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Biomedical subjects

A Herrera

Publications and source records attributed to A Herrera.

At least 109 records · Page 6Linked to original sources

Umbilical polyps.

We report three patients, ages 5 years, 3 years, and 4 days, with umbilical polyps. In the third child the polyp was associated with an umbilical enteric fistula. An umbilical polyp is the result of incomplete closure of the omphalomesenteric duct and becomes apparent after the umbilical cord is detached. It is a reddish tumor of a few millimeters; it seldom bleeds or is exudative. We consider it important to study every case in detail in order to exclude possible underlying embryologic anomalies such as Meckel's diverticulum and umbilical enteric fistula.

Abdominal Neoplasms↗

Single doses of ofloxacin in uncomplicated gonorrhoea.

The clinical efficacies of 2 different single-dose oral treatments of ofloxacin were evaluated in a double-blind, randomised study of 60 males with gonococcal urethritis. 30 patients received a single dose of ofloxacin 100mg and 30 received a single dose of ofloxacin 200mg. The minimal inhibitory concentrations of ofloxacin against all isolates were less than or equal to 0.25 mg/L. Neisseria gonorrhoeae was eradicated from all 50 patients evaluated and clinical cure was achieved in 84%. In total, 8 patients developed post-gonococcal urethritis, although there was a significantly (p less than 0.05) lower rate of post-gonococcal urethritis in the group treated with ofloxacin 200mg. In conclusion, a single oral dose of ofloxacin 100mg could be an alternative treatment for uncomplicated gonorrhoea.

Adolescent↗

Stimulation of mouse liver glutathione S-transferase activity in propylthiouracil-treated mice in vivo by tri-iodothyronine.

Female C57Bl/6J mice were given drinking water containing 0.05% propylthiouracil to induce a hypothyroid condition. Mitochondrial glycerol-3-phosphate dehydrogenase activity, used as an index of hypothyroidism, was 57.1 +/- 4.5 and 29.4 +/- 3.8 nmol/min per mg of protein for control and propylthiouracil-treated animals respectively. Administration of tri-iodothyronine resulted in an approx. 4.5-fold increase in dehydrogenase activity in propylthiouracil-treated animals. A dose-dependent increase in hepatic GSH S-transferase activity in propylthiouracil-treated animals was observed at tri-iodothyronine concentrations ranging from 2 to 200 micrograms/100 g body wt. This increase in transferase activity was seen only when 1,2-epoxy-3-(p-nitrophenoxy)propane was used as substrate for the transferase. Transferase activity with 1-chloro-2,4-dinitrobenzene and 1,2-dichloro-4-nitrobenzene as substrate was decreased by tri-iodothyronine. Administration of actinomycin D (75 micrograms/100 g body wt.) inhibited the tri-iodothyronine induction of transferase activity. Results of these studies strongly suggest that tri-iodothyronine administration markedly affected the activities of GSH S-transferase by inducing a specific isoenzyme of GSH S-transferase and suppressing other isoenzymic activities.

Animals↗

Effects of ex-vivo plasma adsorption over protein A sepharose in acute leukemia.

Plasma adsorption over immobilized Staphylococcus aureus Cowan I has resulted in tumor regression in several animal and human trials. Protein A, because of its ability to bind IgGs has been considered as the effective component of Staphylococcus aureus. In 4 patients with acute leukemia, a plasma volume of 1500 cm3 was passed in an ex-vivo system over immobilized SpA-Sepharose and then reinfused. Almost all of the IgGs contained in the plasma volume could thus be removed. Toxic side-effects were mild. No significant clinical improvement could be obtained. Plasma incubation with SpA did not modify blast cell viability or leukemic progenitor cell growth. Along with others, this study shows that Protein A is probably not the mediator of the tumoricidal responses observed in studies using adsorption over Staphylococcus aureus Cowan I. The ex-vivo system prepared for this study could also be used for plasma IgG removal for the treatment of autoimmune or immune-complex related disorders.

Blood Cell Count↗

Gastrointestinal Richter's syndrome.

The development of a diffuse large cell lymphoma of the stomach in a patient who had chronic lymphocytic leukemia is reported. Richter's syndrome localized to the gut has not been described previously. Morphologic and immunologic studies suggest that the diffuse large cell lymphoma arose from the same clonal proliferation, IgG lambda, as the initially detected serum monoclonal protein associated with the chronic lymphocytic leukemia.

Aged↗

[Thrombocytosis].

