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Biomedical subjects

M Concha

Publications and source records attributed to M Concha.

At least 127 records · Page 7Linked to original sources
PubMedDate not supplied

Pacing requirements after orthotopic heart transplantation: incidence and related factors.

To assess the incidence of severe bradyarrhythmia and pacing requirements after orthotopic heart transplantation, as well as the possible causal mechanisms, we have reviewed our experience on 52 consecutive transplant patients. The overall incidence of bradyarrhythmia requiring pacing for at least 24 hours after transplantation was 27% (14 patients). The conditions of three of them required pacing for less than 1 week; the conditions of the other 11 patients (21%) required pacing for more than 1 week. Normal sinus rhythm resumed in all but four patients within 3 weeks; a permanent pacemaker was implanted in these four patients (7.6% of all 52 patients and 28% of patients requiring temporary pacing). Late complete heart block associated with acute rejection developed in two patients whose conditions required implantation of a permanent pacemaker. The age and sex of the recipient and donor were similar for patients with or without bradyarrhythmia. The percentage of patients with or without bradyarrhythmias taking amiodarone before transplantation (57% and 46%, respectively), total ischemic time (133 +/- 33 and 123 +/- 37 minutes, respectively), and cardiopulmonary bypass time (117 +/- 17 and 132 +/- 65 minutes, respectively) were not significantly different for either group of patients. The initial temperature of cardioplegic solution for organ storage and the preimplantation myocardial temperature were, however, significantly lower in patients whose conditions required pacing immediately after transplantation than in those whose conditions did not require pacing (5.3 +/- 1.7 degrees C versus 6.5 +/- 1.5 degrees C, p less than 0.05, and 3.9 +/- 1.6 degrees C versus 5.7 +/- 2.6 degrees C, p less than 0.01, respectively).(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMedDate not supplied

Pulmonary valve endocarditis during puerperal sepsis.

A case of pulmonary valve endocarditis caused by Staphylococcus aureus during puerperal sepsis in a female patient is reported. The M-mode and two dimensional echocardiographic finding are described. A review of the literature shows that this entity is rare. A large vegetation in the leaflet of the pulmonary valve was excised and the patient recovered after a full course of antibiotics.

Adult↗
PubMedDate not supplied

Noninvasive radioisotopic diagnosis of acute heart rejection.

In a prospective protocol for noninvasive diagnosis and follow-up of acute heart rejection 162 examinations were performed in 36 patients who underwent heart transplantation. The follow-up period ranged from 15 days to 44 months. The protocol comprised multiple gated acquisition ventriculography with albumin labeled with 99mTc (740 MBq), acquired using a forward/backward by thirds framing mode, 32 frames/cycle, and 10 million total counts. Parameters of left ventricular diastolic function were analyzed. Antimyosin antibody labeled with indium 111 (74 MBq) was injected, and myocardium/lung uptake ratios were obtained at 48 hours in counts per pixel. Endomyocardial biopsy was performed in all patients within 48 hours. The results were evaluated by comparison of mean values of each parameter and global and individual correlation analysis in relation to the presence or absence of rejection and treatable (moderate or severe) or nontreatable (mild or absent) rejection. Antimyosin and diastolic function parameters showed significant differences (p less than 0.001) between patients with and without rejection and between patients with treatable and nontreatable rejection. Global correlation with biopsy existed (p less than 0.05) for antimyosin (r = 0.75), average filling rate (r = 0.61), and peak filling rate (r = 0.56). Individual correlation exhibited significance in all patients only for antimyosin (r = 0.78 to 0.98). In eight patients average filling rate also showed significant correlation (r = 0.65 to 0.88). In conclusion, these results provide a noninvasive diagnosis of cardiac allograft rejection episodes and allow an accurate selection between treatable and nontreatable rejection. Individual patient follow-up is possible with antimyosin. The study of diastolic function is also useful in this setting.

Antibodies, Monoclonal↗
PubMedDate not supplied

[Mollicutes in male infertility: is antibiotic therapy indicated?].

Mollicutes are frequently isolated from sperma of infertile men. The potential effect on the fertility of mollicute infection is controversial as is antibiotic therapy. In our andrological patients, the prevalence of mollicutes is approximately 10%. To evaluate the benefit of antibiotic therapy, we investigated two groups of patients: group 1-patients with positive or negative mollicute cultures and normal spermiogram; morphological changes on spermatozoa were particularly evaluated (n = 40); group 2 - patients with positive mollicute cultures treated with doxycycline or erythromycin. Sperm parameters were analysed before and after treatment (n = 20). When infected and non-infected sperma from group 1 were compared, the only difference found was an alteration of the sperm tail (p less than 0.005). Light microscopy and electron microscopy (EM) often revealed coiled tails which were probably due to adhesion of mollicutes (EM). The most frequently observed pathology in group 2 was found in patients with teratoasthenozoospermia. Compared with the post-therapy spermiogram, a significant difference was only observed in spermatozoal morphology (p less than 0.005). Therefore, we conclude that mollicutes produce important alterations in the human spermatozoal morphology, especially in the tail which appears in a spiral form. Since teratozoospermia is considered to be an important factor of infertility in man, antibiotic therapy is recommended in cases of mollicute involvement.

Bacteria↗
PubMedDate not supplied

Ultrastructural analysis of the attachment sites of Escherichia coli to the human spermatozoon after in vitro migration through estrogenic cervical mucus.

The in vitro attachment between Escherichia coli and the human spermatozoon was studied using transmission and scanning electron microscopy, and ultracytochemistry. Samples from estrogenized cervical mucus columns containing migrating spermatozoa revealed two types of contact areas: Type I corresponded to the interaction of the bacterial fimbriae with the spermatozoal surface, and Type II, to the intermingling of the eukaryotic and prokaryotic cell glycocalyx. In both types of associations, the attachment area was lanthanum positive and displayed glycoconjugates. These types of intercellular contacts could represent the morphological basis of a mechanism by which bacteria are attached to spermatozoa and are consequently transported to the upper female genital tract.

Bacterial Adhesion↗
PubMedDate not supplied

Immunocytochemical demonstration of Langerhans' cells in smears and pellets of exfoliated cells from human exocervices.

Immunocytochemical staining with OKT6 monoclonal antibody and S-100 protein antiserum was used to reveal Langerhans' cells in smears and/or pellets of exfoliated cells from uterine cervices (normal and with squamous carcinoma). Immunoreactive Langerhans' cells were found exclusively in smears and pellets of cervices with squamous carcinoma. Langerhans' cells, which appear as rounded cells, showed a peripheral ring of intense fluorescence with OKT6 antibody whereas the entire cell stained with S-100 protein antiserum. The presence of Langerhans' cells among cells exfoliated from exocervical squamous carcinoma can be explained by the increased density of these cells in tissue with neoplastic changes.

Antibodies, Monoclonal↗
PubMedDate not supplied

Accurate length adjustment of right or circumflex coronary artery bypass grafts.

A simple method is described for the accurate adjustment of the length of right and circumflex coronary grafts. The essential feature of the technique is the use of a marking suture initially positioned in the pericardium for future reference. The technique has been adopted and successfully used by us over the past year.

Coronary Artery Bypass↗