[Diagnosis of Wolff-Parkinson-White Syndrome during ketamine anesthesia].
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Adolescent↗
Biomedical subjects
M Muñoz
Publications and source records attributed to M Muñoz.
Outcome of surgical management of superior oblique palsy: a study of 123 cases.
PURPOSE: To determine the outcome of the surgical management of superior oblique palsy at our institution. SUBJECTS AND METHODS: Retrospective review of 123 patients who underwent surgical correction of superior oblique paresis at Bascom Palmer Eye Institute from 1976 to 1996. Subject-Patients: 67% were male and 33% female. The mean age at surgery was 30.5 years (range, 2-78 years). Etiologies of the pareses were trauma (34%), congenital (33%), and acquired/non-traumatic (33%). The mean angle of preoperative vertical deviation in primary gaze was 14.0 delta (range, 0-45 delta). SURGERY: 109/123 (89%) patients underwent single muscle surgery. Of these 109, 57 had single oblique muscle surgery: a superior oblique tuck in 34/57 (60%); an inferior oblique weakening procedure in 22/57 (38%); and a Harada-Ito procedure in 1/57 (2%). The other 14 patients (11%) had bilateral surgery. RESULTS: The final postoperative vertical deviation in primary gaze was < or =3 PD in 60% of patients and < or =7 PD in 80%. The mean change in primary position vertical deviation postoperatively was 10.4 PD for distance and 13.0 PD for near. An "excellent" outcome (final vertical deviation &le3 PD in primary and reading gazes) was achieved most frequently in those patients with congenital pareses and isolated oblique muscle surgery. COMPLICATIONS: Clinically significant Brown's Syndrome occurred in 43/72 (60%) of those cases who had undergone a superior oblique tuck. The incidence of Brown's Syndrome was unrelated to tuck size. Reoperation was three times more likely to be necessary in traumatic cases than in congenital cases (35.0% vs 11.9%, p=0.02). CONCLUSIONS: Based on these results we recommend oblique muscle surgery as the initial procedure to correct superior oblique palsy when appropriate.
Adolescent↗
Occurrence of an antigenic triacyl trehalose in clinical isolates and reference strains of Mycobacterium tuberculosis.
A careful re-examination of the glycolipid content of clinical isolates and reference strains of the tubercle bacillus, Mycobacterium tuberculosis, led to the identification of a glycoconjugate that passed unnoticed in earlier studies. Nuclear magnetic resonance spectroscopy, gas chromatography-mass spectrometry and chemical degradations were used to identify the glycolipid as a 2,3,6-triacyl trehalose. The glycolipid contains a phthienoic acyl substituent, a family of multimethyl-branched, alpha,beta-unsaturated fatty acids specific for virulent strains of the tubercle bacillus. It reacted with sera from tuberculosis patients with a specificity and sensitivity of 96.2% and 76%, respectively. Comparable data were obtained with the 2,3-diacyl trehaloses of M. tuberculosis and M. fortuitum and with the triacyl trehaloses of M. fortuitum, suggesting that the antigens from the latter species may be used for the serodiagnosis of tuberculosis.
Antibodies, Bacterial↗
A novel region of the alpha4 integrin subunit with a modulatory role in VLA-4-mediated cell adhesion to fibronectin.
The integrin VLA-4 (alpha4 beta1) is a receptor for fibronectin and vascular cell-adhesion molecule 1 (VCAM-1). Four functionally different epitopes, designated A, B1, B2 and C, have previously been defined on the alpha4 subunit. Using K562 alpha4 mutant transfectants we found that alpha4 amino acids Tyr151, Gln152, Asp153, Tyr154 and Val155 are important for the structure of the epitope B2. Mutations at alpha4 Gln152 substantially impaired the transfectant adhesion to a CS-1-containing fragment of fibronectin (FN-H89), whereas this adhesion was not affected on the other alpha4 mutant transfectants. None of the alpha4 mutations significantly altered the adhesion of the different alpha4 transfectants to VCAM-1. In addition, we have identified residues Gln152, Asp153 and Tyr154 as part of the alpha4 epitope B2 involved in homotypic cell aggregation. The decrease in adhesion to FN-H89 shown by Gln152 alpha4 mutant transfectants was the result of an inefficient binding of FN-H89 by VLA-4 mutated at this residue. Also, mutant VLA-4 displayed an altered reactivity with HUTS-21, an anti-beta1 monoclonal antibody that reacts with functionally active VLA integrins. Adhesion to FN-H89 was not restored unless stimuli that increase the ligand-binding affinity of VLA heterodimers were added, suggesting that cell adhesion was affected in the initial phases. These results indicate that alpha4 Gln152 modulates cell adhesion to FN-H89 by playing important roles in the maintenance and/or the acquisition of an active state of VLA-4, an integrin that is normally expressed on the cell surface in a range of multiple activation states. The location of the alpha4 Gln152 residue on a loop of the upper surface of the proposed beta-propeller structure suggests a close association with potential ligand-binding sites.
