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Biomedical subjects

C Gutierrez

Publications and source records attributed to C Gutierrez.

At least 91 records · Page 5Linked to original sources
PubMed1998

Microalbuminuria in normotensive patients with autosomal-dominant polycystic kidney disease.

Microalbuminuria (MA) is present in hypertensive autosomal-dominant polycystic kidney disease (ADPKD) patients, but has not been reported in normotensive ADPKD patients. We examined the prevalence of MA and the effect of different determinants on urinary albumin excretion in a group of 42 normotensive ADPKD patients. Metabolic parameters, plasma renin activity and aldosterone and serum angiotensin-converting enzyme (ACE) activity were determined. A 24-h urine sample two or three times over a 6-month period was collected to evaluate MA. Each patient underwent an echocardiography to measure left ventricular mass. Eight patients (19%) showed MA (61.6 mg/day, range 37-164), whereas 34 patients (81%) were normoalbuminuric (8.8 mg/day, range 2-29). The groups were matched for all possible confounding variables, but microalbuminuric patients showed a tendency towards greater systolic blood pressure, plasma renin activity and left ventricular mass. There was no correlation between MA and age, sex, body mass index, systolic or diastolic blood pressure, plasma renin activity, serum ACE levels or left ventricular index. The present study demonstrates a high prevalence of MA in normotensive ADPKD patients. MA may be a predictor of early renal and vascular damage in these patients.

Adult↗
PubMed1998

Traumatic renal artery thrombosis.

We report the case of a unilateral traumatic thrombosis of the renal artery. Revascularization was not performed because the diagnosis was made more than 24 h after the injury. Early diagnosis and prompt surgical repair are the keys to successful management of this complication.

Adolescent↗
PubMed1998

Double-phase Tc-99m sestamibi scintigraphy in the preoperative location of lesions causing hyperparathyroidism.

Hyperparathyroidism (HPT) is one of the most prevalent endocrine diseases, for which the only effective treatment is surgery. The use of imaging techniques in the preoperative localization of the hyperfunctioning glands is the subject of controversy. The purpose of this paper is to assess the use of double-phase scintigraphy with Tc-99m sestamibi in the localization of lesions causing HPT. We used scintigraphy to preoperatively examine 41 patients, 31 of whom had primary HPT and 10 with secondary HPT. We acquired two anterior view planar images of the neck and chest 10 minutes and 3 hours after injection of Tc-99m sestamibi. Final diagnosis, determined with biopsy, was adenoma in 26 patients, 24 of whom had a positive scintigraphic study (sensitivity 92%), with only two false negative results. In the 14 cases of parathyroid hyperplasia, scintigraphy was also positive, and 62% (30/48) of the excised glands were identified by Tc-99m sestamibi. The radioisotope study was of particular interest in the six patients who previously had undergone surgery, since all the studies were positive; in two patients, additional diseased glands were located in the neck, and an ectopic adenoma was found in the remaining four patients. A fifth ectopic lesion was also sestamibi-positive and, in this case, the scintigraphic result was a direct indication for mediastinal surgery. There were no false positive results, even in patients with multinodular goiter. We conclude that, due to its high sensitivity and the ease with which it is performed, double-phase scintigraphy with Tc-99m sestamibi is the preferred technique for the preoperative localization of diseased glands in patients with HPT, especially in cases of parathyroid adenoma, including those with aberrant location. Its use is of particular interest in patients who previously have undergone surgery.

Adenoma↗
PubMed1998

Modifications of the form and amplitude of the electrocardiographic QRS complex during growth in the Spanish-bred Horse.

Configuration and amplitude values of the QRS complex of the electrocardiogram were studied with standard Einthoven leads in 173 healthy Spanish-bred (Andalusian) horses, aged between 1 month and 17 years. Animals which were 1 month old had a predominantly negative QRS complex, whereas a predominantly positive complex direction was found in the rest of the animals. Statistically significant variations were found for the Q-wave and QRS main vector between the different age groups, with highest values for the Q-wave and most negative values for the direction of the QRS main vector in animals up to 2 months of age. The effect of age on the form and amplitude values of the QRS complex could be related to the changes in size and position of the heart in the thorax during growth. This study provides standard electrocardiographic values for the Andalusian horse at different ages.

Aging↗
PubMed1998

Plasma levels of the soluble fraction of tumor necrosis factor receptor 2 and insulin resistance.