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Hematopoiesis↗

Cancer treatment with Staphylococcus aureus protein A.

For 3 years, Protein A of Staphylococcus aureus has been used in cancer treatment, initially because of its potential for removing serum blocking factors in the case of patients with malignancies. Extracorporeal adsorption of plasma over immobilized Protein A has produced beneficial effects on experimental animal cancers and some human tumors. The authors review various aspects of this apparently new form of immunotherapy: the basis of Protein A treatments according to the known effects of Protein A on the immune system; different techniques of plasma adsorption and especially the various Protein A carriers that have been used; the toxic effects which complicated the treatment course in several studies and their mechanisms; treatment results in animal models; and the results of phase I and II trials in patients.

Adjuvants, Immunologic↗

Therapy-related leukemia associated with myelofibrosis. Blast cell characterization in six cases.

Six patients exhibiting severe pancytopenia or overt leukemia associated with myelofibrosis after chemotherapy for malignant disease have been investigated by immunologic techniques and ultrastructural cytochemistry. Initially, five patients displayed severe thrombocytopenia contrasting with mild neutropenia and anemia. Bone marrow biopsies showed a clear megakaryocytic proliferation and an excess of immature mononuclear cells. The demonstration of peroxidase activities at the ultrastructural level and immunofluorescence labeling with a panel of monoclonal antibodies, including an antiplatelet glycoprotein Ib and an antiglycoprotein IIb-IIIa complex, on blood or marrow cells, permitted identification of otherwise unidentifiable promegakaryoblastic proliferation. In two patients, the use of an immunoperoxidase technique with an antifactor VIII-R-Ag antibody has allowed direct confirmation of this diagnosis on bone marrow sections. This megakaryoblastic proliferation was not pure and was variably associated with blasts of other cell lines (erythroblasts or myeloblasts). Changes in the population of blasts were observed during evolution in two patients. The sixth patient had a mild thrombocytopenia associated with severe neutropenia and anemia. Bone marrow biopsy displayed a myelofibrosis and immature cells, without megakaryocytic proliferation. Ultrastructural study revealed a pure basophil-mast cell proliferation. In conclusion, in five of six patients with secondary acute leukemia associated with myelofibrosis, a proliferation of promegakaryoblasts was demonstrated using both immunofluorescent and ultrastructural cytochemical techniques.

Aged↗

Positive Coombs test in acute leukaemia.

We present the results of the immunohaematological tests performed in an unselected group of patients with acute leukaemia at the time of diagnosis, and when possible the follow-up in remission and/or in relapse. Thirteen out of the 112 patients tested had a positive Coombs test at the time of diagnosis and, in six patients, the Coombs test became positive during remission. All the 19 positive Coombs test were of the complement type with, in 11 cases, an anti-I antibody eluted from the patient's RBC. There was no relationship between the FAB morphologic subtype, the presence of other immune abnormalities, the course of the leukaemia and the immunohaematological abnormalities. Several hypotheses on the possible relationships between the acute leukaemias and the immunohaematological abnormalities are discussed.

Adult↗

Molecular defect of spectrin in the family of a child with congenital hemolytic poikilocytic anemia.

We present the study of a black family in which the proband suffered from a severe neonatal hemolytic anemia with poikilocytosis. Both the parents, sister's, and brother's proband were clinically normal. The presence of poikilocytes in proband led to a search for a red cell membrane skeleton defect. Owing to recent improvements in the erythrocyte membrane knowledge, it is now possible to approach the diagnosis by means of biochemical evaluation of both parents, even if they are asymptomatic. So, the first time discovery of a spectrin self-association defect in both parents allowed us to suspect double inheritance of this abnormality in the proband. A complete morphological and biochemical evaluation of the family allowed us to propound the diagnosis of heterozygous type I hereditary elliptocytosis (HE) for both parents and the sister and the diagnosis of homozygous type I HE for the proband owing to the following reasons: slight ovalocytosis was present in both parents and the sister; cell deformability ektacytometric studies gave the same profiles of curve as those observed in patients with HE. Defective spectrin dimer self-association found in both parents was also observed in the sister and proband, associated with the same abnormal spectrin digest pattern, namely a decrease in the amount of a 80,000-dalton peptide and a corresponding increase in a 74,000-dalton peptide. However, clinical presentation of the proband was consistent either with hereditary pyropoikilocytosis or homozygous hereditary elliptocytosis; erythrocyte thermal sensitivity studies in the proband could not be conclusive because of the presence of transfused cells. Both these diagnoses are discussed in detail.(ABSTRACT TRUNCATED AT 250 WORDS)

Anemia, Hemolytic, Congenital↗

Chronic myelomonocytic leukemia according to FAB classification: analysis of 35 cases.

