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Biomedical subjects

A Lopez

Publications and source records attributed to A Lopez.

At least 109 records · Page 6Linked to original sources

[Mechanical value of prostheses and fixation with staples in repair of abdominal eventrations].

From an experimental study on fresh corpses, using a system which allows reproductible measures, we evaluated the physical strain to which prosthetic meshes are subjected during the initial phase of repair of abdominal eventrations treated by mesh. We also studied the various systems of staple fixation. The adhesivity or resistance-to-tear of the mesh is minimally dependent on the texture of the plaque; additionall, we also demonstrated the role of the size of the mesh. Stapling may compensate for the lack in size and increase the resistance-to-slip with larger values for radial stapling as compared to tangential stapling. Other fields of applications are possible. The use of glue or absorbable staples is considered.

Abdomen↗

Secondary drug resistance in breast cancer: failure to reverse with oral nifedipine.

We tested the efficacy of nifedipine to reverse acquired resistance to chemotherapy regimens containing doxorubicin or vinblastine or both in 12 patients with metastatic breast cancer. All patients had been receiving one or both of these drugs, had had a prior partial response (median duration 5 months, range 2-10) and subsequently progressed. Immediately after drug resistance was documented by tumor progression, eligible patients with measurable or evaluable disease were treated with nifedipine beginning 3 days before restarting the same chemotherapy. The initial dose of nifedipine was 20 mg TID, escalating daily to 40 mg TID on day 3 if the patient had no serious side effects. Nifedipine was continued at the highest tolerable dose during and for 2 days after completion of the chemotherapy. Most patients had < or = 2 prior chemotherapy regimens and a median Zubrod performance status of 1. Twelve patients received a total of 23 courses preceded by nifedipine. No objective tumor responses were observed. The expected toxic effects attributable to nifedipine occurred, but nifedipine did not increase the toxicity caused by the chemotherapy. Nifedipine, given in this dose and schedule, did not reverse acquired drug resistance in patients with breast cancer.

Administration, Oral↗

Phosphatidylinositol 3-kinase is a negative regulator of cellular differentiation.

Phosphatidylinositol 3-kinase (PI3K) has been shown to be an important mediator of intracellular signal transduction in mammalian cells. We show here, for the first time, that the blockade of PI3K activity in human fetal undifferentiated cells induced morphological and functional endocrine differentiation. This was associated with an increase in mRNA levels of insulin, glucagon, and somatostatin, as well as an increase in the insulin protein content and secretion in response to secretagogues. Blockade of PI3K also increased the proportion of pluripotent precursor cells coexpressing multiple hormones and the total number of terminally differentiated cells originating from these precursor cells. We examined whether any of the recently described modulators of endocrine differentiation could participate in regulating PI3K activity in fetal islet cells. The activity of PI3K was inversely correlated with the hepatocyte growth factor/scatter factor-induced downregulation or nicotinamideinduced upregulation of islet-specific gene expression, giving support to the role of PI3K, as a negative regulator of endocrine differentiation. In conclusion, our results provide a mechanism for the regulation of hormone-specific gene expression during human fetal neogenesis. They also suggest a novel function for PI3K, as a negative regulator of cellular differentiation.

Androstadienes↗

Crucial role of the residue R280 at the F'-G' loop of the human granulocyte/macrophage colony-stimulating factor receptor alpha chain for ligand recognition.