Recent studies have shown that the tumor necrosis factor (TNF) system is implicated in the insulin resistance of human obesity. Plasma concentrations of the soluble fraction of the TNF receptors 1 and 2 (sTNFR1 and sTNFR2) are thought to reflect the degree of activation of the TNF system. The purpose of this study was to explore whether this activation, as measured by the levels of circulating sTNFR1 and sTNFR2, is associated with insulin resistance. A total of 19 men (mean age 36.2 +/- 1.9; BMI 28.8 +/- 1.2, range 22.2-35.7) and 17 premenopausal women (age 34.9 +/- 1.4; BMI 28.1 +/- 0.8, range 19-37.9) were studied. Men showed higher levels of plasma sTNFR1 and sTNFR2 than women. However, obese men showed increased levels of sTNFR2 but similar levels of sTNFR1 in comparison with obese women. In fact, sTNFR2 levels correlated with BMI (r = 0.50, P = 0.002), fat-free mass (FFM) (r = 0.61, P < 0.0001), and waist-to-hip ratio (WHR) (r = 0.39, P = 0.02), but not with fat mass or percent fat mass. sTNFR2 levels correlated with basal glucose levels (r = 0.45, P = 0.007), area under the curve (AUC) for glucose during an oral glucose tolerance test (r = 0.42, P = 0.013), and with the quotient AUC glucose/log AUC insulin (r = 0.41, P = 0.015). sTNFR2 also correlated negatively with insulin sensitivity (S(I)), evaluated using the frequently sampled intravenous glucose tolerance test with minimal model analysis (r = -0.38, P = 0.02). Plasma sTNFR1 levels were not associated with any of these variables. Because WHR influenced both S(I) and sTNFR2 levels, we constructed a multiple linear regression to predict S(I), with WHR and sTNFR2 as independent variables. In this model, both WHR (P = 0.0078) and sTNFR2 levels (P = 0.025) contributed to 47% of the variance in S(I). In parallel with higher FFM, lean and obese men showed a lower S(I) (2.9 +/- 0.9 vs. 5.2 +/- 1.3 min(-1) x mU x l(-1), P = 0.001; and 1.15 +/- 1.1 vs. 1.8 +/- 0.8 min(-1) x mU x l(-1), P = 0.035, respectively) and higher sTNFR2 levels in comparison with lean and obese women, respectively. After controlling for FFM, the correlation between S(I) and sTNFR2 levels disappeared, indicating that FFM was significantly influencing these associations. In summary, plasma sTNFR2 levels, but not sTNFR1, were proportional to BMI, WHR, FFM (a well-known confounder in the evaluation of insulin sensitivity), basal and postload glucose levels, and insulin resistance. These findings support TNF-alpha as a system regulating insulin action in human obesity.

Adult↗
PubMed1998

Exhaled nitric oxide and bronchial reactivity during and after inhaled beclomethasone in mild asthma.

The measurement of exhaled nitric oxide (ENO) is recognized as a marker of airway inflammation. ENO was measured in 10 nonsteroid-treated asthmatics at recruitment, during 3 weeks of inhaled beclomethasone (1000 microg/day) and for 3 weeks after withdrawal. Baseline ENO was increased in asthma compared with nonasthmatics (85.0+/-54.5 vs. 24.5+/-14.8 ppb, p < 0.0001). After inhaled steroid, there was no significant change in forced expiratory volume in 1 sec (FEV1) and forced vital capacity (FVC), but methacholine PC20 rose significantly (p = 0.0345). ENO (mean+/-SD; % baseline) fell after 1 week on steroid to 60.6+/-31.1 and rose to 95.3+/-46.1 at 1 week after withdrawal. ENO did not correlate with PC20 or FEV1. The changes in ENO and PC20 were inversely correlated (r2 = 0.325). ENO may be an index of airway inflammation and therapeutic response in bronchial asthma.

Administration, Inhalation↗
PubMed1998

The use of technetium-labeled erythrocyte scintigraphy in the evaluation and treatment of lower gastrointestinal hemorrhage.

