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Biomedical subjects

C Garcia

Publications and source records attributed to C Garcia.

At least 271 records · Page 15Linked to original sources

[Peroperative embolization of cerebral arteriovenous malformations with butylcyanoacrylate (18 cases)].

18 cases of cerebral Arterio-Venous malformations (AVM) are reported, treated by direct intra-operative embolisation. A 50% mixture of Butyl-2-Cyanoacrylate and Mono-Iodo-Stearate of Ethyl was used. The clinical history of the patients was a long history of seizures in 8 cases a sub-arachnoid or intra-cerebral hemorrhage in 9 cases, and a transient motor deficit in 1 case. The AVM site was supra-tentorial in 16 cases, and infra-tentorial in 2 cases. The AVM size was large with numerous feeders in 13 cases, and limited with a few feeders in 5 cases. Technically, after catheterisation of a cortical feeder, an intra-operative angiogram was performed (except for the first 6 cases) then the polymerizing mixture was pushed inside the feeder (from 1 cc to 3 cc routinely, depending of the AVM size; exceptionally 7 cc and 11 cc were used). In the immediate postoperative course, 1 patient died (case with the 11 cc embolization), 3 patients had a serious postoperative hemorrhage, 4 patients presented with a transient postoperative deficit, and in 10 patients the postoperative course was uneventful. The long term results are: 1 postoperative death, 1 death after recurrence of intra-cerebral hemorrhage (3 years postoperatively), 1 hemiplegia, 15 patients without long lasting complication. The embolization was performed as unique treatment in 14 cases, and was followed with the AVM removal in 4 cases (immediately in 1 case, delayed in 1 case, late after recurrence of intra-cerebral hemorrhage in 2 cases, respectively after 3 years and 2 years).(ABSTRACT TRUNCATED AT 250 WORDS)

Cerebral Angiography↗

Enhanced late survival following coronary artery bypass graft operation for unstable versus chronic angina.

Late survival following coronary artery bypass operation is time-frame dependent, with a major improvement occurring by 1974. In the cohort of patients undergoing operation between 1974 and mid-1982, subsets were present with further enhanced survival. In this study of 3,575 patients, the urgency of clinical presentation is examined as a survival determinant, and the results are seemingly paradoxical. Among the 1,404 patients with chronic angina, survival at 1 month was 98.3%; at 5 years, 88%; and at 8 years, 79%. Among the 1,008 patients with progressive angina, survival at 1 month was 97.8%; at 5 years, 90%; and at 8 years, 80%. Among the 1,163 patients with unstable angina, 1-month survival was 98.3%; 5-year survival, 92%; and 8-year survival, 89%. The best long-term results were obtained in patients with an acute clinical presentation. Ventricular function was an important determinant of late survival for the groups with chronic (p less than 0.001) and progressive (p less than 0.001) angina, but it had no effect in the group with unstable angina (p = 0.803). For the patients with chronic angina and good left ventricular (LV) function, survival was 99.5% at 1 month; 92% at 5 years; and 86% at 8 years. For those with poor LV function, the respective survival was 96%, 84%, and 71%. For the patients with progressive angina and good LV function, 1-month survival was 98.9%; 5-year survival, 94%; and 8-year survival, 83%. For those with poor LV function, the respective figures were 96.3%, 85%, and 76%. For the patients with unstable angina and good LV function, survival at 1 month was 97.8%; at 5 years, 92%; and at 8 years, 89%.(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗

Glycosylated hemoglobin determination from capillary blood samples. Utility in an epidemiologic survey of diabetes.

