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Biomedical subjects

M Gil

Publications and source records attributed to M Gil.

At least 73 records · Page 4Linked to original sources
PubMed1997

Cloning and expression of a cDNA encoding a novel protein serine/threonine kinase predominantly expressed in hematopoietic cells.

We have isolated a cDNA clone of a new member of protein serine/threonine kinases, MPK38, from a cDNA library constructed from the murine teratocarcinoma PCC4 cell line by the polymerase chain reaction. MPK38 was transcribed as an approx. 2.5 kb mRNA encoding for a protein of 643 amino acids. N-terminus of MPK38 contains the kinase catalytic domain which exhibits approximately 60% protein sequence identity with the SNF1 serine/threonine kinase family. The MPK38 cDNA directs the in vitro translation of two protein species of approx. 70 and approx. 50 kDa, which appear to result from an internal initiation of translation. MPK38 was predominantly expressed in thymus and spleen, but was not detectable in kidney, liver, and muscle in the adult tissues. In addition, MPK38 was apparently expressed in T lineage cells and a macrophage/monocyte cell, but was not detectable in a B cell line and an embryonic cell line. However, a low level of MPK38 transcript was detectable in a mast cell line after a longer exposure. Furthermore, MPK38 gene product showed the kinase activity which was assessed by immune complex kinase assay. Thus, MPK38 gene product seems to play an important role in signal transduction of certain lineages of hematopoietic cells.

Amino Acid Sequence↗
PubMed1997

Seroprevalence and epidemiology of Helicobacter pylori infection in patients with cirrhosis.

BACKGROUND: Helicobacter pylori infection is the major pathogenic factor for peptic ulcer disease. Its epidemiology is not fully known; few data are available in patients with chronic liver disease. AIMS: To investigate the seroprevalence and factors associated with Helicobacter pylori infection in a series of liver cirrhosis patients. METHODS: Two hundred and twenty consecutive patients were prospectively included in a study aimed to evaluate the effect of dietary intervention on cirrhosis complications and survival. At inclusion, an epidemiological and clinical questionnaire was completed. Sera were obtained and stored at -70 degrees C until analyzed. They were tested for Helicobacter pylori antibodies using a commercial ELISA kit. RESULTS: Eleven out of 220 patients had borderline anti-Helicobacter pylori IgG titers. Of the remaining 209 patients, 105 (50.2%) showed positive titers of Helicobacter pylori IgG. Univariate analysis showed that Helicobacter pylori infection was more frequent in older patients, those born outside Catalonia, and in patients with a low educational level. Past ethanol consumption and current smoking correlated negatively with Helicobacter pylori infection. Multivariate analysis selected age (OR 3.1. 95% CI 1.46-6.45), educational level (OR 2.2. 95% CI 1.18-4.2) and alcohol consumption (OR 0.7. 95% CI 0.45-0.99) as the variables independently related to Helicobacter pylori infection. CONCLUSIONS: Helicobacter pylori infection in cirrhosis has the same epidemiological pattern as in the general population. Suggestions that the etiology or the severity of the liver disease could be related to Helicobacter pylori infection were not confirmed by our study.

Adult↗
PubMed1997

Manual nucleofragmentation and endothelial cell loss.

PURPOSE: To compare corneal endothelial cell loss with two cataract surgery techniques: manual nucleofragmentation performed with the Keener nucleus divider and planned extracapsular extraction. SETTING: Department of Ophthalmology "Memorial Cristóbal Garrigosa," Hospital de l'Esperança, Universitat Autònoma de Barcelona, Spain. METHODS: Contact specular microscopy was performed before and 8 weeks after surgery in 51 patients who had been prospectively randomized into 2 groups: 26 patients had manual nucleofragmentation (NF) with the Keener divider and 25, planned extracapsular cataract extraction (ECCE). The analyzed parameters were preoperative and postoperative endothelial cell density and variations in cell size (polymegethism) and cell shape (pleomorphism). The results were compared and statistically analyzed. RESULTS: The mean percentage of endothelial cell loss in the NF group was 11.08% and in the ECCE group, 9.86%. This difference was not statistically significant. Postoperative variation in cell shape and size did not differ significantly between the two groups and was fairly constant. CONCLUSION: The percentage of endothelial cell loss that occurred with manual NF using the Keener nucleus divider was similar to the one that occurs with other cataract surgery techniques. The small variation detected in postoperative endothelial morphology suggests that this endothelial cell population is stable.

Aged↗
PubMed1997

Endoscopic sphincterotomy for choledocholithiasis: a prospective single-center study on the short-term and long-term treatment results in 483 patients.