The percentage of incorrect operations performed as a result of technetium-labeled erythrocyte scintigraphy has been reported as high as 42 per cent. Recent studies have found scintigraphy to be superior to angiography and propose that it be used as the primary diagnostic test in patients with lower gastrointestinal (GI) bleeding. A retrospective analysis was conducted of 105 patients with the symptoms of lower GI hemorrhage to determine the effect of erythrocyte scintigraphy on surgical management. Operative and pathology results were analyzed to determine the accuracy of the scintigraphy for localization of the bleeding source. In addition to tagged erythrocyte scans, 95 of 105 patients had additional diagnostic procedures: colonoscopy (78), upper endoscopy (47), and angiography (9). Scintigraphy localized a site of bleeding in 42 patients (colon, 29; jejunum/ileum, 10; duodenum, 2; esophagus, 1). Surgical intervention was required in 25 patients, and the site of bleeding was correctly determined by scintigraphy in 22 of these patients (88%). The scans were negative in two patients, and the bleeding site was incorrectly reported in another. The patients who had operations were significantly more likely to have positive scintigraphy than the nonoperative group (P < 0.05). Preoperative localization of GI hemorrhage is possible in most patients with technetium-labeled erythrocyte scans (88% of operative patients). When combined with other tests to exclude upper GI bleeding, scintigraphy is a reliable means of guiding surgical intervention.

Angiography↗
PubMed1997

Role of DNA supercoiling and rpoS sigma factor in the osmotic and growth phase-dependent induction of the gene osmE of Escherichia coli K12.

Transcription of the gene osmE of Escherichia coli is osmotically inducible and regulated by the growth phase. In a medium of low osmotic pressure, expression of osmE is induced at the onset of stationary phase. At elevated osmotic pressure, a biphasic induction pattern is observed. The first step occurs during exponential phase, and this is followed by a strong induction at the onset of stationary phase. Both steps appear to result from stimulation of transcription at the same promoter, osmEp. In the absence of sigma s, the stationary phase sigma factor encoded by rpoS, osmEp stationary phase induction is abolished, while the osmotic effect is still observed. Mutations that compensate for the absence of sigma s mapped to the gene topA. The effect of such mutation and of novobiocin, an inhibitor of DNA gyrase, suggest that changes in DNA supercoiling are involved in the osmotic induction of osmEp. In addition, modulation of the supercoiling level of a reporter plasmid was observed during growth in rich media. The kinetics of osmEp transcription are discussed in light of the variations of DNA supercoiling.

Bacterial Proteins↗
PubMed1997

Area V1 in macaque monkeys projects to multiple histochemically defined subdivisions of the inferior pulvinar complex.

To investigate how visuotopic connections relate to chemoarchitecture of the inferior pulvinar (PI) complex in macaques, neuroanatomical tracers were placed into known portions of the visual representation in V1. Separate foci of label associated with both the upper and lower visual quadrants occupied neurochemically defined medial, central, lateral, and lateral-shell subdivisions, PIM, PIC, PIL, and PIL-S. Visuotopic connection patterns thus supported the concept of a larger PI that includes portions of three classically defined 'nuclei' [C. Gutierrez, A. Yaun and C.G. Cusick, Neurochemical subdivisions of the inferior pulvinar in macaque monkeys, J. Comp. Neurol., 363 (1995) 545-562.], and corresponds to the topographically organized V1 projection zone.

Animals↗
PubMed1997

The TNF-beta gene Nco I polymorphism is not associated with hypertriglyceridemia or insulin resistance in lean and obese subjects.

Interindividual differences in TNF-alpha monocyte responses can be accounted for by genetic polymorphisms at the TNF-beta locus defined by the Nco I restriction enzyme. Higher triglyceride levels in non-insulin-dependent diabetic patients homozygous at the 10.5-kb fragment of the TNF-beta gene have been described. The aim of this study was to investigate whether the Ncol polymorphism of the TNF-beta gene influences the relationship between insulin resistance and triglyceride levels. Thirty-eight healthy volunteers were divided into two groups according to the absence [homozygous for class 1 allele (1/1), n=16] or presence of the class 2 allele [n=22; 19 heterozygous (1/2), and 3 homozygous (2/2)]. Both groups were comparable in sex, age, BMI, waist/hip ratio, fat mass and percentage of body fat as measured by bioelectric impedance, skinfold measurements, and blood pressure (all p>0.05). There were no differences in serum cholesterol (total, or HDL and VLDL fractions) or in total or VLDL triglycerides between the groups (all p>0.05). The insulin sensitivity index (Minimal Model method) was comparable for the two groups. In summary, the 10.5-kb homozygous genotype of the TNF-beta locus does not contribute to differences in triglyceride levels or insulin sensitivity among nondiabetic subjects.

Adult↗
PubMed1997

Bronchial foreign body: should bronchoscopy be performed in all patients with a choking crisis?