Total glycosylated hemoglobin was measured from capillary blood specimens obtained from a sample of 1880 individuals of Mexican-American ancestry residing in Starr County, Texas, between January 1981 and February 1982, as part of an epidemiologic survey to assess the prevalence of noninsulin-dependent diabetes mellitus (Type II). No significant difference was found between males and females. Diabetics were found to have significantly higher levels of glycosylated hemoglobin than nondiabetics. However, among diabetics, there was no significant difference between newly diagnosed and known diabetics, and known diabetics taking medication did not differ significantly from those not taking medication. An analysis of the specificity and sensitivity of glycosylated hemoglobin, fasting blood glucose, and casual blood glucose determinations as screening devices in a survey of diabetes prevalence reveals that glycosylated hemoglobin is superior to casual blood glucose determination. The conditions under which various screening devices might be more effective are discussed.

Diabetes Mellitus, Type 2↗

Alpha-lactalbumin as an immunohistochemical marker for metastatic breast carcinomas.

Alpha-lactalbumin (ALA), a milk protein, was demonstrated by immunohistochemistry with polyclonal antisera from three different sources in primary and metastatic breast carcinomas, and mammary Paget's disease. ALA localization was observed in 67% of mammary carcinomas, and in 62% of their metastases to sites which included lymph nodes, lung, bone, liver, pericardium, skin, and subcutaneous tissue. There was close correlation between primary and metastatic breast carcinomas in ALA positivity, but no correlation between ALA positivity and histologic differentiation. A variety of nonmammary neoplasms were examined for ALA immunoreactivity. In contrast to ALA immunoreactivity of breast tissue, which was removed by preabsorption of antiserum with ALA antigen, a number of skin appendage tumors, salivary gland tumors, and mesotheliomas demonstrated positive staining which was not abolished by preabsorption and was most likely due to the presence of cross-reacting antibodies. One commercial ALA antiserum also reacted with pancreatic islet cells in a distribution similar to glucagon. Our results demonstrate the presence of ALA in breast carcinomas and its potential value to the surgical pathologist in the workup of metastatic carcinomas of unknown primary sites. However, the staining encountered in some nonmammary tumors necessitates caution in its interpretation.

Breast Neoplasms↗

Superior vena cava obstruction after Mustard repair of d-transposition of the great arteries.

Superior vena caval obstruction following Mustard repair of d-transposition of the great arteries is usually relieved by partial or complete revision of the intra-atrial repair. We employed a different approach in a patient with isolated total obstruction of the superior vena caval pathway, who suffered from fatigue, venous congestion in the upper part of the body and mild hydrocephalus. A 12 mm polytetrafluoroethylene tube was interposed between the left innominate vein and the left (functionally right) atrial appendage. Early and medium-term relief was demonstrated by repeat catheterization of the right heart and computed tomography brain scan three months postoperatively. The rationale for use of prosthetic material in the venous system is discussed and the need for long-term follow-up is stressed.

Blood Vessel Prosthesis↗

Amyloidosis and the serum amyloid A protein response to muramyl dipeptide analogs and different mycobacterial species.

Serum amyloid A protein (SAA) elevation accompanies induction of secondary amyloidosis in mice given Mycobacterium butyricum in Freund adjuvant. The synthesis of SAA by cultured hepatocytes is induced by a macrophage-derived mediator, which has been identified as interleukin 1. In these studies, SAA synthesis has been used as an index of macrophage activation to examine the in vivo response of mice to challenge with seven different mycobacteria and with synthetic analogs of the immunoadjuvant N-acetylmuramyl-L-alanyl-D-isoglutamine [MDP(L-D)]. SAA synthesis was stimulated by administration (by the intraperitoneal route) of the mycobacteria dissolved in saline, with Mycobacterium vaccae being the most active and Mycobacterium leprae being the least stimulatory. MDP(L-D), which is the minimal structure (molecular weight, 492) able to substitute for mycobacteria in Freund adjuvant, stimulated SAA synthesis, whereas the MDP(D-D) isomer was inactive. The butyl ester of MDP, which induces no detectable pyrogenicity but retains adjuvanticity, required a 100-fold greater dosage than MDP(L-D) in stimulating SAA synthesis. Amyloidosis was detected histologically only when active SAA inducers MDP(L-D), M. vaccae, and M. butyricum, were administered in incomplete Freund adjuvant, with amyloid-enhancing factor. These studies demonstrated that SAA elevation was a sensitive in vivo marker of the capacity of antigens to stimulate macrophages to produce interleukin 1. A point of considerable relevance to the human use of MDP was the observation that repeated injections of the adjuvant MDP in saline did not induce secondary amyloidosis.