BACKGROUND AND STUDY AIMS: Endoscopic sphincterotomy (EST) is the method of choice for the treatment of choledocholithiasis. The aim of the present study was to assess the impact of various prognostic factors on the short-term and long-term results of EST. PATIENTS AND METHODS: Data from 483 EST procedures carried out due to choledocholithiasis without concomitant neoplasms or hepatic cirrhosis, and without subsequent bile duct surgery, were analyzed prospectively. The 324 patients (67%) who agreed to take part in the follow-up examinations and fulfilled the inclusion criteria for the study were divided into four groups, depending on the presence of the gallbladder or cholecystolithiasis prior to EST and on the time of diagnosis, and were prospectively followed up by physical examination laboratory tests, abdominal ultrasound, and endoscopic retrograde cholangiography examinations to evaluate the short-term and long-term outcomes. RESULTS: EST was successful in 95.7% of cases. Early complications were noted in 6.8% of cases. No early complications were seen in the group after cholecystectomy with a T-tube present, whereas this rate was highest in the group with concurrent choledocholithiasis and cholecystolithiasis (six of 48, 12.5%). Recurrent choledocholithiasis was observed in 5.6% of the cases overall. This rate was at its lowest in patients with choledocholithiasis alone, and was highest in the group with concurrent choledocholithiasis and cholecystolithiasis. Among the latter patients, the highest rates of papillary stenosis, chronic pancreatitis, and cholangitis were also observed, the latter complication being noted only in cases of recurrent common bile duct stones. CONCLUSIONS: EST is a relatively safe and effective procedure in the treatment of choledocholithiasis. The best prognostic factor is the presence of choledocholithiasis alone. Concurrent choledocholithiasis and cholecystolithiasis carry a more adverse prognosis, and in these cases cholecystectomy should be considered after EST.

Abdominal Pain↗
PubMed1997

Posterior tibial tendon dysfunction as a cause of acquired flatfoot in the adult: value of magnetic resonance imaging.

Dysfunction of the posterior tibial tendon is the most common cause of acquired flatfoot in adults; despite this, the condition is not commonly recognized. We report three cases with flatfoot secondary to spontaneous tendon rupture, in whom magnetic resonance imaging (MRI) was a helpful non-invasive technique to confirm the suspected diagnosis. This disabling entity, and the usefulness of MRI in the diagnosis and planning the appropriate treatment, are reviewed.

Diagnosis, Differential↗
PubMed1997

[Endoscopic polypectomy in the large bowel--the pathologist's view].

Colonoscopy remains the main diagnostic tool in colorectal diseases. Endoscopic polypectomy is a routine therapeutic method for colorectal adenomas, but its yield must be verified histologically. Complete endoscopic and histologic resection of an adenoma is regarded as a sufficient method of its treatment. Some early colon cancers can also be managed endoscopically, providing that strict histologic criteria are fulfilled. It is the duty of clinicians to supply pathologists with all the clinical data on the patient and to properly mark the resected specimen. Pathologists must understand the therapeutic technique, its limits, and provide physicians with a detailed histopathological report that includes not only a proper histological assessment of the resected tissue, but also a comment on completeness of the neoplasm resection. This article should help both clinicians and pathologists to benefit from the potential of histological examination.

Adenoma↗
PubMed1996

Transforming growth factor-beta1 inhibits human keratinocyte proliferation by upregulation of a receptor-type tyrosine phosphatase R-PTP-kappa gene expression.

We studied regulation of a receptor-type tyrosine phosphatase R-PTP-kappa gene expression in a human keratinocyte cell line, HaCaT. Addition of TGF-beta 1 to the HaCaT cells markedly induced the expression of R-PTP-kappa mRNA in a time- and dose-dependent manner. The induction of R-PTP-kappa mRNA expression was observed at a dose as low as 0.02 ng/ml TGF-beta1 and reached a peak at 2 ng/ml TGF-beta 1 after 6 h treatment. The TGF-beta 1-induced R-PTP-kappa mRNA expression was suppressed by sodium orthovanadate, a tyrosine phosphatase inhibitor, and H7, a serine/threonine kinase inhibitor, but not by genistein, a tyrosine kinase inhibitor. In addition, the inducing effect is not dependent on de novo protein synthesis. Taken together, these results suggest that TGF-beta 1 inhibits the human keratinocyte proliferation in vitro, possibly through induction of R-PTP-kappa gene expression.

Cell Division↗
PubMed1996

Giant cavernous hemangioma of the liver: atypical CT and MR findings.

