is effective in the induction of remission but other therapeutic alternatives are sought in refractory cases or severely relapsing patients. Mycophenolate mofetil, used in renal transplantation, also can be useful in severe lupus nephritis. We describe the evolution of 6 patients (5 women and 1 man; age 17-45 years) with severe lupus nephropathy who after achieving remission with intravenous cyclophosphamide and steroids (5 cases) or cyclosporin A (1 case) showed relapse of proteinuria and were treated with mycophenolate mofetil (dose 1000-2000 mg/day). Two patients have completed 24 months, 1 patient two cycles of 12 months, 2 patients 18 months and 1 patient 6 months. After this treatment, all patients have achieved remission (3 partial and 3 complete). There was no treatment failure and no one patient discontinued medication; however 1 case relapsed. There were no changes in leucocytes, haemoglobin, serum creatinine and serum albumin. ANA and alpha DNA antibodies decreased. Proteinuria (measured as protein/creatinine urine ratio: initial 3 and final 0.3) and dose of steroids (initial: 17.5 mg/d and final 5 mg/d) decreased significantly (p < 0.05 Wilcoxon t-test). The most common side effects were nausea and abdominal discomfort that improved without discontinuation of treatment. We conclude that mycophenolate mofetil is effective and a safe drug in severe relapsing lupus nephritis.

Adolescent↗
PubMed2002

[Diffuse lymphoproliferative disease after renal transplantation and its relation with Epstein-Barr virus. Experience at one center].

Post-transplant lymphoproliferative disorders (PTLD) are a group of heterogeneous lymphoid proliferations in chronic immunosuppressed recipients which appear to be related to Epstein Barr Virus (EBV). Receptor EBV seronegativity, use of antilymphocyte antibodies and CMV disease have been identified as risk factors that may tigger development of PTLD. We have studied the incidence of PTLD and its relationship with EBV in 588 adult renal transplant recipients who were transplanted in our hospital from 1988 to 2001. We have also evaluated the diagnostic and therapeutic methods used, the risk factors and outcome of the patients who developed PTLD. We identified 8 recipients (4 males and 4 females), range from 18 to 67 years (mean age 45.6 years) with a median time between grafting and PTLD of 4.1 years (0.1-7 years), who developed PTLD (1.3%). Only 1 patient received OKT3 and had CMV disease, two of them (25%) had been treated with hight doses of prednisolone, another was EBV seronegative, but the rest of them (50%) had no risk factors. Two patients were diagnosed at autopsy, the diagnosis of 5 was based on the histology of biopsy and the last one by CT scans of chest-abdomen and cytology. The presence of EBV in the lymphoproliferative cells was assessed in 5 out of the 7 studied patients (71.4%). The outcome of our recipients was poor. Five out of 8 patients died shortly after diagnosis as a direct consecuence of PTLD and another of an infectious complication of the treatment (75%). The 2 patients alive started dialysis and 1 of them died 2 years later of a non-related cause. In conclusion, PTLD is a relatively frequent disease with a poor prognosis in renal transplant patients. It seems to have a close relationship with EBV and can develop in the absence of the classical risk factors.

Adolescent↗
PubMed2001

Methionine adenosyltransferase 1A knockout mice are predisposed to liver injury and exhibit increased expression of genes involved in proliferation.