The receptor for granulocyte/macrophage colony-stimulating factor (GM-CSF) is composed of two chains, alpha and betac. Both chains belong to the superfamily of cytokine receptors characterized by a common structural feature, i.e., the presence of at least two fibronectin-like folds in the extracellular domain, which was first identified in the growth hormone receptor. The GM-CSF receptor (GMR)-alpha chain confers low affinity binding only (5-10 nM), whereas the other chain, betac, does not bind GM-CSF by itself but confers high affinity binding when associated with GMR-alpha (25-100 pM). The present study was designed to define the assembly of the GMR complex at the molecular level through site-directed mutagenesis guided by homology modeling with the growth hormone receptor complex. In our three-dimensional model, R280 of GMR-alpha, located in the F'-G' loop and close to the WSSWS motif, is in the vicinity of the ligand Asp112, suggesting the possibility of electrostatic interaction between these two residues. Through site directed mutagenesis, we provide several lines of evidence indicating the importance of electrostatic interaction in ligand-receptor recognition. First, mutagenesis of GMR-alphaR280 strikingly ablated ligand binding in the absence of beta common (betac); ligand binding was restored in the presence of betac with, nonetheless, a significant shift from high (26 pM) toward low affinity (from 2 to 13 nM). The rank order of the dissociation constant for the different GMR-alphaR280 mutations where Lys > Gln > Met > Asp, suggesting the importance of the charge at this position. Second, a mutant GM-CSF with charge reversal mutation at position Asp112 exhibited a 1,000-fold decrease in affinity in receptor binding, whereas charge ablation or conservative mutations were the least affected (10-20-fold). Third, removal of the charge at position R280 of GMR-alpha introduced a 10-fold decrease in the association rate constant and only a 2-fold change in the dissociation rate constant, suggesting that R280 is implicated in ligand recognition, possibly through interaction with Asp112 of GM-CSF. For all R280 mutants, the half-efficient concentrations of GM-CSF required for membrane (receptor binding) to nuclear events (c-fos promoter activation) and cell proliferation (thymidine incorporation) were in the same range, indicating that the threshold for biologic activity is governed mainly by the affinity of ligand-receptor interaction. Furthermore, mutation of other residues in the immediate vicinity of R280 was less drastic. Sequence alignment and modeling of interleukin (IL)-3R and IL-5R identified an arginine residue at the tip of a beta turn in a highly divergent context at the F'-G' loop, close to a conserved structural element, the WSXWS motif, suggesting the possibility of a ligand association mechanism similar to the one described herein for GMR.

3T3 Cells↗

Congenital intrahepatic portocaval shunt associated with trimethylaminuria

A case of congenital portal-systemic shunting due to an intrahepatic connection diagnosed by ultrasound scanning and color Doppler in an 8-month-old girl is reported. She began to manifest trimethylaminuria 3 years later. At 7 years of age, she is asymptomatic without therapeutic measures except for diet. This is the seventh reported case and the third in a child to our knowledge.

Journal Article↗

Development and characterization of desmoglein-3 specific T cells from patients with pemphigus vulgaris.

Pemphigus vulgaris (PV) is a cutaneous autoimmune disease characterized by blister formation in the suprabasilar layers of skin and mucosae and anti-desmoglein-3 (Dsg3) autoantibodies bound to the surface of lesional keratinocytes and circulating in the serum of patients. This disease can be reproduced in neonatal mice by passive transfer of patients' IgG, indicating that humoral immunity plays an important role in the pathogenesis of PV. Currently, the role of T lymphocytes in the development of PV is not clear. Here, we report that three immunoreactive segments of the ectodomain of Dsg3 specifically induced proliferation of T cells from PV patients. We found that T lymphocytes from 13 out of 14 patients responded to at least one of three Dsg3 peptides. T cells from controls and other patient groups did not respond to these Dsg3 peptides. The major T cell population stimulated by these Dsg3 peptides was CD4 positive. Dsg3-specific T cell lines and clones were developed and were shown to express a CD4 positive memory T cell phenotype. Upon stimulation, these cell lines and clones secreted a Th2-like cytokine profile. The Dsg3 responses of these T cells were restricted to HLA-DR, and not -DQ and -DP, of the major histocompatibility complex. This information will help to elucidate the cellular immune abnormalities leading to production of pathogenic IgG autoantibodies in patients with PV.

Autoantibodies↗

GM-CSF and its effects on replication of HIV-1 in cells of macrophage lineage.

Granulocyte-macrophage colony-stimulating factor (GM-CSF) is a hemopoetic growth factor that is a member of the four-helix bundle family of cytokines and growth factors. It regulates the proliferation and differentiation of granulocytes and cells of macrophage lineage from bone marrow progenitor cells, mediating these activities through binding to its receptor. Most studies examining the effects of GM-CSF on HIV-1 replication in primary monocytes and macrophages, and in related cell lines, have demonstrated augmentation of HIV-1 expression in vitro, although some reports have been at variance with these findings. These laboratory-based observations have been confirmed in limited clinical trials. This review outlines the details of these studies and considers mechanisms by which GM-CSF may exert its effects on cells of this lineage.