Thirty-five patients who fulfilled the FAB diagnosis criteria of chronic myelomonocytic leukemia (CMML), i.e., myelodysplastic features, monocytosis over 10(9)/liter, bone marrow monocyte infiltration, blast cells less than 5% in the peripheral blood and less than 30% in the bone marrow, are analyzed. CMML appears as an entity distinct from myelodysplastic and myeloproliferative disorders. Splenomegaly, anemia, thrombocytopenia, leukocytosis with monocytes and granulocytic cells in all stages of development, increased blood and urine lysozyme levels without renal failure, and polyclonal hyperimmunoglobulinemia are its main clinical and biologic features. With conventional cytotoxic drugs (6-mercaptopurine, hydroxyurea), the prognosis of CMML appears poor (median survival 475 days). None of the clinical hematologic or biologic parameters tested had a significant effect on prognosis. As other chemotherapy trials seemed necessary, we recently administered small doses of cytosine-arabinoside (ARA-C) to six patients over several consecutive days and obtained a complete remission in four. These preliminary results must be confirmed by larger series using the diagnostic criteria proposed by the FAB cooperative group.

Aged↗

[Primary lymphomas of the digestive tract. Therapeutic results of a series of 35 cases].

We report the results of a diagnosis and treatment scheme used in 35 patients with primary gastrointestinal lymphoma studied between 1972 and 1982. There were 17 lymphomas of the stomach, 13 of the small bowel, 6 of the colon and/or the rectum. According to the Kiel classification and/or the International Working Formulation, 10 were "good risk" lymphomas, 25 were "bad risk" lymphomas. According to the Musshoff modified Ann Arbor staging classification, 16 were localized lymphomas (stage IE and II1E), 19 were disseminated lymphomas (stages II2E, IIIE or IV). The treatment scheme included laparotomy for staging and resection, total abdominal irradiation (until 1977), and polychemotherapy with or without adriamycin depending on histologic grade. The median survival was greater than the median follow-up with a survival plateau at 0.53 after 47 months. Amongst the prognostic factors studied, the digestive initial localization had no prognostic significance; on the other hand, survival depended on abdominal extension, histologic grade according to the classifications used for lymph-nodes lymphomas, and resection possibilities, and especially on achievement of complete remission. These good results emphasize the importance of combining surgical resection with chemotherapy and early assessment of the treatment in order to rapidly obtain complete remission, the way of achieving prolonged survival.

Adult↗

[Study of erythrocyte deformability using visco-diffractometry (ektacytometry) in hereditary hemolytic anemias].

Deformability is a basic characteristic of red blood cells; its regulating factors are presently well known (surface volume ratio, internal viscosity, viscoelastic properties of the membrane). The contribution of each of these factors in the pathogeny of hemolytic anemias has not been fully established. We report 64 hereditary hemolytic anemias in which we studied the deformability, using a visco-diffractometric method (ektacytometer) on whole blood and various subpopulations separated by density. Comparison of the response of the cells submitted to isotonic and hypotonic media allows the determination of the respective contribution of viscosity and surface volume ratio. Deformability is always decreased in red blood cell membrane diseases and in homozygous or double heterozygous hemoglobinopathies; on the other hand, deformability is normal in all the enzymopathies studied. This decrease could be due either to one regulation factor (increase of internal viscosity easily demonstrated by this method in hereditary xerocytosis and hemoglobin CC) or to several parameters: increase of internal viscosity and decrease of surface volume ratio in hereditary spherocytosis.

Anemia, Hemolytic, Congenital↗

Decreased secretion of cortisol and ACTH after oral clonidine administration in normal adults.

Clonidine, a selective noradrenergic receptor agonist, has been shown to affect various hormones acutely. It increases growth hormone levels in animals and in human adults and children. The effect of clonidine upon ACTH and cortisol levels is not as clear, and both stimulatory and inhibitory effects have been reported. We found a significant decrease in plasma cortisol decreased. No changes in FSH, LH, or prolactin were seen after oral clonidine. Our data are compatible with an inhibitory noradrenergic mechanism modulating ACTH and cortisol secretion in normal adults.

Adrenocorticotropic Hormone↗