The aspiration of a bronchial foreign body (FB) remains a common pediatric problem with serious and sometimes fatal sequelae. The diagnosis is often delayed or overlooked. With the aim of determining a reliable clinical and/or radiologic finding to indicate the requirement for bronchoscopy, 100 patients admitted to our hospital because of FB aspiration who underwent rigid bronchoscopy were retrospectively studied. The clinical and radiologic data were compared with the bronchoscopy findings, which revealed that the history of a choking crisis was the clinical parameter that showed the highest sensitivity (97%) with high specificity (63%), and that other symptoms and radiology, even those with high sensitivity (88% and 85%, respectively), had low specificity (9%). We conclude that bronchoscopy should be performed in all patients with a history of a choking crisis even if they have normal radiologic findings and few symptoms.

Journal Article↗
PubMed1997

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↗
PubMed1997

Structural features of phi29 single-stranded DNA-binding protein. I. Environment of tyrosines in terms of complex formation with DNA.

The single-stranded DNA-binding protein (SSB) of Bacillus subtilis phage phi29 is absolutely required for viral DNA replication in vivo. About approximately 95% of the intrinsic tyrosine fluorescence of phi29 SSB is quenched upon binding to ssDNA, making tyrosine residues strong candidates to be directly involved in complex formation with ssDNA. Thus, we have studied the spectroscopic properties of the phi29 SSB tyrosines (Tyr-50, Tyr-57, and Tyr-76) using steady-state and time-resolved fluorescence measurements. phi29 SSB tyrosines do not seem to be highly restricted by strong interactions with neighbor residues, as suggested by (i) the high value of the average quantum yield of the phi29 SSB fluorescence emission (phiF = 0.067 +/- 0.010), (ii) the fast motions of the tyrosine side chains (phi(short) = 0.14 +/- 0.06 ns), and (iii) the lack of tyrosinate emission at neutral pH. Stern-Volmer analysis of the quenching by acrylamide and I- indicates that phi29 SSB tyrosines are surrounded by a negatively charged environment and located in a relatively exposed protein domain, accessible to the solvent and, likely, to ssDNA. Changes in the intrinsic fluorescence upon ssDNA binding allowed us to determine that temperature has an opposite effect on the thermodynamic parameters K (intrinsic binding constant) and omega (cooperativity) defining phi29 SSB-poly(dT) interaction, the effective DNA binding constant, K(eff) = K omega, being largely independent of temperature. Altogether, the fluorescent properties of phi29 SSB tyrosines are consistent with a direct participation in complex formation with ssDNA.

Bacillus Phages↗
PubMed1997

Requirement of a second signal via protein kinase C or protein kinase A for maximal expression of CD40 ligand. Involvement of transcriptional and posttranscriptional mechanisms.

High levels of CD40 ligand (CD40L) protein expression are induced on native T cells by increasing the intracellular Ca2+ concentration. In the present study we have shown that ionomycin induces CD40L gene transcription leading to mRNA accumulation which translates to high levels of protein expression. Conversely, agents which increase the intracellular levels of cyclic AMP (cAMP), such as prostaglandin E2 (PGE2) or dibutyryl cyclic AMP (dbcAMP), were unable to induce CD40L expression on T lymphocytes. Cell activation by phorbol 12-myristate 13-acetate (PMA) treatment had a slight effect on increasing CD40L mRNA and protein levels. However, PMA and dbcAMP synergized with ionomycin to significantly increase and to prolong the CD40L expression. Nuclear run-on assays revealed that PMA, but not dbcAMP, increased threefold the CD40L gene transcription rate induced by ionomycin. This effect was independent of de novo protein synthesis. In addition, at a posttranscriptional level, both reagents synergized with the Ca2+ ionophore to prolong the CD40L mRNA half-life by a mechanism which was also independent of de novo protein synthesis. Moreover, when transcription was blocked with actinomycin D, an increment of the CD40L transcript levels induced by PMA or dbcAMP on ionomycin-treated cells was observed in the presence of cycloheximide. This probably means that newly synthesized protein may contribute to the CD40L mRNA destabilization. In summary, these data show that PMA and dbcAMP synergized with ionomycin to increase the CD40L mRNA and protein levels. The up-regulatory effect of PMA was accomplished at a transcriptional and posttranscriptional level, whereas dbcAMP exerted its synergistic effect exclusively at a posttranscriptional level.

Bucladesine↗
PubMed1997

Famciclovir for the treatment of acute retinal necrosis (ARN) syndrome.