Liver-specific and nonliver-specific methionine adenosyltransferases (MATs) are products of two genes, MAT1A and MAT2A, respectively, that catalyze the formation of S-adenosylmethionine (AdoMet), the principal biological methyl donor. Mature liver expresses MAT1A, whereas MAT2A is expressed in extrahepatic tissues and is induced during liver growth and dedifferentiation. To examine the influence of MAT1A on hepatic growth, we studied the effects of a targeted disruption of the murine MAT1A gene. MAT1A mRNA and protein levels were absent in homozygous knockout mice. At 3 months, plasma methionine level increased 776% in knockouts. Hepatic AdoMet and glutathione levels were reduced by 74 and 40%, respectively, whereas S-adenosylhomocysteine, methylthioadenosine, and global DNA methylation were unchanged. The body weight of 3-month-old knockout mice was unchanged from wild-type littermates, but the liver weight was increased 40%. The Affymetrix genechip system and Northern and Western blot analyses were used to analyze differential expression of genes. The expression of many acute phase-response and inflammatory markers, including orosomucoid, amyloid, metallothionein, Fas antigen, and growth-related genes, including early growth response 1 and proliferating cell nuclear antigen, is increased in the knockout animal. At 3 months, knockout mice are more susceptible to choline-deficient diet-induced fatty liver. At 8 months, knockout mice developed spontaneous macrovesicular steatosis and predominantly periportal mononuclear cell infiltration. Thus, absence of MAT1A resulted in a liver that is more susceptible to injury, expresses markers of an acute phase response, and displays increased proliferation.

Animals↗
PubMed2001

Dorsal subthalamotomy for Parkinson's disease.

We report our experience of unilateral subthalamotomy in patients with Parkinson's disease (PD). Eleven patients were included in a pilot, open-labeled study to assess the effect of unilateral lesion of the subthalamic nucleus (STN) with a minimum of 12 months of follow-up. The guidelines of CAPIT (Core Assessment Program for Intracerebral Transplantation) were followed for recruitment into the study and follow-up assessment. Levodopa equivalents daily intake (mean 967 mg) were unchanged during the first 12 months in all but one patient who stopped medication. The sensorimotor region of the STN was defined by semimicrorecording and stimulation and a thermolytic lesion was placed accordingly. There was a significant reduction in both UPDRS parts II and III in the "off" state at 1-, 6-, and 12-month follow-up. This effect was maintained in four patients up to 24 months. The dyskinesia score did not change postoperatively. Lesion-induced dyskinesias were not a management problem except in one patient who developed a large infarction several days postsurgery. This initial study indicates that a lesion of the STN is not generally associated with hemiballismus in PD. Subthalamotomy may induce considerable motor benefit and could become another surgical option under specific circumstances.

Aged↗
PubMed2001

Changes of skeletal muscle proteases activities during a chronic low-frequency stimulation period.

Modifications of muscular contractile patterns by chronic low-frequency stimulation induce structural, physiological, and biochemical transformations in fast-twitch fibers that cause them to act like slow-twitch muscle. During this transformation many changes in protein pattern appear and the proteolytic system may be involved in those changes. The activities of cathepsin L, B, H, D, the level of cystatin, as well as the calpain activity in rabbit fast-twitch muscle have been compared with those of slow-twitch muscle. The results show that fast-twitch muscle has lower cathepsin activities and higher calpain activities than slow-twitch muscle. Chronic low-frequency stimulation was applied for 24 days to fast-twitch muscles and changes in proteases and protease inhibitors (cystatin and calpastatin) were studied. After 7-14 days of stimulation, lysosomal cathepsin L, B, and D and cytoplasm calpain and proteosome activities increased several-fold. Involvement of the phagocyte cells in the protein fiber turnover was minimal. Although the turnover of contractile proteins during muscle electrostimulation takes place in synchrony with changes in the muscle proteolytic system, the stimulation period used did not attain the total transformation from fast- to slow-twitch muscle proteolytic pattern.

Acid Phosphatase↗
PubMed2001

Bioactive oleanolic acid saponins and other constituents from the roots of Viguiera decurrens.

The bisdesmoside oleanolic acid saponin, 3-0-(methyl-beta-D-glucuronopyranosiduronoate)-28-0-beta-D-glucopyranosyl-oleanolate along with nine known compounds (two diterpenic acids, one chromene, three triterpenes, one steroidal glycoside, and two monodesmoside oleanolic acid saponins), were obtained from Viguiera decurrens roots. The chemical structure of the bisdesmoside oleanolic saponin was determined by chemical and NMR spectral evidence. A mixture of monodesmoside saponins displayed cytotoxic activity against P388 and COLON cell lines (ED50= 2.3 and 3.6 microg/ml, respectively). Two of the known compounds showed insecticidal activity against the Mexican bean beetle larvae (Epilachna varivestis).

