[Cluster headache and trigeminal nerve].
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Cluster Headache↗
Biomedical subjects
A Moreno
Publications and source records attributed to A Moreno.
[Peritoneal carcinomatosis. Review of CT findings in 107 cases].
CT findings of 107 patients with non lymphomatous malignant peritoneal disease were retrospectively evaluated. The most common malignancies encountered were ovarian neoplasms (46%), followed by gastric (14%) and colonic carcinomas (10%). In 12 cases (11%) the primary site was unknown. Peritoneal and extraperitoneal findings were evaluated. Signs most frequently observed were: peritoneal implants (82%), ascites (70%), mesenteric implants (65%) and omental involvement (52%). Appreciation of the spectrum of CT findings in peritoneal carcinomatosis is essential for an accurate evaluation of scans in patients with abdominopelvic malignancies.
Adult↗
[Cytogenetic alterations found by chromosome analysis and fish technique in two patients with variant chronic lymphocytic leukemia].
Chromosomal studies in CLL have yielded poorer results than in other blood diseases because of the low mitotic index of the B cells. The FISH technique is a very useful tool for trisomy 12 detection in interphase nuclei in CLL, although this method cannot be a substitutive for conventional cytogenetics. The FISH technique was applied in two cases of CLL by means of satellite DNA probing specific for chromosome 12 according to the Oncor S 1370-CF kit protocol. Trisomy 12 was detected, along with other chromosomal abnormalities secondary to this trisomy. Both patients had lymphocyte counts lower than 5.0 x 10(9)/L and their peripheral blood immunophenotype showed 58% lymphocytes with lambda sIg of medium density, co-expressing CD5 and unable to form rosettes with mouse red-cells. Patient no. 1 was 46,XY/47,XY + 12/47,XY + 12,5q-, and patient no. 2 was 46,XX/47,XX + 12,14q-. The presence of secondary anomalies could explain the special clinico-haematological picture, characterised by low lymphocytosis and presence of irregular nuclei in mature lymphocytes, along with the lack of CD23 expression and rosette formation with mouse red-cells. FISH technique combined with chromosome analysis may prove a useful means for diagnosing and recognising variants or specific entities within low-grade lymphoproliferative syndromes.
Aged↗
Renal tubular acidosis following treatment with foscarnet.
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Acidosis, Renal Tubular↗
Alcohol dehydrogenase of class IV (sigma sigma-ADH) from human stomach. cDNA sequence and structure/function relationships.
Human stomach mucosa contains a characteristic alcohol dehydrogenase (ADH) enzyme, sigma sigma-ADH. Its cDNA has been cloned from a human stomach library and sequenced. The deduced amino acid sequence shows 59-70% identities with the other human ADH classes, demonstrating that the stomach enzyme represents a distinct structure, constituting class IV, coded by a separate gene, ADH7. The amino acid identity with the rat stomach class IV ADH is 88%, which is intermediate between constant and variable dehydrogenases. This value reflects higher conservation than for the classical liver enzymes of class I, compatible with a separate functional significance of the class IV enzyme. Its enzymic features can be correlated with its structural characteristics. The residues lining the substrate-binding cleft are bulky and hydrophobic, similar to those of the class I enzyme; this explains the similar specificity of both classes, compatible with the origin of class IV from class I. Position 47 has Arg, in contrast to Gly in the rat class IV enzyme, but this Arg is still associated with an extremely high activity (kcat = 1510 min-1) and weak coenzyme binding (KiaNAD+ = 1.6 mM). Thus, the strong interaction with coenzyme imposed by Arg47 in class I is probably compensated for in class IV by changes that may negatively affect coenzyme binding: Glu230, His271, Asn260, Asn261, Asn363. The still higher activity and weaker coenzyme binding of rat class IV (kcat = 2600 min-1, KiaNAD = 4 mM) can be correlated to the exchanges to Gly47, Gln230 and Tyr363. An important change at position 294, with Val in human and Ala in rat class IV, is probably responsible for the dramatic difference in Km values for ethanol between human (37 mM) and rat (2.4 M) class IV enzymes.
