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Biomedical subjects

V Edwards

Publications and source records attributed to V Edwards.

At least 37 records · Page 2Linked to original sources
PubMed1995

Prevention of biliary cirrhosis following hepatic arterial thrombosis after liver transplantation in children by using ursodeoxycholic acid.

Hepatic artery thrombosis (HAT) after liver transplantation is a severe complication that often requires retransplantation. The authors have adopted a different approach, aimed at treating the perioperative HAT complications aggressively and early, with ursodeoxycholic acid (UDCA), to try to preserve the original graft. Eighty-six liver transplants were performed in 73 children (age range, 4.5 months to 17.5 years; median, 2.6 years). HAT occurred eight times, in seven patients (9.3%). Patients with HAT were significantly younger and smaller (mean age, 0.8 +/- 0.4 v 4.8 +/- 5.3 years; P < .02; mean weight, 7.4 +/- 0.8 v 18.7 +/- 16.2 kg; P < .05). The incidence of HAT varied significantly according to the method of arterial reconstruction used: 4 of 16 (25%) when a donor iliac artery interposition graft to the aorta was used, 4 of 61 (6.6%) when the native hepatic artery was used, and 0 of 9 when the donor celiac axis was anastomosed directly to the aorta (P < .05). The incidence of HAT was not significantly different when reduced-size grafts were used. Early retransplantation was performed in three of the eight patients; two survived. All other patients were treated for 4 to 6 weeks with broad-spectrum antibiotics and amphotericin. Five patients were treated with UDCA, three immediately after the acute event and two after 4 and 6 months (respectively) post-HAT. The patients who had UDCA immediately post-HAT had histologically normal liver biopsy specimens. Results of liver function tests have been normal. One of these patients required transhepatic stenting of a common bile duct stricture for several months.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1994

[Knowledge and attitudes about AIDS and sex behavior among school and university students of main urban cities of the country].

A national survey was conducted interviewing 4,522 students and 334 teachers. The result can be extrapolated to young people over 15 years of age and living in the large urban centers of the country. Thus the results can be extrapolated to approximately 330,000 persons. A good theoretical knowledge was detected but invalidated by erroneous beliefs, such as believing that A.I.D.S. is not contagious if relations are held within the same social group, that can be avoided by post-coital genital cleaning or by inquiring about the partner's previous sexual conduct. Forty four two per cent of the surveyed student are sexually active, and of this 32.6% of the men and 10.8% of the women have sexual relations with others outside their regular partners. The 72.9% believe that there is no possibility of A.I.D.S. contagion or that is very low. The erroneous beliefs, the high level of sexual activity the precocious initiation of sexual activity with prostitutes prostitutes and promiscuity among the surveyed, together with the generalized and false perception that there are not possibilities of contagiouness confirm that our youth is in very high risk level of contracting A.I.D.S. virus. Government politic is required to provide a global solution to this problem.

Acquired Immunodeficiency Syndrome↗
PubMed1991

Permeabilized hepatocyte couplets. Adenosine triphosphate-dependent bile canalicular contractions and a circumferential pericanalicular microfilament belt demonstrated.

The motility of bile canaliculi was examined in hepatocyte couplets permeabilized with palmitoyl lysophosphatidyl choline in a dosage regimen that drastically affected secretory function, yet maintained relative integrity of the cellular cytoskeleton. The permeabilized cells showed no exclusion of trypan blue, notable cytoplasmic organelle and membrane damage, and no uptake or secretion of either fluorescein diacetate or sodium fluorescein. However, bile canalicular structure remained relatively intact and actin and myosin were localized immunocytochemically in the pericanalicular region. Coincident with the administration of 1 mM ATP, 2 mM Mg2+, and 1 microM Ca2+, the canaliculi contracted with partial or complete luminal closure. ADP, AMP, or AMP-PCP could not be substituted for ATP. A dose-dependent relationship was shown between ATP concentration and canalicular contraction rate. The permeabilization procedure also provided enhanced visualization of pericanalicular microfilaments, believed to be actin filaments, and their organization into two layers: an inner membrane-associated network, and an outer filament bundle that inserted into belt junctions (zonulae adherentes). The organization of the microfilament belt of contiguous hepatocytes was such that it formed a circumferential band of microfilaments around the canaliculus. It is analogous to contractile filament belts found in the apical terminal web region of other epithelia. It was also observed that with canalicular luminal closure, there was a change in the organization of the pericanalicular microfilaments. It is concluded that in hepatocyte couplets, differential sensitivity of cell components to permeabilization can be achieved with palmitoyl lysophosphatidyl choline. In addition, the results provide evidence that the bile canaliculus has the capacity to be a contractile structure even in the absence of secretion, that canalicular contraction is ATP-dependent, and hence is a dynamic process.

Actin Cytoskeleton↗
PubMed1990

Pulmonary malacoplakia in a child.

Pulmonary malacoplakia is a rare condition with only five previously reported cases in the literature, all occurring in adults. We describe a case of malacoplakia of the lung in a 6-year-old female with acute lymphoblastic leukemia in remission and a Rhodococcus equi pneumonia and septicemia. The case demonstrates that pulmonary malacoplakia can occur in immunocompromised pediatric patients and that malacoplakia should, therefore, be added to the list of causes of nodular lung infiltrates in immunocompromised children.