Asteraceae↗
PubMed2001

Usefulness of biochemical markers of bone turnover in assessing response to the treatment of Paget's disease.

The aim of this study was to investigate the usefulness of biochemical markers of bone turnover for monitoring treatment efficacy of Paget's disease of bone, and also to evaluate the utility of biological variation data in choosing the best markers for assessment of biochemical response to therapy. Thirty-eight patients with Paget's disease were included in a prospective study. All received 400 mg/day of oral tiludronate for 3 months. In 31 patients that completed treatment, biochemical markers were measured at baseline and at 1 and 6 months after treatment ended. In serum we determined the levels of total alkaline phosphatase (tAP), bone alkaline phosphatase (bAP), procollagen type I N-terminal propeptide (PINP), and C-terminal telopeptide of type I collagen (sCTx). Urine samples were analyzed for hydroxyproline (Hyp) and for C- and N-terminal telopeptides of type I collagen (CTx and NTx, respectively). Quantitative bone scintigraphy was performed at baseline and at 6 months after discontinuation of therapy. A ratio for monitoring response to treatment was obtained for each marker. This ratio reflected the size of treatment response of the marker in relation to the value of its critical difference. Thus, ratio values of >1 indicated a significant decrease of the marker after therapy. In addition, response to therapy was evaluated according to disease activity. Mean values of all markers of bone turnover decreased significantly after therapy. Serum bAP and PINP and urinary NTx showed the highest percentage reduction (between 58% and 68%). Furthermore, serum bAP and PINP showed the highest ratios for monitoring changes induced by treatment, followed by serum tAP and urinary NTx. sCTx and urinary CTx as well as Hyp showed mean ratios for monitoring changes of <1, indicating a low sensitivity for monitoring treatment. Patients with polyostotic disease showed a continuous decrease in mean values for all markers at 6 months from the end of therapy, whereas, in monostotic patients, there was a trend toward increased levels at this timepoint. In conclusion, serum bAP and PINP were the most sensitive markers for monitoring treatment efficacy in Paget's disease, although serum tAP and urinary NTx were also sensitive markers for monitoring changes. Data on biological variation are useful for assessing actual changes induced by treatment.

Adult↗
PubMed2001

On the coupling efficiency of metal-coated near-field probes.

A theory for calculating the optical transmission of nanometric circular apertures in a thick and perfectly conducting screen coated upon an optical fibre has been developed. The theory is intended for the study of near-field probes and differs from other well known theories of radiation transmission through subwavelength apertures in the fact that it includes an optical fibre, making possible to distinguish which part of energy passing through the aperture is effectively coupled in guided modes. In a scanning near-field optical microscope tip, only the guided modes will reach the photodetector, and will contribute to the final read-out. A numerical calculation for different fibre parameters, to show the dependence of the guided transmission coefficient for the guided modes of the fibre, is presented. The agreement of the theory with earlier calculations where the optical fibre is not included is emphasized.

Journal Article↗
PubMed2001

Albendazole sulphoxide enantiomeric ratios in plasma and target tissues after intravenous administration of ricobendazole to cattle.

