Intensive chemotherapy with peripheral progenitor stem cell support: experience of the Hematology Department of São João hospital, Oporto, Portugal.
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Adolescent↗
Biomedical subjects
R Duarte
Publications and source records attributed to R Duarte.
Serum ICAM-1 concentrations following conventional dose consolidation chemotherapy for acute myeloid leukemia and after high dose chemotherapy with autologous haematopoietic stem cell rescue.
Serum concentrations of soluble ICAM-1 (sICAM-1) were studied in patients with acute myeloid leukemia (AML) after conventional dose consolidation chemotherapy and in AML and in breast cancer patients following high dose chemotherapy with autologous haematopoietic stem cell transplantation. Investigations were carried out at 3 phases following treatment; during the chemotherapy induced neutropenic phase (neutrophil counts <0.5x109/l); during early recovery (neutrophil counts 0.5x109/l-1.0x109/l); and at recovery from neutropenia (neutrophil count 1.0x109/l-2.5x109/l). Results showed a significant elevation of serum levels of sICAM-1, above normal, in both groups of patients during the neutropenic phase. A further increase of sICAM-1 was found in conventional dose consolidation chemotherapy treated AML patients during the post-neutropenia recovery phases. By contrast, patients who were treated with high dose chemotherapy plus autologous haematopoietic stem cell transplantation showed a normalisation of sICAM-1 concentration during the post-neutropenic recovery phases. These findings suggest that recovery of neutrophil function do not coincide with recovery of neutrophil count following intensive chemotherapy while rapid recovery of neutrophil function occurred among patients who received autologous haematopoietic stem cell support.
Acute Disease↗
Expression of CD11b/CD18 on neutrophils after consolidation chemotherapy for acute myeloid leukemia and after high dose chemotherapy with autologous haematopoietic stem cell transplantation.
Quantitative expression of neutrophil CD11b/CD18 following chemotherapy (either conventional dose consolidation chemotherapy or high dose chemotherapy with autologous stem cell transplantation) was investigated during the early recovery phase (neutrophil count 0. 5-1.0x109/l) and at full recovery (neutrophil count 1.0-2.5x109/l) following treatment. CD11b/18 expression was normal in stem cell transplantation supported patients during both early and full neutrophil recovery. By contrast CD11b/CD18 expression was markedly decreased in patients who received chemotherapy without stem cell support. These results suggest that recovery of neutrophil count may not always coincide with recovery of neutrophil function and that G-CSF stimulated peripheral stem cell transplantation enhances neutrophil function post chemotherapy.
Acute Disease↗
Purification and characterization of a tungsten-containing formate dehydrogenase from Desulfovibrio gigas.
An air-stable formate dehydrogenase (FDH), an enzyme that catalyzes the oxidation of formate to carbon dioxide, was purified from the sulfate reducing organism Desulfovibrio gigas (D. gigas) NCIB 9332. D. gigas FDH is a heterodimeric protein [alpha (92 kDa) and beta (29 kDa) subunits] and contains 7 +/- 1 Fe/protein and 0.9 +/- 0.1 W/protein. Selenium was not detected. The UV/visible absorption spectrum of D. gigas FDH is typical of an iron-sulfur protein. Analysis of pterin nucleotides yielded a content of 1.3 +/- 0.1 guanine monophosphate/mol of enzyme, which suggests a tungsten coordination with two molybdopterin guanine dinucleotide cofactors. Both Mössbauer spectroscopy performed on D. gigas FDH grown in a medium enriched with (57)Fe and EPR studies performed in the native and fully reduced state of the protein confirmed the presence of two [4Fe-4S] clusters. Variable-temperature EPR studies showed the presence of two signals compatible with an atom in a d(1) configuration albeit with an unusual relaxation behavior as compared to the one generally observed for W(V) ions.
Aerobiosis↗
Thyroid function and autoimmunity during treatment with G-CSF.
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Adult↗
Prospective randomized trial of docetaxel versus doxorubicin in patients with metastatic breast cancer.