The CT and MR appearance of giant cavernous hemangiomas can be confusing, and some atypical radiographic findings have been described. We report the CT and MR features of a giant cavernous hemangioma of the liver with atypical presentation. CT showed a large hypodense geographical lesion involving the majority of the liver and multiple scattered peripheral lesions. The T2-weighted MR images revealed a huge hyperintense lesion with multiple satellite nodules.

Biopsy, Needle↗
PubMed1996

Vocational outcome of aphasic patients following severe traumatic brain injury.

The incidence and course of aphasia, and its impact on vocational outcome, were determined in a group of 351 patients with severe traumatic brain injury (TBI). Aphasia was found in 11.1%, the common forms being amnestic (56%, 22/39), expressive (10.3%, 4/39) and receptive (10.5%, 8/39), as found on the first language assessment. No age difference was found between the aphasic and non-aphasic patients. Coma was more common in the aphasics than the non-aphasics (95% and 82%, respectively), although its mean duration was shorter. Aphasics had more severe locomotor deficits (p < 0.01, Fisher test) and tended towards more severe cognitive disorders (p = 0.07, Fisher test). There was no difference between the groups in incidence of behavioural disturbances or occupational outcome. Most of the aphasic patients improved after therapy, and two recovered completely. The presence of aphasia did not have negative prognostic implications for occupational outcome.

Activities of Daily Living↗
PubMed1996

[Periodical EEG pattern modifications in herpetic encephalitis treated with acyclovir].

The presence of PLED or localized or lateralized periodic activity in encephalitis strongly suggests that the encephalitis is due to the herpes simplex virus. Nevertheless, there has been controversy over its clinical significance. In addition, since the introduction of antiviral drugs in the treatment of herpes encephalitis in its initial stages, the prognosis of the disease has improved. We studied nine patients all diagnosed as having herpes encephalitis and treated with acyclovir. The presence or absence of periodic activity and its characteristics were analyzed. It was seen that either there was no such activity, or if there was, it was not exactly as classically described.

Acyclovir↗
PubMed1996

[Prognostic factors of early mortality in the 1st episode of hemorrhage caused by esophageal varices].

AIM: To assess the prognostic factors of early mortality in cirrhotic patients with the first variceal bleeding episode. PATIENTS AND METHODS: Fifty-five cirrhotic patients with endoscopic evidence of variceal bleeding treated with sclerotherapy during emergent endoscopy were included. RESULTS: Permanent hemostasis was obtained in 36 patients (65.5%). Fourteen (25.4%) patients died within six weeks of the bleeding episode. Twenty-four variables obtained at admission and in the following days were compared between patients who survived (n = 41), and died (n = 14). In the univariate analysis the following variables were related to early mortality: prothrombin ratio (p = 0.04), the presence of ascites (p = 0.004) and encephalopathy (p = 0.06), albumin (p = 0.01), Child-Pugh score (p = 0.0003), hemostasis during endoscopy (p = 0.002), absence of rebleeding at 24 hours (p = 0.01) and early rebleeding (within five days after the bleeding episode) (p = 0.006). Multiple logistic regression identified the Child-Pugh score (OR 11.86, CI 95% 2.54-55.48; p = 0.001) and early rebleeding (OR 6.27, CI 95% 1.29-30.44; p = 0.02) as prognostic independent factors of early mortality. CONCLUSIONS: The degree of hepatic failure and early rebleeding are prognostic independent factors of early mortality in cirrhotic patients after the first variceal bleeding episode.

Analysis of Variance↗
PubMed1996

[Kaposi's sarcoma of the bile ducts with cutaneous involvement in a patient with AIDS].

A 30 year-old man with acquired immunodeficiency syndrome was admitted because of abdominal pain, jaundice and fever. A severe pancreatitis without gallstones was detected. Later, dilation of biliary tract and clinical worsening appeared. Cholangiography revealed sclerosing cholangitis and papillary stenosis. Kaposi's sarcoma of the gallbladder invading the biliary tract was found. Only two reports of Kaposi's sarcoma of the biliary tract without cutaneous lesions have been published in a living patient. Pancreatitis has not been previously described as a clinical presentation of this malignancy.

Acquired Immunodeficiency Syndrome↗
PubMed1996

[Electrical status epilepticus during sleep].