The comparative concentration profiles of the (+) and (-) albendazole sulphoxide (ABZSO) enantiomers obtained in plasma and in selected target tissues/fluids after intravenous (i.v.) administration of a racemic formulation of ricobendazole (RBZ) to cattle were characterised. Fourteen Holstein calves received RBZ (racemic solution, 150 mg/mL) by i.v. administration at 7.5 mg/kg. Jugular blood samples were collected over 48 h post-treatment (plasma kinetic trial) and two animals were sacrificed at either 4, 12, 20, 28 or 32 h post-treatment to obtain samples of abomasal/small intestine mucosal tissue, abomasal/small intestine fluids, bile, liver and lung tissue (tissue distribution study). The (-)ABZSO enantiomer was depleted significantly faster from plasma compared with the (+)ABZSO antipode. The plasma AUC for (+)ABZSO (38.3 microg. h/mL) was significantly higher (P < 0.05) compared with that obtained for (-)ABZSO (20.5 microg. h/mL). The (+)ABZSO enantiomer was the predominant antipode measured in bile, abomasal fluid and abomasal mucosa. For instance, at 12 h post-treatment the (+)/(-) concentration ratios were: 12.9 (plasma), 1.62 (abomasal mucosa), 13.0 (abomasal fluid), 2.92 (intestinal mucosa), 9.87 (intestinal fluid) and 21.5 (bile). No marked differences between the concentration profiles of both enantiomers were observed in the liver tissue. Albendazole (ABZ) was recovered from the liver, lung and gastrointestinal (GI) mucosal tissues of RBZ-treated calves up to 32 h post-treatment, probably produced by a GI microflora-mediated sulphoreduction of RBZ. An enantioselective kinetic behaviour may account both for the faster depletion of the (-) enantiomer and for the higher availabilities of the (+) antipode observed in plasma and in most of the tissues/fluids investigated. The simultaneous evaluation of the plasma kinetics and tissue concentration profiles of both enantiomeric forms reported here, may help to interpret the relationship between chiral behaviour and pharmacological action for sulphoxide derivatives of benzimidazole (BZD) methylcarbamate anthelmintics.

Albendazole↗
PubMed2001

Collagen type Ialpha1 and vitamin D receptor gene polymorphisms and bone mass in primary biliary cirrhosis.

The potential influence of two gene polymorphisms, vitamin D receptor gene (VDR) and the gene encoding collagen type Ialpha1 (COLIA1) Sp1 polymorphisms, in the reduced bone mass observed in patients with primary biliary cirrhosis (PBC) was assessed in 61 women with PBC (age, 54.1 +/- 1.1 years) by restriction enzyme digestion of polymerase chain reaction (PCR)-amplified DNA extracted from whole blood. Bone mineral density (BMD) of the lumbar spine (L2-L4) and proximal femur were measured by X-ray absorptiometry. The severity of liver disease and cholestasis was also evaluated, and changes in BMD were calculated after a mean period of 2.9 +/- 0.3 years in 41 patients. Sixteen patients (26 %) had the BB, 20 the bb (33 %), and 25 Bb (41%) VDR genotypes. There were no significant baseline BMD differences among the 3 VDR genotypes. Forty-one patients (68%) had the SS, 16 the Ss (27%), and 3 the ss (5%) COLIA1 genotypes. The baseline lumbar BMD was significantly lower in patients having the s allele than in the homozygote SS patients (Z-score, -0.76 +/- 0.24 vs. -0.10 +/- 0.17, P =.02). The severity of cholestasis was not related to the VDR or COLIA1 1 polymorphisms. Lumbar bone loss was independent of VDR and COLIA1 genotypes, but it was associated with cholestasis. In conclusion, the COLIA1 but not VDR polymorphism is a genetic marker of peak bone mass in patients with PBC, although the severity of cholestasis is the main factor for osteoporosis since it is associated with the rate of bone loss.

Bone Density↗
PubMed2001

SC-1, an antimycotic spirostan saponin from Solanum chrysotrichum.

A new antimycotic steroidal saponin named SC-1 has been isolated from the leaves of Solanum chrysotrichum by bioassay-guided fractionation. The structure of SC-1 was characterized as 3-O-[beta-quinovopyranosyl(1-->6)-beta-glucopyranosyl(1-->6)-beta- glucopyranosyl]chlorogenin on the basis of spectral analyses and chemical evidence.

Antifungal Agents↗
PubMed2001

Polysomnographic evaluation of the hypnotic effect of Valeriana edulis standardized extract in patients suffering from insomnia.

