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Biomedical subjects

A Castells

Publications and source records attributed to A Castells.

At least 73 records · Page 4Linked to original sources
PubMed1996

Childhood sclerodermatomyositis: report of a case with the anti-PM/Scl antibody and mechanic's hands.

We report a boy with overlap manifestations of systemic sclerosis and dermatomyositis (sclerodermatomyositis) whose disease showed a changing clinical pattern, and who had mechanic's hands, which are a cutaneous marker of myositis. Serological studies revealed antinuclear antibodies with a homogeneous nucleolar pattern. The anti-PM-Scl antibody was demonstrated by immunoblotting. HLA typing was positive for HLA-DR3/4. After a follow-up period of 11 years, no progression to severe systemic involvement was detected, and aggressive treatment was not administered. The recognition of subsets of patients with homogeneous clinical features and serological markers should permit the recognition of separate conditions among overlap syndromes. This would have prognostic and therapeutic implications.

Antibodies, Antinuclear↗
PubMed1996

[Lichen planus associated with liver disease caused by hepatitis C virus].

The association between lichen planus (LP) and liver disease by the hepatitis C virus (HCV) has recently been described although its significance is controversial. The charts of 10 patients (8 women, 2 men) clinically and/or histologically diagnosed of LP and with positive HCV serology were retrospectively reviewed. Nine of the patients presented mucosal involvement, four of which were of the erosive form. In 7 patients liver disease preceded the appearance of LP. In the remaining 3 patients HCV infection was detected after the diagnosis of LP despite no alterations being observed in the liver function tests in 2 cases. Alpha-interferon 2b treatment triggered the lesions in 3 cases while leading to resolution of LP in another case. These data confirm the findings referred in the references and support the direct or indirect participation of HCV in LP.

Aged↗
PubMed1995

[Fibrinogen and factor VII in women with dyslipidemia. The preliminary results of the Bellvitge-Costa de Ponent Study. The Bellvitge Study Group].

BACKGROUND: The distribution of serum fibrinogen levels and factor VII in a population of dyslipemic women and their association with other cardiovascular risk factors are herein described. METHODS: Dyslipemic women between 40-70-years of age without cardiovascular disease and with no hypolipemic treatment who attended 21 primary health care consultations were studied. The following data were collected in a questionnaire: smoking habit, high blood pressure, alcohol consumption and menopause. The analytical parameters determined were: total cholesterol, LDL-cholesterol, HDL-cholesterol, triglycerides, fibrinogen and factor VII. The Pearson correlation coefficient was determined to evaluate the association of fibrinogen and factor VII with other cardiovascular risk factors. RESULTS: Serum fibrinogen levels correlated positively with LDL-cholesterol and with the body mass index and negatively with HDL-cholesterol. Factor VII correlated positively with the triglycerides and total cholesterol. No significant differences were observed in the hematic factors among the hypertensive women and those who were not hypertensive. The same was observed in diabetic and in the pre- and postmenopausal women. CONCLUSIONS: In this transversal study a relationship was found between serum fibrinogen level and factor VII activity and other known cardiovascular risk factors.

Adult↗
PubMed1995

Treatment of hepatocellular carcinoma with tamoxifen: a double-blind placebo-controlled trial in 120 patients.

BACKGROUND & AIMS: The progression of hepatocellular carcinoma may be influenced by estrogens. This has offered the rationale for evaluating the therapeutic usefulness of estrogen-receptor blockers; it is being debated whether long-term tamoxifen administration improves survival in patients with this neoplasm. The aim of this study was to assess the efficacy of tamoxifen administration in the treatment of hepatocellular carcinoma. METHODS: One hundred twenty patients with this neoplasm who were not suitable for surgery, ethanol injection, or transarterial embolization were included in a placebo-controlled trial and randomized to tamoxifen, 20 mg/day per os, (group A, n = 58) or placebo (group B, n = 62). Patients with terminal diseases were excluded. RESULTS: Both groups were similar with regard to sex, age, liver function (Child-Pugh's score, 6.5 +/- 1.4 vs. 6.4 +/- 1.4), baseline performance status, and tumor stage. Tamoxifen had no antitumoral effect with no differences in the survival between groups (1- and 2-year actuarial rate: group A, 51% and 27%; and group B, 43% and 29%; P = 0.75), even when stratifying patients according to baseline status. Furthermore, there were no differences in the probability of disease progression (P = 0.46) and baseline performance status maintenance (P = 0.93) during follow-up. CONCLUSIONS: Tamoxifen has no efficacy in the treatment of patients with advanced hepatocellular carcinoma.