Acquired Immunodeficiency Syndrome↗

Mapping structural damage of the optic disk to visual field defect in glaucoma.

PURPOSE: To evaluate the relation between the location of focal visual field defects and optic disk damage in eyes with glaucoma by short-wavelength automated perimetery and confocal scanning laser ophthalmoscopy. METHODS: In 14 patients (14 eyes) with open-angle glaucoma, focal optic disk damage, and focal visual field loss, we obtain visual fields with short-wave-length automated perimetry. The short-wavelength automated perimetry visual field was divided into 21 zones, representing retinal nerve fiber layer arcuate bundles. Test points were compared with a normative database. The optic disk was assessed with a confocal scanning laser ophthalmoscope. Optic disk measurements were calculated in 10-degree sectors and compared with a normative database using a new measure, the rim area ratio, which adjusts for individual differences in disk size. RESULTS: The mean number (+/-SD) of damaged visual field zones was 3.9 (+/-1.9), and the mean number of damaged rim sectors was 5.0 (+/-2.9). Focal defects on the optic disk and on short-wavelength automated perimetry were topographically related with specific damaged visual field zones corresponding to specific damaged rim sectors. CONCLUSIONS: In patients with open-angle glaucoma with focal optic disk damage and focal visual field loss, defects in optic disk and short-wavelength automated perimetry are topographically related. The rim area ratio can be used to identify focal optic nerve defects.

Adult↗

Pre-operative classification of abdominal aortic aneurysms with spiral CT: the axial source images revisited.

OBJECTIVE: The differentiation of supra-, juxta- and high infrarenal abdominal aortic aneurysms (AAA), which is essential for good surgical management, remains problematic. This prospective study assessed the value of highly overlapping vs. contiguous axial spiral computed tomography (CT) reconstructions in the pre-operative assessment of AAA. PATIENTS AND METHODS: Thirty-five patients with abdominal aortic aneurysms were studied with spiral CT (10 mm collimation, pitch 1). Axial reconstructions were performed at 2 and 10 mm increments and compared with surgical findings. Using each protocol, the aneurysms were classified as infra-, juxta- or suprarenal. Observers also assessed visualization of main and accessory renal artery origins and identification of other surgically relevant vascular anomalies. RESULTS: The 2 mm protocol correctly identified 29/31 infrarenal, 3/3 juxtarenal and 1/1 suprarenal aneurysms; two infrarenal aneurysms were overestimated as suprarenal. The 10 mm protocol correctly classified 25/31 infrarenal, 3/3 juxtarenal and 1/1 suprarenal aneurysms; five infrarenal aneurysms were overestimated as juxtarenal (n = 3) or suprarenal (n = 2) and one case was equivocal. Correct classification was thus 94% using the 2 mm protocol and 83% with the 10 mm protocol (P = 0.063). All 70 main renal artery origins were visualized with the 2 mm protocol, while the 10 mm protocol missed six (P = 0.03) The 2 mm protocol identified 10 accessory renal arteries, four of which were missed by the 10 mm protocol. Both protocols demonstrated five surgically relevant venous anomalies. CONCLUSION: Spiral CT with highly overlapping axial reconstructions correctly classified 94% of abdominal aortic aneurysms; overlapping reconstructions were particularly useful in differentiating high infrarenal from juxtarenal aneurysms.

Aged↗

Minimal surface: a useful paradigm to describe the deeper part of the corpus callosum?