PURPOSE: This phase III study compared docetaxel and doxorubicin in patients with metastatic breast cancer who had received previous alkylating agent-containing chemotherapy. PATIENTS AND METHODS: Patients were randomized to receive an intravenous infusion of docetaxel 100 mg/m(2) or doxorubicin 75 mg/m(2) every 3 weeks for a maximum of seven treatment cycles. RESULTS: A total of 326 patients were randomized, 165 to receive doxorubicin and 161 to receive docetaxel. Overall, docetaxel produced a significantly higher rate of objective response than did doxorubicin (47.8% v 33.3%; P =.008). Docetaxel was also significantly more active than doxorubicin in patients with negative prognostic factors, such as visceral metastases (objective response, 46% v 29%) and resistance to prior chemotherapy (47% v 25%). Median time to progression was longer in the docetaxel group (26 weeks v 21 weeks; difference not significant). Median overall survival was similar in the two groups (docetaxel, 15 months; doxorubicin, 14 months). There was one death due to infection in each group, and an additional four deaths due to cardiotoxicity in the doxorubicin group. Although neutropenia was similar in both groups, febrile neutropenia and severe infection occurred more frequently in the doxorubicin group. For severe nonhematologic toxicity, the incidences of cardiac toxicity, nausea, vomiting, and stomatitis were higher among patients receiving doxorubicin, whereas diarrhea, neuropathy, fluid retention, and skin and nail changes were higher among patients receiving docetaxel. CONCLUSION: The observed differences in activity and toxicity profiles provide a basis for therapy choice and confirms the rationale for combination studies in early breast cancer.
Adult↗
One hundred kidney transplants: one surgeon's experience.
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Adolescent↗
Phospholipase A2 isoforms are altered in chronic pancreatitis.
OBJECTIVE: To determine if phospholipase A2 (PLA2) type II and type IV mRNA expression and protein are altered in chronic pancreatitis. SUMMARY BACKGROUND DATA: PLA2s have an important regulatory function in several signaling pathways, especially in inflammation. In this study, we examined the expression of three PLA2 isoforms (type I, type II, and type IV) in chronic pancreatitis. METHODS: The distribution of PLA2 was studied in 15 pancreas samples obtained from patients with chronic pancreatitis using immunohistochemical, Northern blot, and in situ hybridization techniques. Normal pancreas obtained from healthy organ donors served as control. RESULTS: Northern blot analysis revealed enhanced mRNA levels of PLA2 type II (5.7-fold) and type IV (5.1-fold) in chronic pancreatitis (p < 0.01) versus normal pancreas. In normal pancreas, intense PLA2 type I immunostaining was present in acinar cells, whereas PLA2 type II immunostaining was visible only in some acinar cells. In chronic pancreatitis, PLA2 type II immunostaining was present more frequently and with higher intensity in acinar cells. Furthermore, PLA2 type II immunoreactivity was more abundant in metaplastic ductal cells in the chronic pancreatitis samples. By in situ hybridization, areas with ductal metaplasia in chronic pancreatitis exhibited intense PLA2 type IV mRNA signals. All chronic pancreatitis tissues with concomitantly increased mRNA expression for PLA2 type II and type IV exhibited a higher degree of degeneration, ductal metaplasia, and fibrosis. CONCLUSIONS: Upregulation of PLA2 types II and IV in areas with more histologic damage suggests that these PLA2 isoforms might contribute to the morphologic changes that occur in chronic pancreatitis.
Adult↗
The plasminogen activator/plasmin system is up-regulated after acute necrotizing pancreatitis in human beings.
