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Biomedical subjects

C Sanz

Publications and source records attributed to C Sanz.

At least 91 records · Page 5Linked to original sources

An unusual case of Castleman's disease restricted to the neck.

An unusual case of Castleman's disease (CD) restricted to the left cervical area is reported. CD is rarely confined to the cervical area; when it occurs, it is usually of the hyaline-vascular subtype and small in size. This case was atypical due to its histology (plasma-cell variant), big size (15 x 11 x 6 cm) and the absence of general symptoms. In spite of surgical excision, the disease recurred 11 months later. However, subsequent surgery followed by chemotherapy resulted in a long-lasting control of the disease.

Adult↗

[Microalbuminuria in essential arterial hypertension].

BACKGROUND: The occurrence of microalbuminuria (mAlb) in essential hypertension (HT) was evaluated. METHODS: 100 patients were studied (56 males), with mean age 39 +/- 6 years, body mass index (BMI) 28 +/- 4. 32 had borderline HT, 47 had mild HT and 21 had moderate HT. 74 were in stage I of the WHO and 26 were in stage II. All had normal renal function (creatinine 91 +/- 12 mumol, Clcr 92 +/- 13 ml/m/1.73 m2) and no proteinuria as measured by sulphosalicylic acid. mAlb was immuno-nephelometrically measured in two 24-hour urine samples, and was given as urinary albumin excretion (UAE). In 62 patients, noninvasive ambulatory recording of blood pressure (NIAR) was carried out. In 39, ventricular mass was estimated by echocardiography. RESULTS: UAE was correlated with SPB24h (r = 0.39) and DBP24h, but not with SBP or DBP. UAE was greater in patients with moderate HT than in those with mild or borderline HT (p less than 0.01). UAE was less than 20 mg/24 h in 70 patients (group A) and greater than 20 mg/24 h in 30 (group B). The comparative analysis of the two groups showed different clinical BP values (SBP p less than 0.01; DBP p less than 0.001) and NIAR (SBP 24 h p less than 0.001; DBP 24 h p less than 0.05). In the 47 patients with mild HT the only differential parameter between groups A and B was SBP24h (p less than 0.05). Regarding echocardiographic data, in higher UAE levels a greater left ventricular mass index was found in males (chi-square p less than 0.05). CONCLUSIONS: Increased mAlb is associated with more severe HT. This finding may be helpful for the initial evaluation of hypertensive patients.

Adult↗

Cooling-induced contraction of trachea isolated from normal and sensitized guinea-pigs.

Fast (-7 degrees C/min) cooling of guinea-pig isolated trachea produced a rapidly developing, transient contraction followed by relaxation. Cooling-induced contraction was dependent on temperature (30, 20 or 10 degrees C) and responses in trachea obtained from actively sensitized guinea pigs were significantly greater (20 and 10 degrees C) than those observed in normal trachea. Cooling to 20 degrees C was selected for subsequent experiments. Pretreatment with sufficient concentrations of atropine, clemastine, cromoglycate, indomethacin, or nordihydroguaiaretic acid did not depress contraction to cooling in either normal or sensitized trachea. This indicates a direct effect of cooling. The contraction produced by cooling was resistant to verapamil (1 mumol/l) or dantrolene (0.3 mmol/l). Calmodulin antagonists (trifluoperazine, W-7 and calmidazolium; all of them at 10-100 mumol/l) inhibited contraction in sensitized and normal trachea. Activators of protein kinase C (phorbol 12,13-diacetate, 1 mumol/l) enhanced while inhibitors (H-7, 20 mumol/l; staurosporine, 10 mumol/l) depressed cooling-induced contraction in both normal and sensitized tissues. Incubation (20 min) in a Ca(2+)-free solution inhibited cooling-induced contraction in normal but not in sensitized trachea. Exposure to a low Na+ (25 mmol/l) or a K(+)-free medium abolished contraction to cooling in normal and sensitized trachea. Ouabain (0.1-10 mumol/l) and vanadate (0.01-5 mmol/l) inhibited cooling-induced contraction to a greater extent in normal than in sensitized trachea. Polymyxin B (0.5 mmol/l) selectively depressed responses to cooling in sensitized trachea. In a separate series of experiments, it was shown that sensitized trachea was hyperresponsive to ouabain and vanadate. Previous cooling to 20 degrees C abolished responses to ouabain but only attenuated those to vanadate.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗

Immune hemolytic anemia and renal failure associated with rifampicin-dependent antibodies with anti-I specificity.