PURPOSE: To document a case of acute retinal necrosis syndrome in an immunocompetent patient who was successfully treated with famciclovir after unsuccessful treatment with acyclovir. METHODS: After diagnosing acute retinal necrosis syndrome in the patient's left eye, we treated him with 13 mg/kg/24 hours of intravenous acyclovir in three daily doses for 14 days, followed by 800 mg of acyclovir five times per day orally. New areas of retinitis developed within the posterior pole despite treatment with the maximum dosage of acyclovir; thus, we used a new antiviral agent, famciclovir. RESULTS: When we administered 500 mg of famciclovir orally every 8 hours for 3 months, the retinitis regressed within 1 month, leaving atrophic granular pigmented scars. CONCLUSION: Famciclovir can effectively treat acute retinal necrosis syndrome in immunocompetent patients.

2-Aminopurine↗
PubMed1997

Prevalence of hepatitis B, C, and D markers in sub-Saharan African immigrants.

We determined the prevalence of hepatitis B, C, and D virus markers in a cohort of 229 (adult group, n = 187; pediatric group, n = 42) asymptomatic sub-Saharan African immigrants recently arrived to Madrid, Spain. Evidence of a recent or past hepatitis B virus infection marker was seen in 68 of 187 (36.4%) adults and in 14 of 42 (33.3%) children. The rate of chronic carriers of hepatitis B surface antigen in the entire population was 10.9% (25 of 229). Anti-hepatitis C virus antibodies were seen in 16 of 187 (8.6%) of the adults and in 1 of 42 (2.4%) of the children. Two of the 20 adults (10%) who were positive for hepatitis B surface antigen and none of the children had anti-hepatitis D virus antibodies. We found no significant differences in the prevalence of any viral infection marker between the two groups. Ten of the 125 (8%) patients in the adult group and none of the pediatric group had serologic evidence (recent or past) of hepatitis B and C coinfection. The hepatitis markers of this group should be studied and these persons should be considered a risk group in the hepatitis B virus vaccination campaigns.

Adolescent↗
PubMed1997

The TNF-alpha gene Nco I polymorphism influences the relationship among insulin resistance, percent body fat, and increased serum leptin levels.

Tumor necrosis factor-alpha (TNF-alpha), acting as a modulator of gene expression in adipocytes, is implicated in the development of insulin resistance and obesity. The aim of this study was to investigate whether the Nco I polymorphism of the TNF-alpha gene influences the relationship among insulin resistance, percent body fat, and serum leptin levels. A sample of 38 subjects (19 men, mean age 36.2 +/- 1.9 years, BMI 28.8 +/- 1.2 kg/m2, range 22.2-35.7; and 19 women, age 34.9 +/- 1.4 years, BMI 28.1 +/- 0.8 kg/m2, range 19-37.9) was divided into two groups on the basis of the Nco I genotype. Twenty-three subjects were (+/+) homozygotes for the presence of the Nco I restriction site that is associated with a guanine at position -308 of the TNF-alpha promoter. Of the other subjects, 12 were (+/-) heterozygotes and 3 (-/-) homozygotes for the absence of the restriction site, resulting from a guanine-to-adenine substitution at position -308 of the TNF-alpha promoter. This substitution (termed TNF-2) leads to higher rate of transcription of TNF-alpha than the wild-type allele TNF-1 in vitro. TNF-1 (+/+) and TNF-2 (+/- and -/-) groups of subjects were comparable in sex, age, BMI, waist-to-hip ratio, and several skinfold measurements. Basal serum insulin was greater (14.2 +/- 2 vs. 9.2 +/- 0.9 mU/l, P = 0.041) in the TNF-2 group in the presence of comparable serum glucose concentration. The integrated area under the curve of serum insulin concentrations, measured in response to a 75-g oral glucose challenge, and the percent body fat, measured by bioelectric impedance, were significantly increased in TNF-2 subjects (226.8 +/- 33 vs. 139.4 +/- 17.8 mU/l, P = 0.032; 33.6 +/- 2.8 vs. 24.9 +/- 2%, P = 0.01). TNF-2 subjects also showed a decreased insulin sensitivity index, as determined by the frequently sampled intravenous glucose tolerance test with minimal model analysis (1.9 +/- 0.4 vs. 3.05 +/- 0.3 min(-1) x mU(-1) x l(-1), P = 0.03). These differences were more marked among women. Paralleling the known relationship between insulin and leptin levels, serum leptin concentration was clearly increased in the TNF-2 group (19.6 +/- 3.4 vs. 11.1 +/- 1.5 ng/ml, P = 0.03). Therefore, (+/-) heterozygotes and (-/-) homozygotes may be more susceptible to developing insulin resistance and increased percent body fat. Results of the present study suggest that TNF-alphaNco I polymorphism may exacerbate the alterations in leptin levels normally found among insulin-resistant subjects.

Adult↗