The aim of this magnetic resonance imaging study was to find a geometrical characterization of the deeper part of the corpus callosum. Its shape was studied in 12 middle-aged persons free of white matter pathology. Profiles of curvatures were measured showing that this surface was close to a minimal one, especially at the genu and near the splenium. To assess the effect of a white matter pathology on these geometrical features, the same measurements were performed in an extra group of nine patients with definite multiple sclerosis. The hypothesis of curvatures profiles parallelism for the two groups could be rejected at the 0.05 confidence level for the mean curvatures but not for the Gaussian ones. Curvatures profiles may give indications on balance between the cortex and the fiber bundles growth rates during the development and on large scale modifications co-occurring with multilocular white matter pathologies.

Adult↗

Evaluation of the toxicity of Uncaria tomentosa by bioassays in vitro.

Aqueous extracts of Uncaria tomentosa (Willdenow ex Roemer and Schultes) DC. (Rubiaceae) ('Uña de gato'), were analyzed for the presence of toxic compounds in Chinese hamster ovary cells (CHO) and bacterial cells (Photobacterium phosphoreum). Toxicity was evaluated by four systems: Neutral red assay (NR), total protein content (KB), tetrazolium assay (MTT) and Microtox test. The extracts of U. tomentosa did not show toxicity in vitro at the concentrations tested. Testing in vitro could be a valuable tool for evaluating toxicity of medicinal plants.

Analysis of Variance↗

Electrophysiological actions of neuropeptide Y and its analogs: new measures for anxiolytic therapy?

Neuropeptide Y (NPY) has neuromodulatory actions on multiple brain functions including endocrine, behavioral, and circadian processes. Behavioral studies suggest that NPY is a potent anxiolytic; however, little is known about how NPY affects general arousal and/or attention states. The present study evaluated the effects of NPY on spontaneous brain activity as well as auditory processing by using electrophysiological measures. Electroencephalographic (EEG) and event-related potentials (ERPs) were obtained in awake animals after intracerebroventricular administration of NPY (1.0, 3.0 nmol) and two of its analogs, active at Y1 (1.0, 3.0 nmol) and Y2 (1.0, 3.0 nmol) receptor sites. NPY was found to produce dose-related effects on electrophysiological measures. Spectral analyses of the EEG revealed that NPY produced slowing of delta activity (1-2 Hz) in the frontal cortex and high frequency theta activities (6-8 Hz) concomitant with a speeding up of low frequency theta (4-6 Hz) in cortex, hippocampus, and amygdala. At higher doses (3.0 nmols) in addition to shifts in frequency, EEG power was also significantly reduced in all frequencies (0.5-50 Hz) in cortex, and in the higher frequencies (8-32 Hz) in the amygdala. The Y1 and Y2 agonists had a somewhat different profile of EEG effects than the parent compound. At the 1 nmol dose both agonists were found to produce selective depressions in power in the hippocampus. The 3.0 nmols dose of the Y1 agonist produced decreases in EEG stability, an effect commonly produced by anxiolytic drugs, whereas the Y2 agonist produced increases in EEG stability in cortex and amygdala. Auditory processing, as assessed by ERPs, was affected most significantly in the frontal cortex where dose-dependent decreases in the N1 component of the ERP, a finding also commonly seen after anxiolytics, was found. Y1 and Y2 agonists were also found to significantly reduce the amplitude of the N1 component of the ERP but less so than the parent compound. The electrophysiological and behavioral profiles of NPY and the Y1 agonist resembles those of anxiolytics such as ethanol and benzodiazepines. Taken together these data suggest that electrophysiological measures of the actions of this peptide system may represent a new potentially useful assay for the development of anxiolytic drugs.

Amygdala↗

A relative-value-based system for calculating faculty productivity in teaching, research, administration, and patient care.