Aged↗
PubMed1995

Transarterial embolization for hepatocellular carcinoma. Antibiotic prophylaxis and clinical meaning of postembolization fever.

BACKGROUND/AIMS: The aim of this prospective randomized controlled trial was to investigate the need for prophylactic antibiotherapy in patients with cirrhosis and hepatocellular carcinoma who underwent transarterial embolization and to establish the parameters that determine the development of fever > 38 degrees C after this procedure. METHODS: Sixty-one consecutive patients with cirrhosis undergoing 75 procedures were randomized into Group I [(n = 37) allocated to receive prophylactic antibiotics (Cefotaxime + Metronidazole)] and Group II [(n = 38) allocated to receive no antibiotic treatment]. RESULTS: Twelve of the 37 patients (32%) in Group I and 13 of the 38 patients (34%) in Group II developed fever > 38 degrees C after treatment. However, none of them developed bacterial infection, and all biological fluid cultures were negative. A logistic regression analysis disclosed that the obtention of an extensive tumor necrosis was the unique parameter independently associated with the development of fever. CONCLUSIONS: Antibiotic prophylaxis is therefore not necessary in patients with cirrhosis and hepatocellular carcinoma undergoing transarterial embolization. The appearance of fever after this procedure does not indicate bacterial infection; it rather represents a clinical marker of extensive tumor necrosis and thus of a favorable response to treatment.

Aged↗
PubMed1995

Androgen receptors in hepatocellular carcinoma and surrounding liver: relationship with tumor size and recurrence rate after surgical resection.

BACKGROUND/AIMS: This study aimed to evaluate the parameters associated with the presence of androgen receptors in hepatocellular carcinoma and surrounding non-tumoral liver. Furthermore, we have assessed whether androgen receptor positivity influences disease recurrence after surgical resection. METHODS: Androgen receptor concentration was calculated by receptor binding assay in tumoral and non-tumoral liver in 43 patients (40 of them with cirrhosis) with hepatocellular carcinoma who underwent surgical resection. RESULTS: Androgen receptors were found in 28 of the tumoral and in 30 of the non-tumoral samples, at concentrations ranging between 5 and 211 fmol/mg protein. The presence of androgen receptors within the tumor was significantly related to a smaller tumor size. Thereby, 22 of the 29 nodules < or = 3 cm contained androgen receptors, while this occurred in only six of the 14 tumors larger than 3 cm (p < 0.05). In contrast, the only parameter associated with the presence of androgen receptors in the non-tumoral liver was a lower gamma-glutamyltranspeptidase concentration. Disease recurrence after surgical resection was not only related to some tumor characteristics (increased alfa-fetoprotein concentration, presence of satellites, differentiation degree), but also to the presence of androgen receptors in the surrounding liver. Thus, the probability of recurrence after 1- and 2-year follow up in patients with androgen-positive livers was 33% and 50%, respectively, while it was 0% and 20% in those with androgen-negative livers (p < 0.05). In contrast, the presence of androgen receptors within the tumor was not associated with a higher recurrence rate. CONCLUSIONS: These results show that only two thirds of hepatocellular carcinomas contained androgen receptors and that this feature was more frequent in small tumors. In addition, our data indicate that the presence of androgen receptors within the tumor does not imply a different outcome after surgical resection. In contrast, the presence of these receptors in the surrounding non-tumoral liver may be considered a risk factor for a higher incidence of disease recurrence.

Carcinoma, Hepatocellular↗
PubMed1995

Evaluation of a preservation solution containing fructose-1,6-diphosphate and mannitol using the isolated perfused rat kidney. Comparison with Euro-Collins and University of Wisconsin solutions.