A 50-year-old woman with primary biliary cirrhosis developed immune hemolytic anemia and renal failure while receiving rifampicin for the treatment of refractory pruritus. Serological studies revealed the presence of rifampicin-dependent antibodies of the IgM class that, when tested against a wide panel of erythrocytes, had anti-I specificity. Subsequently, rifampicin was withdrawn and prednisone treatment instituted, this resulting in a rapid resolution of the hemolysis, whereas hemodialysis was required for recovery of the renal function. A role is suggested for the anti-I specificity of the antibodies in the development of renal failure associated with rifampicin therapy.

Anemia, Hemolytic↗

[Causes of death in chronic myeloid leukemia. Analysis of 109 patients].

The cause of death was revised in 109 cases of Ph'-positive chronic myelogenous leukaemia (CML) who died in a 15-year period. The median survival of the series, which included eight patients with initial criteria of blastic crisis, was 33.7 months (ranging between 2 and 192). Eight patients (7.3%) died during the chronic phase of the disease, 7 (6.4%) in the accelerated phase, and 94 (86.3%) in the blastic crisis. The cause of death in the chronic phase was frequently unrelated to CML (a second malignancy, cirrhosis of the liver, suicide, in four cases as opposed to infection, haemorrhage of hyperuricaemic renal failure in four others), but this was not so in the deaths occurred in the accelerated phase or blastic crisis. Thus, most of the deaths appearing in the accelerated phase were due to infection or haemorrhage, whereas in the blastic crisis they were mainly due to infection (54 of the 94 cases), followed by haemorrhage and leucostasis. All in all, these three complications were responsible for 94% of the deaths occurring in that evolutive phase of CML.

Adolescent↗

[Microangiopathic thrombotic syndromes in adults: results of treatment with intensive plasmapheresis].

The response to intensive plasmapheresis was evaluated in 13 patients (7 males, 6 females; median age 28 years) with microangiopathic thrombotic syndromes (MTS) who were treated at our center during the last 10 years. The most common initial clinical features were anemia, hemorrhage and neurologic abnormalities. Twelve patients had severe thrombocytopenia and 8 had renal failure. Fourteen plasmapheresis courses were carried out to treat 13 initial episodes and one relapse. The mean volumes of removed plasma and fresh frozen plasma infused at each exchange were 57 ml/kg and 41.7 ml/kg, respectively. Eight patients received antiplatelet drugs and/or corticosteroids. After a mean number of 10.6 exchanges per patient and course, complete remission (CR) was achieved in 7 cases (6 initial episodes and one relapse) and a partial response in 3. Four patients did not respond to therapy and died from progression of the disease. The early institution of plasmapheresis and the rapidity to respond were the only factors significantly associated with the achievement of CR.

Adolescent↗

Relationship between nonspecific airway hyperreactivity and antigen-induced contraction in an allergic animal model in vitro.

Tracheal strips from actively sensitized guinea pigs exhibited an enhanced responsiveness (greater maximal effects; Emax) and sensitivity (smaller effective concentration 50%; pD2) to CaCl2 (in K(+)-depolarized tissues), KCl and histamine compared with that of strips from nonsensitized animals. A significant correlation was found between the magnitude of the contraction produced by bovine serum albumin (1 mg/ml) and the Emax and pD2 values of CaCl2, KCl and histamine in tracheal strips from sensitized guinea pigs. This indicates that specific and nonspecific challenges correlate in sensitized guinea pig trachea.