Alcohol Dehydrogenase↗
[138 episodes of bacteremia or fungemia in patients with solid organ (renal or hepatic) transplantation].
BACKGROUND: To study the bacteremias and fungemias of the patients with solid organ transplantation (kidney or liver) and analyze the differences according to the type of graft. METHODS: A prospective study included in a control program of bacteremias of a 1000-bed hospital and a follow up study of the infections of the patients who had undergone kidney transplantation (KT) (1985-1991) and liver transplantation (LT) (1988-1991) were carried out. RESULTS: One hundred thirty-one bacteremias and 5 fungemias, 75 in 62 patients with KT out of a total of 568 transplantations (11%) and 63 out of 54 patients with LT out of a total of 185 transplantations (29%) were identified. The prevalence of bacteremia in LT was greater (p < 0.001). The origin was nosocomial in 95% in LT and 70% in KT (p < 0.001). Around 50% of the bacteremias occurred during the first month post LT and KT. The microorganisms isolated were: Staphylococcus sp. (21 in KT and 30 in LT), with greater incidence in LT (p < 0.05); Enterococcus sp. (9 and 5, respectively), enterobacterias (12 and 12, respectively), Pseudomonas sp. (14 and 6, respectively), Candida sp. (2 and 3, respectively) with similar rates in both transplants. The origin of bacteremia was; renal and urinary tract, most frequent in KT (21 and 2 respectively) (p = 0.001). The origin of bacteremia was: renal and urinary tract, most frequent in KT (21 and 2 respectively) (p < 0.001), intraabdominal and biliary tract, most frequent in LT (4 and 14, respectively) (p = 0.007); intravenous catheter, most frequent in LT (16 and 24 respectively) (p < 0.05); lung, most frequent in LT although without statistical significance (3 and 8, respectively), (p = NS), and finally, surgical wound (4 and 1, respectively) (p = NS). Seventeen patients died (14 with LT and 3 with KT). CONCLUSIONS: The incidence of bacteremia and the mortality related, was greater in LT than that observed in KT. The most frequent origin in KT was the kidney and urinary tract and the biliary and intraabdominal organs and the intravenous catheter were most prevalent in liver transplants. Staphylococcus sp was the most frequent germ in both types of transplantation and polymicrobian infection in liver transplants. Gram-negative germs caused higher mortality in liver transplantation.
Bacteremia↗
[CD4+ lymphocytes and opportunistic infections and neoplasms in patients with human immunodeficiency virus infection].
BACKGROUND: The CD4+ lymphocytes are the principal target cell for the human immunodeficiency virus (HIV). Their depletion originates a very severe cell immunosuppression, which conditions the appearance of opportunistic infections and neoplasms characteristic of AIDS. The aim of this study was to evaluate whether there is a relation between the degree of cell immunosuppression and the type of opportunistic infections and neoplasms which these patients develop in Spain. METHODS: The CD4+ lymphocyte counts in 400 adults with HIV infection who developed opportunistic infections or neoplasms were retrospectively reviewed (1987-1991). This determination was carried out during between two months prior to diagnosis of AIDS (CDC, 1987) to one month after such diagnosis. RESULTS: The results allowed opportunistic infections to be classified into three groups according to the grade of immunosuppression: 1) opportunistic infections with more than 0.2 x 10(9) CD4+ lymphocytes/l (45-60% of cases of tuberculosis, esophageal candidiasis and enteritis by Isospora belli); 2) opportunistic infections with 0-0.2 x 10(9) CD4/l (87-100% of the cases of pneumonia by Pneumocystis carinii, encephalic toxoplasmosis, visceral leishmaniasis and enteritis by Cryptosporidium); 3) opportunistic infections with 0-0.1 x 10(9) CD4 lymphocytes/l (70-100% of the cases of systemic cryptococcosis, retinitis by cytomegalovirus, progressive multifocal leukoencephalopathy and infection by Mycobacterium avium-intracellulare). With respect to the neoplasms, Kaposi's sarcoma was observed in patients with different degrees of immunosuppression. Seventy-five and 80% of the patients with non Hodgkin's lymphoma and primary cerebral lymphoma had less than 0.2 x 10(9)/l and less than 0.1 x 10(9)/l CD4+ lymphocytes, respectively. CONCLUSIONS: The CD4 lymphocyte counts may predict the type of opportunistic infections which patients with the human immunodeficiency virus infection may develop.