Antibodies, Monoclonal↗
Easy differentiation of Mycobacterium mucogenicum from other species of the Mycobacterium fortuitum complex by thin-layer and gas chromatography of fatty esters and alcohols.
The mycolate pattern of a recently recognized mycobacterial pathogen, Mycobacterium mucogenicum (formerly Mycobacterium chelonae-like organism), was established for the first time. The reference strains, together with 31 environmental and clinical isolates belonging to this species, were examined for their mycolate composition by thin-layer chromatography. All strains tested exhibited the same mycolate profile. Mycolates were identified as belonging to the type without additional oxygenated chemical groups (mycolate I) and the type with a dicarboxylic group (mycolate VI); the identification of the latter was reinforced by the presence of 2-octadecanol, as seen by gas-liquid capillary chromatography. This mycolate profile permits the clear differentiation of M. mucogenicum from other related species, as members of the Mycobacterium fortuitum complex. This fact is especially important-because strains of M. mucogenicum are very difficult to differentiate from other species of the M. fortuitum complex by means of conventional biochemical tests. Moreover, the characteristic mycolate profile exhibited by the strains of M. mucogenicum supports the recent proposal which considers them as members of a new species.
Base Sequence↗
Pharmacological characterization and distribution of muscarinic receptors in human placental syncytiotrophoblast brush-border and basal plasma membranes.
Based on the existence of choline acetyltransferase and acetylcholine in human placenta, we have investigated the presence of muscarinic acetylcholine receptors in brush-border and basal plasma membranes from human term placenta. Radioligand binding assay, using [3H]N-methyl-scopolamine as tracer, showed the existence of acetylcholine muscarinic receptors in brush-border (Kd 0.28 +/- 0.04 nM; Bmax 9.4 +/- 1.6 fmol/mg protein) and basal plasma membranes (Kd 0.24 +/- 0.05 nM; Bmax 34.3 +/- 6.3 fmol/mg protein). In order to perform a pharmacological characterization of these receptors, competition binding experiments were carried out using the muscarinic receptor antagonists pirenzepine, (11(2-diethyl-amino)methyl)-1-piperidinylacetyl-5-11-dihydro-6H-py rido(14) benzodiazepine (AF-DX 116), himbacine, 4-diphenylacetoxy-N-methylpiperidine methiodide (4-DAMP), dicyclomine and hexahydro-sila-difenidol (HHSD). The results obtained showed that the muscarinic receptors in brush-border and basal plasma membranes belong to different subtypes. In brush-border membranes, the receptor found match in terms of affinity for the antagonists with the muscarinic M1 receptor subtype (Ki pirenzepine, 13.6 +/- 8.2 nM; Ki AF-DX 116, 1680 +/- 271 nM; Ki himbacine, 212 +/- 6.5 nM; Ki 4-DAMP. 1.5 +/- 0.4 nM; Ki dicyclomine, 5.1 +/- 0.8 nM; Ki HHSD, 34.3 +/- 7.3 nM), whereas the receptor in basal plasma membrane seems to be of the muscarinic M2 receptor subtype (Ki pirenzepine, 202 +/- 48 nM; Ki AF-DX 116, 124 +/- 60 nM; Ki himbacine, 20.6 +/- 4.8 nM; Ki 4-DAMP, 4.5 +/- 1.2 nM; Ki dicyclomine, 54.6 +/- 22 nM; Ki HHSD, 89.2 +/- 15.8 nM). The results obtained show the existence of muscarinic acetylcholine receptors in brush-border and basal plasma membranes from human term placenta with a different distribution pattern in terms of number of receptors and distribution of different subtypes. The functional significance of these findings is as yet unknown, but these receptors probably mediate different functions as they belong to different subtypes and are coupled to different second messengers.
