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Biomedical subjects

C Otero

Publications and source records attributed to C Otero.

At least 37 records · Page 2Linked to original sources
PubMed1993

A controlled trial of high-dose intravenous immune globulin infusions as treatment for dermatomyositis.

BACKGROUND: Dermatomyositis is a clinically distinct myopathy characterized by rash and a complement-mediated microangiopathy that results in the destruction of muscle fibers. In some patients the condition becomes resistant to therapy and causes severe physical disabilities. METHODS: We conducted a double-blind, placebo-controlled study of 15 patients (age, 18 to 55 years) with biopsy-proved, treatment-resistant dermatomyositis. The patients continued to receive prednisone (mean daily dose, 25 mg) and were randomly assigned to receive one infusion of immune globulin (2 g per kilogram of body weight) or placebo per month for three months, with the option of crossing over to the alternative therapy for three more months. Clinical response was gauged by assessing muscle strength, neuromuscular symptoms, and changes in the rash. Changes in immune-mediated muscle abnormalities were determined by repeated muscle biopsies. RESULTS: The eight patients assigned to immune globulin had a significant improvement in sores of muscle strength (P < 0.018) and neuromuscular symptoms (P < 0.035), whereas the seven patients assigned to placebo did not. With crossovers a total of 12 patients received immune globulin. Of these, nine with severe disabilities had a major improvement to nearly normal function. Their mean muscle-strength scores increased from 74.5 to 84.7, and their neuromuscular symptoms improved. Two of the other three patients had mild improvement, and one had no change in his condition. Of 11 placebo-treated patients, none had a major improvement, 3 had mild improvement, 3 had no change in their condition, and 5 had worsening of their condition. Repeated biopsies in five patients of muscles whose strength improved to almost normal showed an increase in muscle-fiber diameter (P < 0.04), an increase in the number and a decrease in the diameter of capillaries (P < 0.01), resolution of complement deposits on capillaries, and a reduction in the expression of intercellular adhesion molecule 1 and major-histocompatibility-complex class I antigens. CONCLUSIONS: High-dose intravenous immune globulin is a safe and effective treatment for refractory dermatomyositis.

Adolescent↗
PubMed1993

Purification and characterization of two distinct lipases from Candida cylindracea.

We have purified and characterized two isoenzymes from a commercial lipase preparation of Candida cylindracea. The purification procedure includes ethanol precipitation and DEAE-Sephacel and Sephacryl HR 100 chromatographies. Lipase A and lipase B were purified 11-fold with a 5% and 21% recovery in activity, respectively. The enzymes have similar amino acid content, N-terminal sequence and molecular weight, but differ on neutral sugar content, hydrophobicity, presence of isoforms and stability to pH and temperature. They also show some differences in the substrate specificity.

Amino Acid Sequence↗
PubMed1991

[Percutaneous mitral valvuloplasty as a treatment of choice for mitral stenosis. Immediate results and long-term follow-up].

We evaluated 77 patients with symptomatic mitral stenosis for balloon valvuloplasty. Five patients were excluded from the procedure due to the presence of intra-atrial thrombi or mitral valve endocarditis as detected by 2D echocardiography. The mean age of the 72 treated patients was 38 +/- 11 years, 68 were NYHA functional class II or IV: only 6 patients had valvular calcification. Three patients had severe liver failure, 2 were chronic alcoholics, one had liver cirrhosis, 2 had severe weight loss and 13 had pulmonary hypertension at systemic levels. 69 patients had a technically adequate procedure, one patient died, 1 developed cardiac tamponade and 1 failed. Mitral valve area increased from 0.93 +/- 0.34 to 2.38 +/- 0.67 cm2. Mitral incompetence increased in only 16 patients. After a mean follow up period of 15 +/- 5 months (range 8 to 27), 56 patients remained in FC I or II. Mitral valve area remained satisfactory in 54 patients. Mitral valve anatomy evaluated by echocardiography is helpful to predict immediate and late outcome. We conclude that balloon mitral valvuloplasty is the first choice for patients with severe symptomatic mitral stenosis.

Adolescent↗
PubMed1990

Influence of the support on the reaction course of tributyrin hydrolysis catalyzed by soluble and immobilized lipases.

Lipases from different origins have been immobilized in supports chosen by its different aquaphilicity and used as biocatalysts for the hydrolysis of tributyrin. The changes of the concentration of tri-, di-, monobutyrin, glycerol, and butyric acid during the reactions catalyzed by soluble, as well as immobilized, lipases were evaluated by gas chromatography. The experimental data were fitted to a simple kinetic model for the sequential reaction of tributyrin hydrolysis. The calculated apparent rate constants were different for the biocatalysts used and were apparently related to diffusional effects and aquaphilicity of the supports. Maximal yields of dibutyrin were found with the soluble Candida lipase, whereas the highest yield of monobutyrin (90%) was obtained with the least aquaphylic derivative (Candida-Celite).