BACKGROUND: Proteolysis and formation of new extracellular matrix components are important mechanisms in tissue remodeling and repair. In this study we analyzed the expression and distribution of the urokinase plasminogen activator (uPA), its membrane receptor (urokinase plasminogen activator receptor [uPAR]), and its inhibitor (plasminogen activator inhibitor-1 [PAI-1]) in acute necrotizing pancreatitis in human beings. In addition, we studied the concomitant expression of transforming growth factor-beta-1 (TGF-beta 1), which is activated by uPA from its precursor and is a potent regulator and stimulator of formation of extracellular matrix. METHODS: With immunohistochemistry and Northern blot analysis, the expression and cellular distribution of uPA, uPAR, PAI-1, and TGF-beta 1 were determined in 12 normal pancreata obtained from organ donors and 12 pancreatic tissues obtained from patients undergoing operation because of complications of acute necrotizing pancreatitis. RESULTS: Northern blot analysis showed enhanced expression of uPA, uPAR, and PAI-1 in eight of 12, seven of 12, and nine of 12 necrotizing pancreatitis samples, respectively, compared with normal control samples. In addition, increased TGF-beta 1 mRNA expression was present in eight of 12 necrotizing pancreatitis samples. In contrast, amylase mRNA expression was markedly decreased in the samples of acute necrotizing pancreatitis. Immunohistochemistry revealed elevated uPA, uPAR, and PAI-1 immunoreactivity in the remaining acinar and ductal cells adjacent to the necrotic tissue areas. In contrast, acinar and ductal cells that were located farther from pancreatic necrosis exhibited less uPA and uPAR immunoreactivity. A similar staining pattern in samples of necrotizing pancreatitis was found for TGF-beta 1. CONCLUSIONS: Up-regulation of uPA and uPAR, which activate proteolysis, might create a milieu that enhances lysis and removal of pancreatic necrosis. The increase in TGF-beta 1 might result from the enhanced catalytic conversion of its precursors by uPA, which subsequently might stimulate formation of extracellular matrix, formation of granulation tissue, and fibrosis.
Adolescent↗
[Free me from this nail! Please!].
Ingrowing toenails are a very frequent pathology in children and adolescents. There is an anatomic component, but also other factors, such as inadequate shoes and incorrect nail-trimming. We treated 47 patients with 69 ingrowing toenails, between one and 15 years of age. The evolution time was one month to 10 years and 11 patients had precedent surgeries. Lateral electrosurgical matricectomy was the choice technique. With a follow up of at least eight months, there is only one case of recurrence.
Adolescent↗
Mycobacterium tuberculosis induces apoptosis in gamma/delta T lymphocytes from patients with advanced clinical forms of active tuberculosis.
Antigens from inactivated Mycobacterium tuberculosis H37Ra induce activation in a subpopulation of gamma/delta (gamma/delta) T lymphocytes in a manner that resembles that of superantigens from alpha/beta T cells. After culture in vitro with H37Ra proteins, gamma/delta T lymphocytes from patients with advanced clinical forms of active tuberculosis (ACF-TBC) display cytotoxic activity against homotypic target cells exposed to H37Ra. Cytotoxicity by gamma/delta T lymphocytes from ACF-TBC patients occurs in a range similar to that observed in healthy subjects. Following activation, H37Ra-stimulated gamma/delta T lymphocytes from healthy subjects did proliferate in the presence of exogenous recombinant human interleukin 2. However, under the same conditions, gamma/delta T lymphocytes from ACF-TBC patients not only did not proliferate but died by apoptosis. These results suggest that in gamma/delta T lymphocytes from patients with ACF-TBC, antigens from M. tuberculosis may induce cell activation that leads to apoptotic cell death.
Antigens, Bacterial↗
A role for gamma delta T lymphocytes in the development of advanced clinical forms of tuberculosis in HIV-infected patients.
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HIV Infections↗
[Adenocarcinoma of the Vater's ampulla associated with Von Recklinghausen's neurofibromatosis].
Von Recklinghausen's Neurofibromatosis is an autosomal dominant disease of variable manifestations. Association with gastrointestinal and hepatobiliary tumours is well documented, most of them being benign neurofibromas. Other tumours, such as leiomyomas, sarcomas, ganglioneuromas and carcinoids are less frequent. Much rarer is the development of epithelial malignancies and an ontogenic relation is not clear. The authors reports a case of adenocarcinoma of Vater's Ampulla and duodenal neurofibromas, in a patient with Von Recklinghausen's disease, presenting obstructive jaundice.
Adenocarcinoma↗
Stroke and pregnancy.
OBJECTIVE: To study the controversial relationship between pregnancy and stroke. Old studies and those from developing countries suggest that pregnancy considerably increases the risk of stroke. METHODS: The records of 946 consecutive cases of stroke observed in Saudi patients in 10 years were reviewed. Cases which occurred during pregnancy or during the first 15 days postpartum were included in the study. RESULTS: Twelve patients (1.3%) were pregnant or in postpartum at stroke onset. They constituted 27% of women of childbearing age. Cerebral infarction was diagnosed in nine cases and cerebral hemorrhage in three. Four patients died. CONCLUSION: The risk of stroke is only marginally increased (x 1.5) in pregnant compared with non-pregnant Saudi women. Many factors including peripartum cardiomyopathy, patent foramen ovale, changes in clotting factors, peripartum angiopathy and vasoactive steroid hormones, could be responsible for this increased risk.