The renal preservation ability of a flushing solution (F-M) with fructose-1,6-diphosphate (1 g/dl) and mannitol (2 g/dl) during cold ischaemia was studied with the isolated perfused rat kidney model and compared with the Euro-Collins (EC) and University of Wisconsin (UW) solutions. Kidneys were stored in hypothermia for 4 and 18 h after initial flushing with the solution being tested, and then reperfused at 37 degrees C in an isolated perfusion circuit for 90 min with a Krebs-Henseleit solution containing 4.5% albumin. Forty-four kidneys were studied and divided in a control group and six study groups according to the cold ischaemia time and flushing solution used. Renal functional parameters of plasma flow rate (PFR), renal vascular resistance (RVR), urine flow rate (UFR) glomerular filtration rate (GFR), fractional (FRNa) and net (TNa) sodium reabsortion were assessed during reperfusion. Conventional histology and malondialdehyde tissue levels (MDA) were also evaluated. Our results show that PFR, RVR, and UFR were similar in all study groups. After 4 and 18 h of cold ischaemia, GFR, FRNa and TNa were better, and conventional histology worse in F-M than in EC flushed kidneys. After 4 and 18 h of cold ischaemia, GFR, FRNa and TNa, in fact, were not different between F-M and UW flushed kidneys. After 4 h of cold ischaemia, conventional histology was similar in F-M and UW flushed kidneys. Nevertheless, after 18 h of cold ischaemia, UW flushed kidneys showed worse histological parameters than F-M flushed kidneys. After 4 h of cold ischaemia, MDA was similar in kidneys flushed with three solutions. After 18 h of cold ischaemia MDA was higher in EC than in F-M or UW flushed kidneys. In summary, our newly developed cold storage solution shows promising results in renal preservation and its ability to preserve is at least as good as UW solution assessed in the isolated perfused rat kidney.

Adenosine↗
PubMed1995

Effect of ciclosporin on serum lipids and modification with LSL 90202, a lysine salt of eicosapentaenoic acid.

Ciclosporin (CS-A) has recently been considered a separate risk factor for the development of hyperlipidemia in transplant patients. In the present work, the effect of chronic CS-A administration on serum lipids and its modification using dietary supplementation with LSL 90202, a lysine salt of eicosapentaenoic acid, was studied. Thirty-one male Wistar rats were divided into four groups, receiving (1) 20 mg/kg CS-A in olive oil (CS-A group; n = 8); (2) isovolumetric olive oil (olive oil groups; n = 8); (3) 20 mg/kg CS-A in olive oil plus 20 mg/kg LSL 90202 (CS-A + LSL 20 group;) and (4) 20 mg/kg CS-A in olive oil plus 40 mg/kg LSL 90202 (CS-A+LSL 40 group; n = 8). Both, CS-A and LSL 90202 were given by daily gavage. On day 28, CS-A whole-blood levels and serum levels of total cholesterol, triglyceride, high-density lipoprotein (HDL) cholesterol fractions (HDL, HDL-2, HDL-3, non-HDL), and malondialdehyde were measured. On day 28, the rats given CS-A showed significantly higher cholesterol, triglyceride, and non-HDL cholesterol serum levels than rats given olive oil. Rats given CS-A and LSL 90202 (20 mg/kg) showed significantly lower triglyceride serum levels than rats given CS-A only. Rats given CS-A and LSL 90202 (40 mg/kg) showed significantly lower triglyceride, total cholesterol, and non-HDL cholesterol serum levels than rats given CS-A only. There were no differences in HDL, HDL-2, and HDL-3 cholesterol serum levels between the groups. The CS-A whole-blood levels were not different between groups of animals given CS-A.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMed1995

[Hepatic angiosarcoma: a report of a case associated with treatment with arsenic salts and a review of the literature].

Hepatic angiosarcoma is an infrequent neoplasm representing 1-3% of all the primary liver cancers. One fourth of the cases have demonstrated a relation with chemical carcinogens with the most frequent being thorium dioxide (thorotrast) and vinyl chloride. The case of an hepatic angiosarcoma which presented as an intraperitoneal hemorrhage in a patient who had undergone treatment with Neosalvarsán (dioxidiaminoarsenobenzol) 46 years beforehand is reported. The previous published reports include 6 cases of hepatic angiosarcoma related with treatment with arsenic salts and 4 cases in whom exposure was environmental.

Arsenicals↗
PubMed1994

Circadian variations of portal pressure and variceal hemorrhage in patients with cirrhosis.