Binding, Competitive↗
Spinal ascending pathways in amphibians: cells of origin and main targets.
As part of a research program on the evolution of somatosensory systems in vertebrates, the various components of ascending spinal projections were studied with in vivo and in vitro tract-tracing techniques in representative species of amphibians (the large green frog, Rana perezi, the clawed toad, Xenopus laevis and the ribbed newt, Pleurodeles waltl). Three main ascending sensory channels, each with largely separate targets, were demonstrated: 1. Ascending projections via the dorsal funiculus include primary and nonprimary projections that ascend to terminate mainly in the dorsal column nucleus at obex levels. A small component ascends farther rostralwards to terminate in the reticular formation, the octavolateral area, the trigeminal nuclear complex, and in the granular layer of the cerebellum. 2. Projections ascending via the dorsolateral funiculus reach other spinal and supraspinal targets than the dorsal funicular fibers, mainly ipsilaterally. At upper cervical cord and obex levels, many fibers innervate a region considered the amphibian homologue of the lateral cervical nucleus of mammals. In the medulla, these fibers ascend ventral to the descending trigeminal tract to terminate in the dorsal column and the solitary tract nuclei, and more rostrally, in the reticular formation, the descending trigeminal nucleus and the medial aspect of the ventral octaval nucleus. Major projections reach the area between the facial motor nucleus and the ventral octaval nucleus, and a mediolateral subcerebellar band. These projections arise in neurons located mainly in the ipsilateral deep dorsal and lateral fields throughout the spinal cord. 3. Ascending spinal projections via the ventral quadrant of the spinal cord (the ventral and ventrolateral funiculi) ascend throughout the brainstem up to the diencephalon. Along its course, this component innervates various parts of the reticular formation, the octavolateral area, the granular layer of the cerebellum, the region ventromedial and ventrolateral to the isthmic nucleus, and the subcerebellar region. In the mesencephalon, the torus semicircularis, the midbrain tegmentum and, sparsely, the tectum mesencephali are innervated. Beyond the midbrain, various dorsal and particularly ventral thalamic nuclei and the posterior tubercle are innervated by this ascending sensory channel. The cells of origin of some of these projections were observed in the dorsal, and to a lesser extent, in the lateral and ventral spinal fields of the spinal cord. Evidence for the presence of these three main ascending sensory channels throughout vertebrates will be discussed. The presence of such channels appears to be a shared character in the brain of both amniotes and anamniotes.
Afferent Pathways↗
Cyclin D1 and retinoblastoma gene expression in human breast carcinoma: correlation with tumour proliferation and oestrogen receptor status.
Cyclin D1 (CCND1) and retinoblastoma (Rb) genes are cell cycle regulators which are altered in some breast carcinomas. However, the possible cooperation between CCND1 and Rb, as well as the influence and coincidence of their abnormalities in the proliferative capacity of mammary carcinoma cells in vivo, is still unknown. In order to assess both the significance of the CCND1 gene and Rb alterations in breast carcinomas and their relationship with the proliferative capacity of the tumours and other clinico-pathological factors, CCND1 mRNA expression was studied in 46 cases of primary breast carcinomas and matched normal tissue, 45 of which were also studied immunohistochemically, Rb expression was analysed in the same cases by immunohistochemistry, whereas the proliferative activity of the carcinoma was evaluated by flow cytometry. CCND1 mRNA was overexpressed in 19 tumours (41 per cent). Sixteen cases showed diffuse immunohistochemical expression, ten carcinomas had few positive cells, and 19 were absolutely negative. CCND1 mRNA and protein overexpression was associated with oestrogen receptor (ER) expression by the tumour. Interestingly, lack of ER expression was associated with a decreased CCND1 mRNA signal in non-overexpressed tumours. No association was observed between CCND1 mRNA or protein overexpression and tumour proliferation or other clinico-pathological parameters. Loss of Rb expression was observed in 26 per cent of the tumours. This abnormality was significantly associated with increased mean S-phase (P = 0.017) and decreased CCND1 mRNA expression in non-overexpressed tumours, supporting in vivo the postulated regulatory loop between Rb and CCND1 in vitro. We conclude that CCND1 up-regulation is not associated with increased proliferative activity in breast carcinomas, whereas its expression might be regulated in vivo by hormones and Rb. Loss of Rb expression is significantly associated with an increased proliferation of tumour cells, suggesting an important role in the progression of a subset of breast carcinomas, regardless of CCND1 abnormalities.