AIDS-Related Opportunistic Infections↗
Mammalian class IV alcohol dehydrogenase (stomach alcohol dehydrogenase): structure, origin, and correlation with enzymology.
The structure of a mammalian class IV alcohol dehydrogenase has been determined by peptide analysis of the protein isolated from rat stomach. The structure indicates that the enzyme constitutes a separate alcohol dehydrogenase class, in agreement with the distinct enzymatic properties; the class IV enzyme is somewhat closer to class I (the "classical" liver alcohol dehydrogenase; approximately 68% residue identities) than to the other classes (II, III, and V; approximately 60% residue identities), suggesting that class IV might have originated through duplication of an early vertebrate class I gene. The activity of the class IV protein toward ethanol is even higher than that of the classical liver enzyme. Both Km and kcat values are high, the latter being the highest of any class characterized so far. Structurally, these properties are correlated with replacements at the active site, affecting both substrate and coenzyme binding. In particular, Ala-294 (instead of valine) results in increased space in the middle section of the substrate cleft, Gly-47 (instead of a basic residue) results in decreased charge interactions with the coenzyme pyrophosphate, and Tyr-363 (instead of a basic residue) may also affect coenzyme binding. In combination, these exchanges are compatible with a promotion of the off dissociation and an increased turnover rate. In contrast, residues at the inner part of the substrate cleft are bulky, accounting for low activity toward secondary alcohols and cyclohexanol. Exchanges at positions 259-261 involve minor shifts in glycine residues at a reverse turn in the coenzyme-binding fold. Clearly, class IV is distinct in structure, ethanol turnover, stomach expression, and possible emergence from class I.
Alcohol Dehydrogenase↗
[Incidence of enteropathogens in patients with human immunodeficiency virus infection].
BACKGROUND: To establish the incidence of diarrhea and its evolution over time, the causal microorganisms, recurrence and associated mortality in patients with AIDS or severe immunologic alterations (CD4 lymphocytes lower than 0.5 x 10(9)/l). METHODS: A prospective longitudinal study was carried out from 1984 to 1992. The following patients were included in the study: 1) all those patients with diarrhea in whom a pathogenic microorganism was identified in the stools, and 2) patients with fever and positive blood cultures for enteropathogenic bacteria. The patients belonged to a series of 1,456 patients with infection by HIV. RESULTS: Of the 1,456 controlled patients, 253 (17%) had infection by enteropathogenic microorganisms. The incidence was greater in homosexual patients (26%) than in drug addicts (12%). The most frequent germs were Cryptosporidium, in 104 episodes and Salmonella sp. in 78 episodes (31 as isolated bacteria). The mortality in the 15 days following isolation was 2%, the referred microorganisms being the most frequent responsible for the deaths. The mean of CD4 lymphocytes in the patients with enteropathogens was 0.17 x 10(9)/l). SD 0.14 x 10(9)/l). In patients with infection by Cryptosporidium the CD4 lymphocyte count was lower than that observed in the cases of infection by Isospora belli. Prior to 1988, 21% of the patients had infection by enteropathogenic bacteria and 23% by parasites, those percentages being 3% and 6%, respectively in 1991. CONCLUSIONS: Infections by enteropathogenic microorganisms in patients with infection by the human immunodeficiency virus in an advanced stage are frequent, particularly, in homosexuals. The patients with enteritis by Cryptosporidium have a greater grade of immunosuppression (CD4 lymphocytes lower than 0.1 x 10(9)/l) than patients with infection by other enteropathogenic microorganisms. In the last few years, the incidence of enteropathogenic bacteria, especially Salmonella sp. and protozoa has decreased [corrected].