PURPOSE: To design and test a simple, easily modifiable system for calculating faculty productivity in teaching, research, administration, and patient care in which all areas of endeavor would be recognized and high productivity in one area would produce results similar to high productivity in another at the Louisiana State University School of Medicine in New Orleans. METHOD: A relative-value and time-based system was designed in 1996 so that similar efforts in the four areas would produce similar scores, and a profile reflecting the authors' estimates of high productivity ("super faculty") was developed for each area. The activity profiles of 17 faculty members were used to test the system. RESULTS: "Super-faculty" scores in all areas were similar. The faculty members' mean scores were higher for teaching and research than for administration and patient care, and all four mean scores were substantially lower than the respective totals for the "super faculty". In each category the scores of those faculty members who scored above the mean in that category were used to calculate new mean scores. The mean scores for these faculty members were similar to those for the "super faculty" in teaching and research but were substantially lower for administration and patient care. When the mean total score of the eight faculty members predicted to have total scores below the group mean was compared with the mean total score of the nine faculty members predicted to have total scores above the group mean, the difference was significant (p < .0001). For the former, every score in each category was below the mean, with the exception of one faculty member's score in one category. Of the latter, eight had higher scores in teaching and four had higher scores in teaching and research combined. CONCLUSION: This system provides a quantitative method for the equal recognition of faculty productivity in a number of areas, and it may be useful as a starting point for other academic units exploring similar issues.

Delivery of Health Care↗

T lymphocytes from a subset of patients with pemphigus vulgaris respond to both desmoglein-3 and desmoglein-1.

Pemphigus vulgaris and pemphigus foliaceus are cutaneous autoimmune diseases characterized by intraepithelial blisters and autoantibodies to desmosomal glycoproteins. The antigens recognized by pemphigus vulgaris and pemphigus foliaceus autoantibodies are desmoglein-3 (Dsg3) and desmoglein-1 (Dsg1), respectively. Dsg3 and Dsg1 are members of the desmoglein subfamily of the cadherin supergene family of cell adhesion molecules. It has been well documented that a subset of pemphigus vulgaris sera have IgG reactivity to both Dsg1 and Dsg3, suggesting that Dsg1 may also participate in the autoimmune response of these patients. The cellular mechanisms of T cell autoimmunity in these patients, however, are completely unknown. In this study, we tested the proliferative responses of T lymphocytes from eight pemphigus vulgaris patients after incubation with Dsg3 and Dsg1 fusion proteins. The sera of four of these PV patients showed reactivity with both Dsg1 and Dsg3, whereas the remaining four reacted only with Dsg3. We found that T cells obtained from those patients that exhibited the combined Dsg1/Dsg3 autoantibody reactivity showed a proliferative response after exposure to either Dsg1 or Dsg3 fusion proteins. The cellular responses to both of these recombinant proteins were highly specific and restricted to the CD4-positive T cell population. T cells from pemphigus vulgaris patients with no anti-Dsg1 serum reactivity showed a proliferative response to Dsg3, but not to Dsg1. The Dsg1 fusion protein used in this study has minimal sequence homology with Dsg3. Thus, this study provides the first evidence that T cells from a subset of pemphigus vulgaris patients respond to both Dsg1 and Dsg3.

Amino Acid Sequence↗

Right phrenic nerve palsy as a complication of indwelling central venous catheters.

Five cases are reported of patients who developed a raised right hemidiaphragm while an indwelling central venous catheter was in situ. The patients were being treated with protracted venous infusions of chemotherapy for colorectal carcinoma. All five patients had a chest radiograph following insertion of the Hickman line which showed normal diaphragmatic positions. A mean of 93 days later (range 55-134 days) elevation of the right hemidiaphragm was noted in these patients on repeat chest radiographs. Two of the patients had a right phrenic nerve palsy demonstrated by magnetic stimulation of the nerve. The remaining three patients had paradoxical motion of the right hemidiaphragm on sonography, but were unable to undergo studies of phrenic nerve function before death from metastatic disease. It is suggested that right phrenic nerve palsy is a late complication of an indwelling central venous catheter.

Aged↗

Remission of a chemotherapy resistant tumor of low malignant potential with tamoxifen.

Low Malignant Potential (LMP) tumor of the ovary represents 15% of all ovarian tumors. The prognosis is excellent even in patients with extensive tumor involvement. However 20% of the patients die of disease in a 20 year period. Management of patients after surgery is not defined. Chemotherapy has shown response rates of 20% but no improvement in survival. Toxicity has been reported. We present a case of chemotherapy resistant LMP tumor with serologic response to tamoxifen, no evidence of disease and an excellent quality of life. Hormonal therapy may be considered in the treatment of LMP tumors.

Aged↗