Child↗
PubMed1988

Markers of viral replication in patients with chronic hepatitis B virus infection.

Serum samples from 56 patients with biopsy-proven chronic B viral hepatitis without superimposed delta hepatitis were analyzed for the various markers of viral replication, including serum hepatitis B e Ag (HBeAg), hepatitis B virus deoxyribonucleic acid (HBV-DNA), and hepatitis B core antigen (HBcAg) in the liver tissues. Twenty-seven patients had persistent viral hepatitis (PH) and 29 patients had chronic active hepatitis (CAH) with or without cirrhosis. HBV-DNA was identified in the sera of 81% of patients with PH and 60% of patients with CAH. Significantly higher levels of HBV-DNA were found in patients with PH than in those with CAH. Both HBeAg in serum and HBcAg in liver correlated positively with serum HBV-DNA. Nine patients had serum HBV-DNA in the absence of HBeAg (four had anti-HBe), and seven of these nine patients had stainable HBcAg in the liver (two did not have staining). None of these patients had hepatic HBcAg in the absence of serum HBV-DNA. When these patients were stratified according to their epidemiologic background, serum HBV-DNA was present in a significantly higher number of male homosexuals than in any other groups. This was unrelated to their status of human immunodeficiency viral serology.

Chronic Disease↗
PubMed1988

Experience with human immunodeficiency virus infection in patients with hepatitis B virus and hepatitis delta virus infections in Los Angeles, 1977-1985.

Stored serum specimens from 723 patients with acute hepatitis B and 228 patients with chronic hepatitis B seen between 1977 and 1985 in the Hepatitis Clinic of the Los Angeles County-University of Southern California Medical Center, Los Angeles, CA, were tested for antibody to human immunodeficiency virus (anti-HIV). Risk factors were ordered hierarchically; cases with multiple risk factors were tabulated only in the risk group listed first on the clinic records. Anti-HIV was first detected in 1979, and by 1983 was found in about half of all homosexual men with chronic hepatitis B. The prevalence was significantly lower in patients with acute hepatitis B than in patients with chronic hepatitis B, and in nonhomosexual subjects compared with homosexual subjects. By 1985, 30 per cent of intravenous drug users with chronic hepatitis B were anti-HIV-positive. The highest annual seroconversion rate for anti-HIV, 21 per cent, was found in homosexual men in 1983. A significant association existed between anti-HIV positivity and hepatitis delta virus infection in homosexual men but not in drug abusers. This study provides data on the natural history of the human immunodeficiency virus epidemic in Los Angeles. Further study on the interaction of these different viruses is warranted.

Acute Disease↗
PubMed1988

Sinusoidal lining cell damage: the critical injury in cold preservation of liver allografts in the rat.

We have previously defined viability limits in a rat transplantation model. All liver allografts stored in a simple preservation solution (NaCl 0.9%, CaCl2 2 mM) at 4 degrees C for 4 hr or at 37 degrees C for 1 hr were viable upon transplantation, but all those stored at 4 degrees C for 8 hr or at 37 degrees C for 2 hr were nonviable. Only cold-preserved, nonviable livers showed increased vascular resistance, platelet trapping and an initially low, but then high, rise in aspartate transaminase (AST) upon reperfusion, all suggesting injury to the microcirculation, with secondary injury to the hepatocyte. In the present study, we investigated the morphological changes that occur in livers stored for the defined critical times, using light and electron microscopy after perfusion-fixation. Accurate and reproducible identification of specimens as belonging to viable or nonviable and warm- or cold-preserved could be made in this way. Preservation in the cold first resulted in reversible changes consisting of cellular swelling, alterations of intracellular organelles, and partial denudation of the sinusoidal lining (cold-preserved viable group). Later, under conditions of nonviable cold preservation, detachment of cell bodies of sinusoidal lining cells with nuclear changes and almost complete denudation of the sinusoidal lining was observed. Endothelial cells of larger vessels were only injured mildly. In contrast, under conditions of warm preservation, changes involving mitochondria and later nuclei were found in hepatocytes, and blebbing was more extensive. Endothelial cells were spared relatively. We also examined livers stored in isotonic citrate solution at 4 degrees C for 8 hr and 16 hr, the critical times determined for this solution in another model of rat liver transplantation. The findings were very similar to storage in saline with respect to the changes in the sinusoidal lining cells after cold preservation for the two critical times. The results provide convincing evidence of a qualitative difference between warm and cold preservation injury, with relatively selective damage to hepatocytes or sinusoidal lining cells, respectively. Endothelial damage represents the primary event, resulting in the loss of organ viability following hypothermic storage. Thus morphology may serve as a useful viability marker after preservation.

Animals↗
PubMed1987

Diagnostic electron microscopy of male genital tract tumors.