Blotting, Northern↗
Seizures caused by chloral hydrate sedative doses.
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Child, Preschool↗
Use of buccal fat pad to repair intraoral defects: review of 30 cases.
The buccal fat pad has been frequently used for the closure of oro-antral and oro-nasal communications. There are a few studies in the literature reporting its use in defects secondary to tumoral resections. In this paper we consider both the anatomical basis and the surgical technique. We also review 30 cases, used for the repair of 15 defects due to tumoral resections, 8 to maxillary cysts, 6 to communications and 1 secondary to a postraumatic defect. It has been successful in 28 of the 29 patients, with a complete epithelization of the flap, even in 4 cases with partial necrosis of the pad. It is an acceptable type of reconstruction, versatile and of a simple surgical technique. However, its use is limited to small or medium defects, being sometimes scarce.
Adenoma, Pleomorphic↗
Distribution of surface-exposed antigenic glycolipids in recent clinical isolates of Mycobacterium tuberculosis.
The distribution of surface-exposed antigenic glycolipids in seven recent clinical isolates of Mycobacterium tuberculosis was established. Thin-layer and liquid chromatographies revealed a uniformity in the glycolipid pattern. Chemical analysis of the individual glycolipids of a selected strain enabled the identification of glycolipids of serological interest in all the other clinical isolates. Phenolic glycolipid-Tb1 (PGL-Tb1) was lacking in all strains, but appreciable amounts of a partially deglycosylated version (PGL-Tb1D) were present in the seven isolates. Diacyltrehaloses (DATs) were detected in all strains, showing themselves to be major glycolipids. Lipooligosaccharides (LOS-II) were present in the seven strains studied though only in trace amounts. These results shed new light on the open debate on the distribution of these interesting glycolipids in typical clinical isolates of M. tuberculosis. In the search for a serological test for tuberculosis, and in accordance with our observations, we believe that PGL-Tb1 and LOS-II should not be the target molecules for serology and that it is worthwhile to continue investigating the value of DATs as antigens. We also believe that it would be of interest to undertake research to assess the usefulness of PGL-Tb1D as an antigen.
Antigens, Bacterial↗
Quintuple cancers: report of a case with triple cancers in the head and neck.
The incidence of multiple primary cancers is increasing. We report a case of quintuple cancers, two located in the genitourinary tract and three arising on the upper aerodigestive tract, two synchronous squamous cell carcinomas of the oral mucosa and another on the larynx. We also present a brief review of the literature.
Adenocarcinoma↗
Comparison of Colombian and Costa Rican strains of rice hoja blanca tenuivirus.
The sequences of RNA-3 and RNA-4 of rice hoja blanca tenuivirus isolates from Colombia and from Costa Rica were determined and analyzed. These isolates were 98.9% and 98.6% identical in the coding and non-coding regions of RNA-3, and 96.9 and 91.5% identical in the coding and non-coding regions of RNA-4, and are therefore strains of the same virus. There is about three times as much variation between isolates (based on consensus sequences) as there is within isolates (based on sequences of individual clones). There is also considerably more variation for RNA-4 (both between and within isolates) than there is for RNA-3, even though between tenivirus species RNA-3 has diverged more than RNA-4, implying that the evolution of the tenuivirus RNAs is not necessarily dependent on the amount of variation found for these RNAs.
Colombia↗
Lifetime and 12-month prevalence of DSM-III-R mental disorders among the homeless in Madrid: a European study using the CIDI.
The characteristics of homeless people in Europe are almost unknown. The aim of this study was to describe the lifetime and 12-month prevalence of DSM-III-R/CIDI mental disorders among the homeless population of Madrid. A total of 261 homeless subjects, sampled from different sites, participated in the study. In terms of DSM-III-R lifetime rates, 50% of the sample had substance-related disorders and 35% had non-substance-related disorders. In total, 67% of the study subjects had some type of disorder. The lifetime prevalence of schizophrenia (4%) was lower than reported in most previous studies. Although the mental illness pattern is similar to that observed in studies using the same diagnostic methods, the results reported here show a lower prevalence of drug abuse and schizophrenic disorders. The reasons for these cultural differences and their implications for international public health research are discussed.