Animals↗

[Effect of the administration of rhGM-CSF in a patient with marrow aplasia resistant to immunosuppressive treatment].

The treatment of patients with refractory bone marrow aplasia in whom bone marrow transplant cannot be performed is unsatisfactory. Infections and haemorrhages are the most frequent cause of death in such patients. Human recombinant proteins from haemopoietic growth factors provide new therapeutic possibilities. The clinical and biologic course of one such patient treated with rhGM-CSF is reported here. The patient had severe bone marrow aplasia refractory to immunosuppressive treatment, and an improvement of leucocyte, neutrophil and eosinophil counts, along with the healing of an infection only partially controlled with antibiotics, followed the administration of rhGM-CSF. However, such peripheral blood improvement was not accompanied by any increase of bone marrow cellularity, as measured by conventional histopathologic methods, and the patient died due to ictero-ascitic evolution of post-transfusion chronic liver disease.

Anemia, Aplastic↗

Evaluation of dialysis treatment in uremic patients by gel filtration of serum.

A group of substances of molecular masses between 300 and 1500 Da have been found to be toxic metabolites in patients with uremia. We determined the concentration in serum of these molecules in the following groups of patients: two hemodialyzed groups (one with cuprophane and the other with polyacrylonitrile dialyzers), one group treated with continuous ambulatory peritoneal dialysis, one group of nondialyzed azotemic patients, and one control group of healthy persons. Ultrafiltrates of the subjects' sera were fractionated on Sephadex G-15 followed by ion-exchange chromatography. Eluates were monitored by absorbance at 254 and 206 nm. Partially characterized peaks P1 and P2, obtained by gel filtration, correlated with the concentration of creatinine in serum; their concentrations were significantly (P less than 0.01) larger in hemodialyzed groups than in peritoneal dialyzed or in nondialyzed azotemic patients. After ion-exchange chromatography, two peaks (P'5 and P'6) correlated with serum creatinine and also were larger in hemodialyzed patients than in the other groups. Apparently, adequate discrimination is obtained by gel-filtration analysis and further analysis by ion-exchange chromatography does not provide additional information in most of the affected patients.

Chromatography, Gel↗

Modification by indomethacin of airway contractile responses in normal and sensitized guinea-pigs.

Active sensitization of guinea-pigs resulted in an increase in responsiveness and sensitivity of tracheal and lung parenchymal strips to CaCl2 (in K+-depolarised tissue), KCl, acetylcholine and histamine. Indomethacin (5 microM) preferentially enhanced the response of tracheal strips from normal animals to histamine and to a lesser extent acetylcholine but not to CaCl2 or KCl. A similar trend was observed in sensitized tissues. Indomethacin pretreatment did not cause changes in responsiveness or sensitivity of lung parenchymal strips from normal or sensitized guinea-pigs to the agonists tested. It is concluded that immunological sensitization produced a non-specific hyperresponsiveness in trachea and lung parenchymal strips. Conversely, cyclooxygenase inhibition by indomethacin elicited a selective increase in the responsiveness to certain agonists in central but not in the peripheral airways.

Animals↗

Responses to histamine and selective H2-receptor agonists in lung parenchymal strips from normal and sensitized guinea-pigs.

Histamine produces concentration-dependent contractions of lung parenchyma strips obtained from normal and sensitized guinea-pigs. The responsiveness of the sensitized lung strips to histamine was significantly increased compared to normal tissues. Clemizole (0.1 microM) was equally effective as an H1-antagonist in normal (dose-ratio 9.12) and sensitized (dose-ratio 9.77) tissues. The concentration-response curves to histamine were displaced to the left by cimetidine (0.1 microM to 0.1 mM) with similar dose-ratios in normal and sensitized tissues. Cimetidine enhanced maximal responses to histamine only in normal lung strips. The effects of submaximal equieffective concentrations of histamine were augmented to the same extent by cimetidine (0.1 mM) in normal and sensitized tissues. The responses to histamine were not modified by indomethacin (5 microM). The responsiveness and sensitivity of sensitized lung strips to isoprenaline, impromidine, 4-methyl-histamine and dimaprit were not different from those of normal tissues. Cimetidine yielded, as antagonist of dimaprit, similar pA2 values in normal and sensitized tissues. In conclusion, there is no experimental evidence in favour of the existence of an impairment of H2-receptor activity in sensitized airways. Hyperreactivity to histamine is probably due to differences between normal and sensitized tissues with respect to Ca2+ entry and/or intracellular Ca2+ release in response to H1-receptor activation.