Acetylmuramyl-Alanyl-Isoglutamine↗

Cesarean section IUD insertion.

A trial was carried out on 154 selected volunteers who underwent cesarean section and then received an ML Cu 250 IUD during the operation. 56% of the operations were planned while 44% were not. The IUD was inserted in 65, 80, and 9 cases in the 1st, 2nd, and 3rd cesarean section, respectively. The patients were followed-up after 1, 3, 6, 12, and 24 months. Hospitalization time and postoperative morbidity did not increase with device insertion. Maternal lactation was not altered. 8% of the patients had postpartum bleeding which lasted more than 40 days. At the 1 year examination, 52% of the patients were menstruating normally while at 2 years, the percentage had increased to 62.5%. The acceptability, continuity, and efficiency of the contraceptive procedure proved successful. There were only 4 cases (2.6%) in which the device had to be removed for medical reasons (due largely to endometritis) and 8 cases (5.2%) because of patient desire (menstrual abnormalities). Spontaneous expulsion of the IUD occurred in 4 cases (2.6%). As of the present time, no pregnancies have been detected. The cesarean section insertion of an ML Cu 250 IUD produced excellent results and further, more widespread use is suggested.

Endometritis↗

[Normotensive hydrocephalus. Retrospective clinical study of 47 cases].

The clinical observation of 47 patients, undergoing surgery for "normotensive hydrocephalus" during the period January 1975 to January 1981 have been analysed retrospectively. The condition of half the patients improved following insertion of a cerebrospinal fluid bypass. Complications of varying degrees of severity were noted in 21 percent of cases. The correlation between the post-operative results and the clinical data was subjected to statistical analysis. Some factors appeared to have an important predictive value. These were the age, the absence of cortical atrophy on C.T. scan and the prolonged ventricular filling on cisternography. Other factors, although without statistical significance, seem to predict a better result: the existence of prior etiological data, presence of a frontal syndrome and evidence of periventricular hypodensity on C.T. scan. Finally, some other factors in our series appeared to have no influence on the prognosis. These were: duration of the preoperative evolution of the disorder, the degree of mental disturbance and difficulties of gait, the presence of urinary incontinence, the value of the ventricular cranial ratio. None of the recognized significant criteria was sufficiently reliable to predict the quality of surgical result, when studied in isolation. The association between the different significant criteria, such as have been described above notably, improves the chances of a favorable post-operative outcome but it is insufficient to predict it with great certitude. The continuous monitoring of the intracranial pressure during periods of 24 to 48 hours appears to be the most reliable factor on which to make a decision to operate in the light of the findings described in recent literature.

Adult↗

Localization of kainic acid-sensitive cells in mammalian retina.

Short-term (15 minutes) in vitro exposure to kainic acid (KA), a rigid structural analog of L-glutamic acid (Glu), caused two morphologically distinct neuronal lesions in retinas of several species. In rabbit retina, one type of lesion was characterized by rapid swelling after exposure to low concentrations of KA (10(-4)M). This lesion was observed in elements of both plexiform layers and, more specifically, in cell bodies and neurites of horizontal cells that contact cones. A few cell bodies from the amacrine cell layer showed some limited swelling. The swelling was completely blocked when sodium was removed from the incubation medium. The second type of lesion was generally seen after longer exposures of after exposure to higher concentrations of KA and was evidenced by degeneration of neurons in the amacrine and ganglion cell layers. One exception was noted in that a few cells from the ganglion cell layer degenerated even under low exposure conditions. The second type of lesion was not blocked by removal of sodium ions. Photoreceptor cells appeared resistant to all effects of KA. The results suggest that a correlation may exist between certain KA-induced lesions of the retina and putative glutamoreceptive neurons. At the same time, the two types of retinal lesions produced by KA are morphologically and chemically differentiable and may be useful in elucidating the differences between specific, Glu-related toxicity and nonspecific toxicity of KA.