Valeriana edulis ssp. procera, commonly known as "valeriana mexicana", is widely used in Mexican traditional medicine for the treatment of insomnia and anxiety. To evaluate the hypnotic effect and safety of 450 mg of Valeriana edulis standardized hydroalcoholic extract in patients with insomnia, a double-blind, cross-over, controlled study was carried out. Valeriana officinalis extract, at the same doses, was used as a positive control. In a sleep laboratory, polysomnographic (PSG) recordings were performed for analyzing the quantity and architecture of sleep as well as evaluating morning sleepiness, memory quotient, and side effects. The experimental procedures were conducted on four consecutive nights of 8 h each. Twenty patients were admitted. Based on the PSG results, V. edulis reduced the number of awaking episodes while both treatments increased the rapid eye movement (REM) sleep; this last parameter was better improved by V. officinalis extract. Other PSG data did not achieve outstanding statistical differences, but the clinical tendency with both treatments was to increase the sleep efficiency index. These Valeriana extracts produced beneficial effects on sleep architecture because they diminished the time of stages 1 and 2 in non-REM sleep while they increased delta sleep. Validated clinical tests showed that both species reduced notoriously the morning sleepiness, that was further improved by V. officinalis extract, and did not affect anterograde memory. In only three cases were slight side effects observed, one due to the experimental extract. Chemical analysis of the hydroalcoholic extract of V. edulis indicated that this extract contains 0.26 % of dihydroisovaltrate as the main valepotriate, and that it does not contain valerenic acid. In general, the results support the hypnotic effect and safety of acute treatment of Valeriana edulis and Valeriana officinalis on patients suffering insomnia.

Adult↗
PubMed2001

Carbonic anhydrase II associated with plasma membrane in a human pancreatic duct cell line (CAPAN-1).

The subcellular distribution of carbonic anhydrase II, either throughout the cytosol or in the cytoplasm close to the apical plasma membrane or vesicular compartments, suggests that this enzyme may have different roles in the regulation of pH in intra- or extracellular compartments. To throw more light on the role of pancreatic carbonic anhydrase II, we examined its expression and subcellular distribution in Capan-1 cells. Immunocytochemical analysis by light, confocal, and electron microscopy, as well as immunoblotting of cell homogenates or purified plasma membranes, was performed. A carbonic anhydrase II of 29 kD associated by weak bonds to the inner leaflet of apical plasma membranes of polarized cells was detected. This enzyme was co-localized with markers of Golgi compartments. Moreover, the defect of its targeting to apical plasma membranes in cells treated with brefeldin A was indicative of its transport by the Golgi apparatus. We show here that a carbonic anhydrase II is associated with the inner leaflet of apical plasma membranes and with the cytosolic side of the endomembranes of human cancerous pancreatic duct cells (Capan-1). These observations point to a role for this enzyme in the regulation of intra- and extracellular pH.

Carbonic Anhydrases↗
PubMed2001

Effect of malaria on soluble transferrin receptor levels in Tanzanian infants.

The diagnosis of iron deficiency anemia in malaria endemic areas is complicated by the influence of the infection on the laboratory tests conventionally used to assess iron status. Determination of soluble transferrin receptor (sTfR) levels has been shown to be a sensitive indicator of iron deficiency in adults and is not affected by a range of infectious and inflammatory conditions. The utility of sTfR levels in the diagnosis of iron deficiency in malaria endemic areas remains unresolved. Three hundred and fourteen infants in a rural area of southern Tanzania living under conditions of intense and perennial malaria transmission were studied to determine the utility of sTfR plasma levels in the assessment of iron deficiency anemia. Independent of the presence of anemia, malaria parasitemia was associated with a significant increase in sTfR plasma levels that were even higher than those found in iron deficiency anemia. We conclude that the measurement of sTfR levels does not have a role in the diagnosis of iron deficiency anemia in young children exposed to malaria infection.

Anemia, Iron-Deficiency↗