Candida↗
PubMed1989

Computed tomographic study of cervical carotid calcification.

Contrast-enhanced computed tomography of the neck permits low-risk evaluation of morphologic complications of carotid plaque, including (and foremost) calcification. To investigate the patterns and clinical significance of calcified deposits in the cervical carotid arteries using computed tomography we studied 40 patients with unilateral symptoms of hemispheric ischemia. Calcium deposits observed in the external, internal, and common carotid arteries were oriented in space and individually scored. We found calcified deposits in 39 patients. Stepwise multiple regression of the data provided evidence strongly suggesting a correlation between advancing age and calcium scores. Calcium was more heavily concentrated in the posterior half of arteries (p less than 0.01), in particular of the internal and common carotid arteries, and always in relation to an atheromatous plaque, suggesting a causative link to hemodynamic forces within the arteries. There was no difference in calcification scores between symptomatic and asymptomatic sides, indicating that calcium deposits do not contribute to the development of symptoms.

Adult↗
PubMed1988

Immobilization/stabilization of lipase from Candida rugosa.

With the aim of fixing the enzyme to the matrix by multiple covalent linkages, lipase from Candida rugosa (formerly cylindracea) has been insolubilized through its amino groups on Sepharose 6B previously activated with 2,3-epoxy-1-propanol. Two main variables that are known to control the number of bonds formed have been tested: the contact time between enzyme and activated support, and the temperature at which the immobilization reaction is carried out. Studies on activity and stability of the different derivatives prepared showed that higher temperatures and longer contact times lead to insolubilized enzymes that are more resistant to inactivation by temperature and the presence of organic solvents. At 50 degrees C and pH 7.2, the insoluble lipase was found to be 140 times more stable than its soluble counterpart.

Candida↗
PubMed1988

Detection of diaphragmatic disruptions by peritoneoscintigraphy using technetium-99M diethylene-triamine pentacetic acid.

Intraperitoneal injection of a selected radiopharmaceutical results in the diffusion of radioactive material throughout the peritoneum. A diaphragmatic injury should theoretically result in the diffusion of the radioactive material into the chest. To test this hypothesis, Technetium-99m diethylene-triamine pentacetic acid (Tc-99m DTPA) was administered intraperitoneally by either direct needle injection or catheter into 18 rabbits. Four of the rabbits served as controls and did not have any diaphragmatic injury. Fourteen rabbits had surgically induced diaphragmatic tears of varying size (1/4 to 1 cm) after thoracotomy. Four of the 14 rabbits were dropped from the study because they had inadequate peritoneal injections of the radiopharmaceutical. The remaining ten rabbits showed peritoneoscintigraphic evidence of diaphragmatic injury either by showing passage of the radiotracer into the chest, demonstrating the site of injury as a focal region of increased radiotracer uptake, or showing both of these features. Peritoneoscintigraphy appears to be a potentially useful modality in the detection of diaphragmatic injury.

Animals↗
PubMed1988

Injury to the abdominal wall musculature: the full spectrum of traumatic hernia.

It is unusual for all anterior abdominal wall muscles to be disrupted in blunt trauma. We have described such a case, which necessitated reevaluation of the recommendations for treatment of traumatic hernia. We have proposed a method of classification of the different types of traumatic hernias so that treatment can be tailored.

Abdominal Muscles↗
PubMed1987

Epidemiological survey of 6 years' federal health service experience of pyloric stenosis: case report of presentation in a 26-month male.

Congenital hypertrophic pyloric stenosis (CHPS) is primarily a surgical process of the neonate and infant. Diagnosis and treatment of CHPS in a 26-month-old male prompted an inquiry of the military health service database for age of onset, sex, and birth position data. Data were analyzed on 604 cases found in a 71-month time period. The incidence for first-born males was .43 percent, for other than first-born males .34 percent, and for females .091 percent, the peak age being 3 weeks and 1 month old. Children diagnosed at age 6 months and older, as well as adults, were identified. Utilization of the Federal Health Care System data base allowed the study of a large number of patients with a broad spectrum of social, racial, and geographic backgrounds. We feel the study of this data provides a unique understanding of the epidemiology of this entity (CHPS).

Birth Order↗
PubMed1985

Ticlopidine as a hemorrhagic risk factor in coronary surgery.

We retrospectively reviewed the postoperative hemorrhagic risk in patients undergoing surgery for coronary revascularization who had received platelet antiaggregants preoperatively. A significant increase in postoperative hemorrhage and a higher percentage of reoperations for this reason was observed in the patients treated with ticlopidine. However, there were no major differences in the platelet counts among the groups compared.

Adult↗