As illustrated in this review, neoplasms of the male genital tract are markedly heterogenous, reflecting their complex embryologic derivation and histogenetic classification. Transmission electron microscopy has greatly increased our understanding of the structure of these tumors, and in doing so has greatly improved our light microscopy. Additionally, in a number of selected situations, TEM also provides important practical diagnostic information. Currently, light microscopy in conjunction with clinical information is the central tool of tumor taxonomy. However, TEM with histochemistry, immunohistology, analytic cytometry, and molecular biology provide practical and useful information in some situations. In all cases, the application of these techniques has greatly increased our overall understanding of tumor structure, pathobiology, and classification.

Diagnosis, Differential↗
PubMed1984

A multicentre comparison of piroxicam and indomethacin in acute soft tissue sports injuries.

One hundred and five patients suffering from sport-associated soft tissue injuries were included in a randomized controlled trial comparing the efficacy and side-effects of piroxicam and indomethacin. Patients were treated for 7 days. Both groups showed a similar degree of improvement in joint tenderness, swelling and pain. Eighty-eight per cent of patients on piroxicam showed a marked or moderate improvement in their injury at the end of the trial and 79% of indomethacin-treated patients. Approximately 50% of patients in both groups resumed full activity within 7 days. One patient, in the indomethacin group, was withdrawn from treatment due to a side-effect.

Athletic Injuries↗
PubMed1984

Hepatitis B virus antibody in blood donors and the occurrence of non-A, non-B hepatitis in transfusion recipients. An analysis of the Transfusion-Transmitted Viruses Study.

Patients who received transfusions and nontransfused control patients were followed to assess the incidence and cause of post-transfusion hepatitis and to identify donor factors that might relate to risk of hepatitis. We evaluated as risk factors in donors the presence of antibody to hepatitis B virus compared with elevated alanine aminotransferase (ALT) level. Units of blood that were positive for antibody to hepatitis B core antigen (anti-HBc) were associated with a twofold to threefold greater risk of non-A, non-B hepatitis in the recipients than were units without anti-HBc. In the absence of specific serologic tests for non-A, non-B agents, screening of donors for anti-HBc might be considered. Our data suggest that the incidence of non-A, non-B hepatitis might have been reduced by about one third by such screening. However, elevated ALT levels in donors had a similar association with non-A, non-B hepatitis in recipients but would have resulted in fewer units of blood being discarded than would screening for anti-HBc.

Alanine Transaminase↗
PubMed1983

Pleomorphic adenoma, I: Ultrastructural organization of "epithelial" regions.

Twenty-four major and minor salivary gland pleomorphic adenomas were studied ultrastructurally to determine the growth patterns, organization, and cytologic modifications of the proliferating neoplastic cells. In compact and highly cellular regions, two cell types--luminal epithelial and myoepithelial--could often be identified; their organization mimicked that of the normal salivary gland duct or acinar unit. Results of the study indicate that the principal proliferating tumor cell is a structurally modified myoepithelial cell that frequently shows squamous differentiation. At the immediate margins of cellular regions of many tumor cells, gradual dedifferentiation of modified myoepithelial cells with a loss of squamous features occurs, although in some cells the squamous features are retained to varying degrees. Within cellular regions, the earliest development of matrix occurs in relation to small, basal lamina-lined extracellular spaces between myoepithelial-like cells. Modifications of such intercellular spaces are helpful in tracing the development of myxoid zones and the evolution of cell types in this unique region. The authors postulate that salivary gland pleomorphic adenomas result from the neoplastic transformation of the complete ductal-acinar unit rather than from one particular ductal "reserve" cell.

Adenoma, Pleomorphic↗
PubMed1983

Pleomorphic adenoma, II: Ultrastructural organization of "stromal" regions.

Findings from an ultrastructural study of 24 major and minor salivary gland pleomorphic adenomas suggest that the principal cell type in the myxoid and chondromyxoid regions of these tumors is a structurally modified myoepithelial cell. This interpretation is based on findings in the transitional zone between myxoid regions and compact cellular areas that have a ductal-acinar organization, that is, are composed of luminal epithelial and modified myoepithelial cells. Survey-type low-power electron micrographs allowed appreciation of the original orientation of the major proliferating component of these tumors to the perimeter of ductal-acinar units. The low-power electron micrographs also revealed residual features of this organization, the early development and subsequent sequential alteration of matrix compartments as tumor cells became increasingly separated by extracellular products, and a variety of myoepithelial cell modifications, such as squamous and chondroid metaplasia, resulting from neoplastic induction. According to the authors' interpretation, modified myoepithelial cells in myxoid and chondromyxoid regions form a continuum with similar tumor cells in transitional and solid areas, forming what can be visualized as markedly expanded and merging ductal-acinar units that tend to converge with similarly altered adjacent neoplastic ductal-acinar units. Thus, a multiplicity of processes are involved in the formation of the complex and varied histologic patterns that characterize pleomorphic adenomas.

Adenoma, Pleomorphic↗
PubMed1979

Successful coping styles in professional women.

This paper describes the experiences of seven women mental health professionals who met in a leaderless group over a period of a year and a half. There is a discussion of the conflicts for women in four major areas--competition, dependency needs, economic success and the search for role models, and the suggestion of possible successful resolutions in these conflict areas. The resolutions are a result of individual experiences and discussions in the group.

Adaptation, Psychological↗