Acquired Immunodeficiency Syndrome↗
Gastrointestinal bezoars.
Of 99 patients with 117 gastrointestinal bezoars, 69 had undergone previous surgery, the most common operation being bilateral truncal vagotomy with pyloroplasty (55 patients). An excessive intake of vegetable fibre was found in 38 patients and poor mastication in 27. Thirty bezoars presented with gastric symptoms and patients had endoscopy as the diagnostic technique; 87 caused symptoms of intestinal obstruction with the diagnosis made by plain abdominal radiography. Medical treatment by enzymic or endoscopic fragmentation was used for 17 of 30 gastric bezoars; surgery was required in the remainder. Intestinal bezoars causing obstruction can be fragmented and 'milked' to the caecum. The stomach should be explored for associated gastric bezoars.
Adolescent↗
Comparison between preoperative cytology and intraoperative frozen-section biopsy in the diagnosis of thyroid nodules.
The value of intraoperative frozen-section biopsy of thyroid nodules (solitary or dominant in a multinodular goitre) was examined in patients who underwent fine-needle aspiration cytology (FNAC) for diagnosis before operation. A total of 170 consecutive patients were evaluated and classified according to whether the cytological diagnosis was benign, suspicious or malignant. In the benign group, diagnostic accuracy was 98 per cent for FNAC and 97 per cent for intraoperative biopsy. In those with suspicious cytology, diagnostic accuracy was 12 per cent for FNAC and 96 per cent for intraoperative biopsy. In those with malignant cytology there was 100 per cent accuracy for FNAC and 76 per cent for biopsy. Intraoperative biopsy by frozen section is useful in patients undergoing surgery for a thyroid nodule with a 'suspicious' cytology. It adds no information in patients with a diagnosis of malignancy following cytological assessment and is of limited use in those in whom a benign lesion is diagnosed.
Adolescent↗
GFAAS determination of selenium in infant formulas using a microwave digestion method.
A method for determining the selenium content of infant formulas is proposed. It includes wet digestion with nitric acid and hydrogen peroxide in medium pressure teflon bombs in a microwave oven and determination by graphite furnace atomic absorption spectrometry (GFAAS). The absence of interferences is checked. Values obtained for the limit of detection (19.4 ng/g), precision (RSD = 2.2%) and accuracy by analysis of a reference material show that the method is reliable.
Humans↗
In vitro development of infectious liver stages of P. yoelii and P. berghei malaria in human cell lines.
The preerythrocytic stages of the malaria parasite are the focus of intense efforts to identify new immunological and pharmacological methods for the control of the malaria parasite. The study of the malaria hepatic stages requires an in vitro system to facilitate the analysis of parasite/host cell interactions and the characterization of exoerythrocytic form (EEF) antigens. At the present time, only the rodent malaria, Plasmodium berghei, and the human malaria, Plasmodium vivax, develop into mature infectious EEF within established cell lines in vitro. We therefore used the rodent malaria, Plasmodium yoelii, which lacks a cell line for in vitro cultivation of EEF, to screen a series of human cell lines as potential host cells for the intracellular stage of the malaria parasite. Two human hepatomas, huH-1 and huH-2, were identified that supported the development of P. yoelii EEF which were antigenically and morphologically mature. Infectious merozoites that were shown to be capable of inducing P. yoelii blood infections in vivo developed within these in vitro EEF. In addition, mature, infectious EEF of P. berghei, but not P. yoelii, were found to develop within human HeLa cells. Preliminary results suggest that the cell lines that support the intracellular growth of P. yoelii might also serve as host cells for EEF of Plasmodium falciparum. The identification and characterization of the unique intracellular requirements for differentiation and development of P. berghei and P. yoelii EEF may provide new approaches to the prophylaxis of the human malaria species.