This study was aimed at investigating whether portal pressure, which is usually measured in the morning, is subject to circadian variations in patients with cirrhosis. Furthermore, a possible circadian variation for the occurrence of variceal bleeding was also investigated. Ten patients with alcoholic cirrhosis and portal hypertension had serial measurements of portal pressure, evaluated by the hepatic venous pressure gradient (the difference between wedged and free hepatic venous pressures), during a 24-hr period. In addition, a survey of the hour of occurrence of variceal hemorrhage was performed in 101 consecutive cirrhotic patients with hematemesis, in whom the precise moment of onset of bleeding could be determined, and the origin of bleeding was confirmed by emergency endoscopy. Statistical evaluation with the population-mean cosinor method allowed detection of a circadian variation in portal pressure. Portal pressure progressively declined during the afternoon and evening (from 17.9 +/- 5.3 mm Hg at 12 PM to a nadir of 16.8 +/- 4.9 mm Hg at 7 PM (p < 0.05). Thereafter, portal pressure increased during the night, returning to baseline values at 9 AM (18.1 +/- 5.1 mm Hg). The acrophase was at 8:32 AM (+/- 100 min) with an amplitude of 3.45 +/- 1.1 (% of mean +/- S.E.) (rhythm detection: p < 0.03). Similarly, the analysis of the time of occurrence of variceal hemorrhage with the use of a multiple-components rhythmometry test disclosed two peaks in the prevalence of esophageal bleeding.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1994

Immunohistochemical localization of filaggrin in benign, premalignant and malignant cervical tissue.

Epithelial distribution of filaggrin, a histidine-rich protein related to squamous terminal differentiation, was investigated in 87 cervical biopsies using an avidin-biotin-peroxidase technique with a monoclonal anti-human filaggrin antibody (AKH1). Normal squamous cervical epithelium exhibited a positive homogeneous immunoperoxidase stain in the upper parabasal, intermediate and superficial cell layers. Similar findings were obtained in cervical condylomas, although full-thickness staining was observed in 35.7% of the cases (P < 0.001). Filaggrin expression in CIN was inversely related to the severity of the lesion (P < 0.001). An irregular staining pattern was present in most high-grade CIN. Filaggrin expression was closely connected to the degree of tumour differentiation (P < 0.05) in squamous cell carcinomas of the cervix. Abnormal filaggrin stainings identified a premalignant/malignant cervical squamous lesion with a positive predictive value of 92.3%. Non-squamous epithelia showed lack of filaggrin expression. Filaggrin may therefore be considered a marker of squamous differentiation in both the normal and pathological human uterine cervix.

Adult↗
PubMed1994

nm23-H1 expression and disease recurrence after surgical resection of small hepatocellular carcinoma.

BACKGROUND/AIMS: The nm23-H1 gene is thought to act as a metastasis-suppressor gene. This study investigates the relationship between nm23-H1 messenger RNA (mRNA) expression and intrahepatic tumor recurrence after surgical resection of small hepatocellular carcinoma. METHODS: Seventeen cirrhotic patients with solitary hepatocellular carcinoma < 5 cm underwent surgical resection. In 7 patients, the neoplasm recurred after a 12-month median follow-up, whereas the other 10 patients were free of disease after a 30-month median follow-up. Both groups were similar according to age, sex, etiology, status of the underlying liver, tumor size, and other pathological characteristics of the neoplasm. nm23-H1 mRNA levels were assessed in matched tumor and surrounding cirrhotic liver samples by Northern blot hybridization using a 900-base pair probe, which is a BamHI fragment of pnm23-H1 recombinant complementary DNA clone encoding the nm23-H1 human gene. RESULTS: Eight of the 10 patients without disease recurrence during follow-up showed nm23-H1 overexpression with an increase ranging between three- and 45-fold when compared with the nontumoral surrounding liver. Only 1 of the 7 patients with tumor recurrence showed higher nm23-H1 mRNA levels in the tumor than in the nonneoplastic sample (P = 0.013). CONCLUSIONS: nm23 mRNA overexpression in small solitary hepatocellular carcinoma is associated with a lower recurrence rate after surgical resection, suggesting that this gene may participate in the metastatic dissemination of this neoplasm.

Aged↗