Animals↗

Non-specific hyperreactivity to pharmacological stimuli in tracheal and lung parenchymal strips of actively sensitized guinea-pigs.

The responsiveness of tracheal and lung parenchymal strips isolated from actively sensitized guinea-pigs to CaCl2 (in K+-depolarized tissue), KCl, acetylcholine and histamine was compared with that of strips from unsensitized animals. The concentration-response curves to the mentioned agonists exhibited, in the sensitized group, a left upward displacement (greater maximal effect, lesser effective concentration 50% and a steeper slope) compared with those obtained in the unsensitized group. These results indicate the existence of a non-specific increase in responsiveness in the airway smooth muscle from sensitized animals.

Acetylcholine↗

The spasmogenic effect of caffeine in trachealis isolated from control and actively sensitized guinea-pigs.

The spasmogenic activity of caffeine (10 mM) was evaluated in tracheal strips obtained from control and sensitized guinea-pigs then pretreated with indomethacin (2.8 microM) and cooled to 20 degrees C. The contraction elicited by caffeine was inhibited by verapamil (100 microM), trifluoperazine (100 and 500 microM) and dantrolene (50 and 500 microM) in the control and the sensitized tissues but was unaffected by disodium cromoglycate (39 microM). However, the same concentration of verapamil produced significantly less inhibition of the caffeine-induced contraction in sensitized compared to control tissues while the reverse was found for trifluoperazine and dantrolene. Exposure to a Ca2+-free, EGTA-containing medium resulted in 33% inhibition of the response to caffeine in control tissues but no inhibition in sensitized tissues. These results suggest the existence of differences in calcium movements in response to caffeine between control and sensitized tissues that may reflect abnormalities in calcium handling by the sensitized tissue.

Animals↗

Serum amylase levels in ectopic pregnancy.

Thirty-four women with abdominal complaints and a positive pregnancy test were evaluated for possible ectopic pregnancy (EP). Serum amylase levels were obtained as part of the diagnostic workup to note any correlation of enzyme levels with the presence of EP. Thirteen individuals (30%) were subsequently diagnosed as having an EP, and serum amylase levels in all of these patients were within normal limits, averaging 81 U/L. There was no statistically significant difference in amylase levels between the EP group and the non-EP group (P = .70). Serum amylase levels cannot reliably predict the presence of EP and should not be used as a screening or diagnostic test for this disorder.

Adolescent↗

Different ability of trifluoperazine to inhibit agonist-induced contraction of lung parenchyma strips from control and sensitized guinea-pigs.

There is increasing interest in the therapeutic potential of calcium antagonists in asthma. Among them the use of calmodulin antagonists deserves consideration. In the present work the effect of trifluoperazine on contractions generated by different mechanisms (CaCl2, KCl, acetylcholine, histamine and 5-hydroxytryptamine) in lung parenchyma strip isolated from control and actively sensitized guinea-pigs has been studied. Trifluoperazine produced both in unsensitized and sensitized lung strips, a concentration-dependent, right, downward displacement of the concentration-response curves to the agonists used, although the sensitization procedure resulted in a potentiation in the ability of trifluoperazine to inhibit agonist-induced contractions. The basis for this greater potency of trifluoperazine in sensitized tissues remains to be elucidated but raises attention to the future use of selective calmodulin antagonists in the management of asthma.

Acetylcholine↗