Biomedical subjects
Publications and source records attributed to D Vega.
The complete nucleotide sequence of a very small plasmid whose presence and level in Pseudomonas cepacia have been linked to herbicide resistance is presented. The structural features of the plasmid are discussed.
Allograft coronary artery disease (CAD) is the major determinant of long-term survival following heart transplantation (HTx). In a group of 210 heart transplant recipients, we diagnosed CAD in 54 (27.1%) by coronary angiography, postmortem examination or examination of the transplanted heart at the time of retransplantation. Retrospective analysis of potential risk factors for the development of CAD was performed for both immunological (rejection pattern, immunosuppressive therapy, cytomegalovirus [CMV] infection), and nonimmunological (hyperlipidemia, smoking, hypertension, diabetes mellitus, obesity) risk factors. The total number of rejection episodes correlated significantly with the occurrence of CAD (P less than 0.05), showing that patients who experienced two or more rejection episodes had an incidence of CAD of 40%, as opposed to a 23% incidence in patients who experienced no rejection. A composite rejection score derived from multivariate regression analysis of the severity, frequency, and timing of acute cardiac rejection episodes was found to correlate with the development of CAD (P less than 0.05). Postoperative arterial hypertension also correlated significantly with the onset of CAD (P less than 0.01), with a 92.6% incidence of hypertension in the group with CAD versus 76.3% in the group without CAD. Smoking after transplantation correlated significantly with the occurrence of CAD (P less than 0.05). There was no significant correlation with other analyzed factors in this group of patients. In this review, the development of CAD after heart transplantation correlated with treated allograft rejection. Aggressive treatment of hypertension and cessation of smoking may contribute to alleviation of this serious complication.
Decreased hepatic clearance of exogenous sodium lactate has previously been demonstrated in patients with hepatic dysfunction. The purpose of this study was to obtain a more precise understanding of the rate of metabolic normalization or decrease of endogenously produced lactate in patients with hepatic cirrhosis. The differential kinetics of lactate metabolism are of clinical interest. Male volunteer patients with hepatic cirrhosis (n = 7), who had survived acute hospitalization, were compared to healthy age-matched males with normal liver function (n = 7). After arterial cannulation, bicycle ergometry was performed at a workload of 25 watts (W); the load was increased by increments of 25 W at 2-min intervals to maximum aerobic capacity. Lactate was measured in arterial blood before, at 4-min intervals during, and on a minimum of 11 occasions in the 30 to 70 min after exercise. The time interval during which lactate declined linearly to half its maximal concentration (Lt50) was graphically computed. The Lt50 was 34.8 +/- 4.5 min (mean +/- SEM) in the experimental group and 14.1 +/- 1.3 min in the control subjects (p less than .005). Lactate disappears from the bloodstream almost three times more slowly in patients with hepatic cirrhosis. The implication for interpretation of changes in lactate during circulatory shock in the presence of liver dysfunction is addressed.
A new starch serum medium, Granada medium, for isolation and identification of group B streptococci (GBS) anaerobically as red colonies is described. The medium contains 3.8% Proteose Peptone no. 3 (Difco), 15% soluble starch 1252 (Merck), 10% coagulated horse serum, 15 micrograms of trimethoprim per ml, and 0.06 M phosphate buffer (pH 7.8; medium pH 7.4). This medium inhibited fecal flora and at the same time supported growth of GBS. A new pigment-enhancing effect of folate inhibitors on GBS is reported and used in the formulation of the medium. The good selective and differential properties of the Granada medium favor quicker and easier detection of GBS in heavily contaminated specimens. Since the medium is convenient to use and requires only 18 h of incubation to detect and identify GBS, it should be useful in any clinical microbiology laboratory and would assist in the early detection of GBS in clinical specimens.
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The isolated kidney of the dog was perfused with autologous blood through an oxygenator. Responses of arterial input pressure (PI), venous pressure (PV), and venous flow (UV) were measured during sinusoidal forcing of arterial inflow (UA) at 5 to 1,000 cpm superimposed on a steady-state flow level. Pre- (RA) and postglomerular (REV) resistances, and compliances of artery (CA) and glomeruli (CG) were estimated based on a network model and using the Bode diagram of gains PI/UA, UV/UA. The data were evaluated by the least square method with a digital computer. The mean values of the parameters normalized for the average weight of the kidney (64.5g) were: CA = 0.0027 ml/mmHg, CG = 0.088, RA = 0.45 mmHg . min/ml, and REV = 0.35. Mean arterial pressure (PA) and glomerular pressure (PG) were 111 and 50 mmHg, respectively. The regression lines of PG against PA were significantly different at high and low PA, this being taken as a manifestation of autoregulation of the renal circulation. PG values were less than those given by the classical study of Winton but close to those recently obtained on mutants rats with a direct puncture method by Brenner et al. It is concluded that the present study has given an experimental background with which we may continuously estimate, under more intact conditions, circulatory parameter values by monitoring pressures and flows which respond to external perturbations.
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