Animals↗

Multilaboratory evaluation of an ultrafiltration procedure for high density lipoprotein cholesterol quantification in turbid heparin-manganese supernates.

High density lipoprotein (HDL) can be quantitated by measurement of cholesterol in supernates after precipitation of low and very low density lipoprotein (LDL and VLDL) with heparin and Mn(2+). Supernatant turbidity, often observed with hypertriglyceridemic specimens, indicates incomplete sedimentation of LDL/VLDL and precludes accurate quantitation of HDL. Ten Lipid Research Clinic Laboratories compared an ultrafiltration technique for clearing turbid heparin-Mn(2+) supernates to current methods involving repeat precipitation of either the original specimen after dilution or the d > 1.006 g/ml fraction after removal of VLDL from the initial specimen by ultracentrifugation. Results for ultrafiltration of 429 turbid supernates averaged only slightly higher (1.0-1.1 mg/dl) than results by the dilution or ultracentrifugation methods on the same specimens, but this difference was found to be significant (P < 0.005). The agreement of the ultrafiltration method with the other two methods is indicated by the following linear regression equations: a), ultrafiltration = (0.964 x ultracentrifugation) + 2.4 mg/dl, and correlation coefficient = 0.926; and b), ultrafiltration = (0.936 x dilution) + 3.3 mg/dl, and correlation coefficient = 0.933. We conclude that ultrafiltration of turbid heparin-Mn(2+) supernates is a convenient alternative to precipitation after either dilution or removal of VLDL.-Warnick, G. R., J. J. Albers, P. Bachorik, J. Turner, C. Garcia, C. Breckinridge, K. Kuba, S. McNeely, G. Hillerman, P. King, R. Muesing, B. Most, and K. Lippel. Multi-laboratory evaluation of an ultrafiltration procedure for high density lipoprotein cholesterol quantification in turbid heparin-manganese supernates.

Chemical Phenomena↗

[Dacryocystorhinostomy using the endonasal approach (author's transl)].

Recent progress in microsurgery has led to a reappraisal of the endonasal approach to the lacrymal sac. The lacrymal duct is located in the orbito-nasal septum and is visible in the anterior part of the middle meatus. A technique is described which was applied in 20 cases, with one complete failure and two temporary failures, the patients having been successfully operated upon a second time.

Adolescent↗

Visual evoked potentials in two forms of hereditary spastic paraplegia.

Visual evoked potentials (VEPs) were used to study two forms of hereditary spastic paraplegia. We recorded the VEP in 6 homozygotes and 5 obligate heterozygotes in one family with recessively transmitted disease and in 5 persons with dominantly transmitted hereditary spastic paraplegia. The VEPs in the affected persons from both families were similar; both had delayed conduction times and changes in the wave form. The VEPs of the obligate heterozygotes were indistinguishable from those of the unaffected control subjects. Comparison of our findings with those of other disease processes that affect the VEPs suggest that the conduction delays in our patients' VEPs may be associated with changes in myelin.

Adult↗

Dialysis pruritus: effect of cimetidine.

The effect of oral Cimetidine compared to a classic antihistaminic and to a placebo was evaluated, under the double hypothesis of its anti-PTH and anti-pruritus action, in a population of patients recently included in Hemodialysis that were asked about the incidence and intensity of pruritus according to a scored questionnaire made for this purpose. No different efficacy of Cimetidine versus the antihistaminic classic and the placebo was observed in our study.

Cimetidine↗