INTRODUCTION: Sleep electrical status epilepticus (SESE) is a rare entity whose diagnosis depends or showing spike and wave complexes on the EEG during more than 85% of the duration of NoREM sleep. Typically it presents in children, most of whom have subjacent epilepsy. It is currently accepted that SESE is asymptomatic, although its persistence may give rise to severe neuropsychological sequelae. There are no references to sleep disorders in these patients. We present the case of a seven year old girl with SESE, hypersomnia and secondary nocturnal enuresis. CLINICAL CASE: The seven year old patient had a past history of simple partial crises with motor symptoms. There was progressive hypersomnia and nocturnal enuresis. The polysomnogram showed SESE. The Test for Multiple Latencies in Sleep (TMLS) showed pathological diurnal somnolence. HLA DR2 typing was negative. Neuropsychological study showed severe alterations in the language area, with a normal intelligence quotient. CONCLUSIONS: The new findings presented suggested that SESE is an intrinsic sleep disorder and not merely an EEG pattern. Since it occurs in children, sometimes with neuropsychological deficits, systematic TMLS should be done. The association of hypersomnia, changes in immediate visual memory and autistic regression suggest involvement of the limbic system.

Brain↗
PubMed1995

[Left ventricular hypertrophy in a general hypertensive population in Barcelona].

BACKGROUND: Left ventricular hypertrophy (LVH) is a well known cardiac risk factor. There are no data available as to the epidemiology of this disease in the general hypertensive population in Spain. METHODS: A randomized sample (n = 267) of a general hypertensive population under the age of 80 years was followed in a Basic Health Care Area located in the center of Barcelona, Spain. A Doppler-echocardiographic study of the patients was carried out. The patients were considered to have LVH when they demonstrated an index > 134 g/m2 of left ventricular mass in males and > 110 g/m2 in females. The odds ratio (OR) was estimated on presentation of LVH associated with exposure to different factors. RESULTS: A prevalence of LVH diagnosed by echocardiogram was observed in 64% (confidence interval 95% from 58.3 to 69.8%). The independent risk factors associated with the presence of LVH were female sex, age and systolic blood pressure. CONCLUSIONS: Left ventricular hypertrophy is a frequent cardiovascular risk factor in the general hypertensive population in Spain. A systematic search by echocardiography cannot be recommended in primary health care until cost-effectiveness studies have been performed.

Aged↗
PubMed1995

Plasma leukocyte elastase concentration in angiographically diagnosed coronary artery disease.

OBJECTIVE: To evaluate the clinical usefulness of leukocyte elastase determination in the diagnosis of coronary artery disease (CAD). BACKGROUND: Recent research has shown the important role of elastase, a proteolytic enzyme released by neutrophils, in the pathogenesis of CAD. METHODS: 141 patients underwent coronary angiography during investigation of chest pain and/or heart valve disease. Ninety-six had coronary lesions and 45 non-stenotic coronaries. The patients were characterized as regards presence or absence of angina (stable or unstable), family history of CAD, smoking, diabetes mellitus, hypertension, leukocyte counts, and plasma lipid and elastase concentrations. Among CAD-group patients, those with simple atheromatous plaques were distinguished from those with complex plaques. RESULTS: Elastase concentrations were greater in the CAD group than in the non-CAD group (49.7 +/- 2.8 micrograms.l-1; as against 29.5 +/- 2.2 micrograms.l-1; P < 0.001), and greater among complex-plaque CAD patients than among simple-plaque CAD patients (65.2 +/- 5.3 micrograms.l-1 as against 38.6 +/- 1.9 micrograms.l-1; P < 0.001). Logistic regression analysis showed (a) that the risk of CAD varied with elastase concentration, angina status, age and sex, increasing by 11% for every 1 microgram.l-1 increase in elastase concentration; and (b) that among CAD patients the risk of complex plaques was greatest for those with unstable angina and high elastase concentration, increasing by 6% for every 1 microgram.l-1 increase in elastase concentration. CONCLUSIONS: Peripheral blood leukocyte elastase concentration is a sensitive diagnostic marker of CAD. High values suggest the presence of complex atheromatous plaques.

Clinical Enzyme Tests↗
PubMed1995

Doppler echocardiographic comparison of small (19 mm) bileaflet and pericardial heart valve prostheses in aortic position.

The resting haemodynamics of five types of small (19 mm) aortic valve prosthesis (2 bileaflet, 3 pericardial) were evaluated with Doppler echocardiography in 43 patients. Two received St Jude Medical and six CarboMedics bileaflet valves and 35 were given bioprostheses--16 Ionescu-Shiley, four Mitroflow and 15 Labcor-Santiago. No significant differences in peak or mean transvalvular pressure drop or in effective valve area were found between the bileaflet and the pericardial valves or among the three types of bioprosthesis. All but one of the bileaflet prostheses showed a characteristic regurgitation pattern, with two lateral and one central jet, and 16 (46%) of the bioprostheses showed central regurgitation, but in no case were these jets haemodynamically significant. Thus the 19 mm bileaflet and the studied pericardial prostheses all have satisfactory resting haemodynamics, and all are suitable for implanting in small aortic roots.

Adult↗