Adolescent↗
Stability study of epirubicin in NaCl 0.9% injection.
OBJECTIVE: To determine the stability of epirubicin in NaCl 0.9% injection under hospital storage conditions. METHODS: NaCl 0.9% solution was added to epirubicin lyophilized powder to make a final concentration of 1 mg/mL to study the degradation kinetics and 2 mg/mL to study the stability in polypropylene syringes under hospital conditions. SETTING: Physical chemistry laboratory, Unitat de Fisicoquímica, Universitat de Barcelona. MAIN OUTCOME MEASURES: Solutions of epirubicin at 2 mg/mL in NaCl 0.9% solutions stored in plastic syringes were studied under hospital conditions at room temperature (25 +/- 1 degrees C) and under refrigeration (4 +/- 1 degrees C) both protected from light and exposed to room light (approximately 50 lumens/m2). All samples were studied in triplicate and epirubicin concentrations were obtained periodically throughout each storage/time condition via a specific stability-indicating HPLC method. To determine the degradation kinetics, solutions of epirubicin in NaCl 0.9% at 1 mg/mL were stored at different temperatures (40, 50, and 60 degrees C) to obtain the rate degradation constant and the shelf life at room temperature and under refrigeration. RESULTS: The degradation of epirubicin in NaCl 0.9% solutions follows first-order kinetics. The shelf life was defined as the time by which the epirubicin concentration had decreased by 10% from the initial concentration. In this study, epirubicin was stable in NaCl 0.9% injection stored in polypropylene containers for all time periods and all conditions. That results in a shelf life of at least 14 and 180 days at 25 and 4 degrees C, respectively. The maximum decrease in epirubicin concentration observed at 25 degrees C and 14 days was 4%, and at 4 degrees C and 180 days was 8%. The predicted shelf life obtained from the Arrhenius equation was 72.9 +/- 0.2 and 3070 +/- 15 days at 25 and 4 degrees C, respectively, in both dark and illuminated conditions. CONCLUSIONS: Solutions of epirubicin in NaCl 0.9% at 2 mg/mL are chemically stable when they are stored in polypropylene syringes under hospital storage conditions. No special precaution is necessary to protect epirubicin solutions (2 mg/mL) from light.
Antibiotics, Antineoplastic↗
Effect of aspirin plus dipyridamole on the retinal vascular pattern in experimental diabetes mellitus.
Platelet hyperactivity has been one of the mechanisms implicated in the pathogenesis of diabetic retinopathy. Antiplatelet agents have been shown, in experimental models, to prevent the development of retinal vascular abnormalities when given from the first day after the onset of diabetes. We assessed the effect of aspirin plus dipyridamole (6 + 12 mg/kg daily) on the retinal vascular pattern in experimental streptozotocin-induced diabetes in rats, when the treatment was given at different intervals after the induction of diabetes, over a 3-month study period. Saline-pretreated diabetic rats showed a time-dependent increases in the platelet production of thromboxane B2 (r = 0.981, P < .0001) and a decrease in the aortic production of 6-keto-PGF1 alpha. The percentage of retinal area occupied by horseradish peroxidase-labeled vessels decreased progressively in relation to the length of time of the evolution of diabetes (r = 0.983, P < .00001) and the thromboxane/prostacyclin ratio. Treatment with aspirin plus dipyridamole caused an inhibition of the platelet production of thromboxane B2 and a decrease in the vascular synthesis of prostacyclin. Treatment with antiplatelet agents slowed down the decrease in the percentage of retinal area occupied by horseradish peroxidase-labeled vessels. These data provide further evidence to support the results of previous clinical trials in which antiplatelet agents had a beneficial effect on the evolution of retinal lesions in early diabetic retinopathy.
6-Ketoprostaglandin F1 alpha↗
Massive bronchoalveolar aspiration of barium sulfate during a radiologic study of the upper digestive tract.
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Barium Sulfate↗
[Cervical cancer screening. False negative smears].
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Algorithms↗