Animals↗
Esthetic contour analysis of the submental cervical region: a study based on ideal subjects and surgical patients.
A cephalometric analysis of the submental-cervical region was carried out by examining and comparing 16 white adults who had ideal submental-cervical esthetics with 16 adult orthognathic surgery patients who were treated by submental lipectomy or liposuction and various orthognathic surgical procedures. A normative data base of the submental-cervical region was derived from the ideal subject group. The submental-cervical morphology of the preoperative patients differed significantly from the ideal subjects. The submental-cervical angle (Sm-Ce) and the submental soft tissue thickness at C point (IBM-Sm) presented the greatest disparity between the ideal subjects (118.0 degrees, 28.0 mm) and the preoperative patients (158.3 degrees, 42.1 mm, each P < .001). After surgery, Sm-Ce and IBM-Sm decreased to 132.8 degrees (P < .001) and 28.7 mm (P < .001), respectively. By the end of 6 months postoperative, the mean values of Sm-Ce and IBM-Sm were 131.1 degrees and 28.6 mm. The submental soft tissue thickness of the patients 6 months after surgery was not statistically different from the ideal subjects (each P > .05). Orthognathic surgical procedures with concomitant submental lipectomy or liposuction had a significant effect on the contour of the submental and cervical soft tissues.
Adolescent↗
Primary cutaneous CD30-positive large-cell lymphoma: a case with fatal outcome.
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Adult↗
In vivo, ex vivo, and in vitro one- and two-dimensional nuclear magnetic resonance spectroscopy of an intracerebral glioma in rat brain: assignment of resonances.
An in vivo study of intracerebral rat glioma using proton-localized NMR spectroscopy showed important modifications of the spectra in the tumor as compared with the contralateral brain. To carry out the assignment of the resonances of the glioma spectra, tumoral and normal rat brain tissues were studied in vivo, ex vivo, and in vitro by one-dimensional and two-dimensional proton spectroscopy. N-Acetylaspartate was found at an extremely low level in the glioma. The change of peak ratio total creatine/3.2 ppm peak was found to be due to a simultaneous decrease of the total creatine content and an increase of the 3.2 ppm peak. The 3.2 ppm resonance in the glioma spectra has been shown to originate from choline, phosphocholine, glycerophosphocholine, taurine, inositol, and phosphoethanolamine. The increase of the 3.2 ppm peak in the glioma was found to result from the increase of taurine and phosphoethanolamine contents. The peak in the 1.3 ppm region of the glioma spectra was due to both lactate and mobile fatty acids. Moreover, two-dimensional spectroscopy of excised tissues and extracts showed the presence of hypotaurine only in the tumor.
Amino Acids↗
Analysis of factors influencing the outcome and development of septic metastasis or relapse in Salmonella bacteremia.
One-hundred seventy-two consecutive adult patients with salmonella bacteremia documented by at least one positive blood culture were prospectively evaluated over a 10-year period. Salmonella enteritidis was isolated in 121 cases (70.3%), Salmonella typhimurium in 29 (16.9%), and other Salmonella species in 22 (12.8%). Twenty-seven patients (15.7%) developed septic metastasis; 21 patients (12.2%) died of bacteremia, and 24 (16.7%) of the 144 patients who survived had at least one relapse. A logistic regression analysis selected three variables as independently influencing outcome: septic shock (P = .005), coma (P = .029), and immunosuppression (P = .04). By means of the same statistical analysis, leukopenia (a white blood cell count of < 4 x 10(9)/L) was identified as an independent risk factor for relapse (P < .0001). The possibility of salmonella bacteremia must be considered when immunosuppressed patients have fever and no obvious source of infection. Treatment with a drug active against Salmonella species is essential in this population. Patients with leukopenia should be considered as recipients of prophylaxis for relapse.
Adolescent↗