Adolescent↗
Interferon-alpha facilitates renal transplantation in hemodialysis patients with chronic viral hepatitis.
Interferon-alpha has not been used previously in hemodialysis patients with chronic hepatitis B and C. This uncontrolled report evaluates the biochemical and/or histologic profile resulting from the administration of interferon-alpha in seven hemodialysis patients, two with chronic hepatitis B and five with hepatitis C. Biochemical improvement was noted in all patients. Histologic progression did not occur in the two cases in which such assessment was made, and five of them were subsequently transplanted without recurrence of disease.
Adolescent↗
Spontaneous rupture of renal allograft.
Spontaneous rupture of a renal allograft was encountered in 3 male patients among 75 consecutive renal transplants over a three-year period. In 1 patient, the transplant was from a living related donor, while the other two were cadaveric kidneys from pediatric donors. In 2 patients, allograft rupture followed steroid-resistant rejection, while in the third with cadaveric kidney transplant, the rupture was associated with renal vein thrombosis. Two patients presented with classic symptoms of renal allograft rupture: sudden onset of severe pain and swelling over the allograft and hypotension, while in the third the rupture was found during exploration of the allograft with clinical diagnosis of renal artery thrombosis. Transplant nephrectomy was done in 2 patients, while successful surgical repair was performed in the third patient with living related transplant.
Adult↗
Conserved cis-elements bind a protein complex that regulates Drosophila ras2/rop bidirectional expression.
The Drosophila ras2 promoter region exhibits bidirectional activity, as has been demonstrated for the human c-Ha-ras1 and the mouse c-Ki-ras. Here we address a unique case of ras regulation, as Drosophila ras2 provides the only example to date in which the flanking gene (rop) and its product have been isolated. A linking mechanism of control suggests a mutual interaction between the two gene products. Our studies indicate that the Drosophila ras2 promoter region shares with the human c-Ha-ras1 promoter a CACCC box and an AP-1-like sequence. A 14 bp promoter fragment which holds a CACCC element is demonstrated to interact with a specific transcription factor (factor B). This CACCC promoter element represents a stretch of imperfect palindrome. We present evidence that this factor can form a complex with another specific DNA-binding protein (factor A). The binding sites (A + B) for these protein factors are essential for 95% expression of both genes flanking the promoter (ras2 and rop). Region A consists of four overlapping consensus sequences: a TATA-like element, a DSE-like motif (the core sequence of the serum response element), a DRE octamer, which has been shown to play a role in cell proliferation, and a 5 bp direct repeat representing the GATA consensus sequence. Factor A has a very weak affinity to the full promoter region, but when complexed with factor B binding efficiency is enhanced. We also show that alterations of DNA-protein binding specificities can be achieved by supplementing the growth media with different sera.
Animals↗
[Children and lead exposure. Preliminary study].
UNLABELLED: Lead poisoning is one of the most common and preventable childhood illness. The authors believe that the present study is the first evaluation of this problem in Portugal. OBJECTIVES: a) to characterize blood lead levels in children aged 1 to 6 years living in the Oporto area; b) to identify risk groups and develop screening strategies. MATERIAL AND METHODS: The authors studied an opportunistic sample of children that were observed at the Hospital Maria Pia and the Instituto Nacional de Saúde Dr. Ricardo Jorge (Porto) to whom blood testing was requested. All children with neurological or digestive symptoms were excluded (October-December 1991; n = 113). RESULTS: One child had a blood lead level of 46.6 micrograms/dl (class-IV, CDC); 32% (n = 36) were between 20 e 44 micrograms/dl (class-III), while only four children (3.2%) presented values < = 9 micrograms/dl (class-I). Class II included the remainder (n = 73). The results clearly point out that lead poisoning is a real problem among Portuguese children, since the proportion of children not considered to be lead-poisoned is very small. Children in the other classes are at risk of developing acute and chronic toxicity.
Child, Preschool↗