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Biomedical subjects

E Esteban

Publications and source records attributed to E Esteban.

14 recordsLinked to original sources

Induction and inhibition of bovine leukaemia virus expression in naturally infected cells.

Bovine leukaemia virus (BLV) resides in infected lymphocytes in a latent, repressed state but becomes expressed a few hours after the cells are cultured in vitro. We have identified several conditions and factors affecting the expression of BLV in short-term cultures of naturally infected lymphoid cells. The presence of foetal calf serum in the culture medium greatly stimulates virus expression. This stimulation is not due to cellular proliferation. Transcription of BLV RNA and synthesis of p25 in the cultures of peripheral blood lymphocytes are preceded by a lag period of several hours. Synthesis of BLV p25 in these cultures takes place almost immediately after viral RNA synthesis. Extending previous results, we demonstrate that the plasma and lymphatic fluid of cattle contain factors that suppress and stimulate BLV expression. As a result of systematic examination of several parameters, we have developed reproducible assays for the detection of these factors. It is very likely that their relative concentration in the host is an important determinant of susceptibility and resistance to the development of lymphosarcoma and persistent lymphocytosis in BLV-infected cattle.

Animals

[Usefulness of transesophageal echocardiography in the critical patient].

To assess the usefulness and safety of transesophageal echocardiography in critically ill patients, we analysed the transesophageal echocardiography studies in 60 of such cases (age: 58 +/- 11 and 38 males). Every patient underwent a previous transthoracic echocardiogram, that was considered inadequate for diagnostic purposes. Thirty patients (50%), were on mechanical ventilation and 17 patients (28%) showed hypotension and/or shock. Forty patients (66%) were at special care units and in 31 (52%) of them, pulmonary and systemic pressures, and continuous analysis of venous pressure of oxygen were available. Indications for study were: 17 patients with clinical suspicion of aortic dissection (confirmed in 5 cases): 9 patients infective endocarditis (4 cases showed valvular vegetations); 6 patients with mitral prosthesis dysfunction (confirmed in 4 cases); complicated acute myocardial infarction (MI) in 8 patients (2 cases with mitral insufficiency, 3 with left ventricular dysfunction, 1 with right ventricular MI, 1 with left ventricular pseudoaneurysm and other with isolated inferior MI); in 11 patients the study was performed to evaluate the result of cardiac transplantation immediately (< 4 h) and it showed 2 cases of left ventricular dysfunction; 3 patients were studied for severe cardiac dysfunction of unknown etiology (a dilated cardiomyopathy was confirmed in one and ruled out in the other, and one patient showed signs of restrictive situation); there were other causes in the rest. The procedure could be completely performed in all cases. In conclusion in critically ill patients the transesophageal echocardiography has a great usefulness and minimal complications.

Adolescent

[The catheter ablation of accessory atrioventricular pathways using a radiofrequency].

Sixteen consecutive patients (5 males and 11 females) aged 40 +/- 22 years suffering for spontaneous symptomatic arrhythmias underwent attempted transcatheter ablation of an atrioventricular accessory pathway using radiofrequency current. Five patients had the WPW syndrome. The Kent bundle was located in the left free wall in 14 patients, in the right anteroseptal region in one patient and in the posteroseptal zone in one patient. A 7F catheter (Polaris, Mansfield) with a 4 mm2 distal electrode, was used for ablation positioned on the left atrioventricular annulus in the 13 patients with left free wall accessory pathways or at the right atrium in the two patients with right accessory pathways. Without general anesthesia, a mean of 12 +/- 9 applications of radiofrequency current were delivered between the large tip electrode and a large skin patch positioned on the left posterior chest. By using radiofrequency current, a successful clinical outcome was achieved in 14 of 16 patients (87%). In patients with concealed accessory pathways, accessory conduction was abolished in 10 of 11 patients, in 8 patients in the first radiofrequency session and in two other patients in a successful second procedure. In the 5 patients with the WPW syndrome, the anterograde conduction disappeared after the procedure but the retrograde conduction remained, although deteriorated, in 2 patients. One patient developed uncomplicated tibioperoneal thrombophlebitis and in 2 cases an elevated concentration of creatine kinase value was found. In one female patient with a concealed accessory pathway, the Kent bundle conduction reappeared 3 months after the procedure and was ablated in a second session.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent

Phase II trial of ifosfamide in recurrent and metastatic head and neck cancer.

Thirty-six patients with recurrent carcinoma of the head and neck and no prior exposure to chemotherapy were treated with Ifosfamide. This drug was administered, concomitantly with Mesna, as a 24-hr infusion at a dose of 5-6.25 g/m2 every 3 weeks. Objective activity in 32 evaluable patients was 28% (9/32, 95% C.I. 17%-39%); 40% of patients had leukocyte values less than 2000 mm3 and 6% platelets less than 50,000 mm3. Nonhematologic toxicity consisted mainly of nausea/vomiting (66% greater than or equal to grade 2) and alopecia (80% greater than or equal to grade 2). The activity encountered warrants further studies with this drug in head and neck cancer.

Adult

The trans-activating C-type retroviruses share a distinct epitope(s) that induces antibodies in certain infected hosts.

Using sera from hosts infected with bovine leukaemia virus (BLV), human T cell lymphoma virus types I and II (HTLV-I and -II), or simian T cell lymphoma virus type I (STLV-I), we found that the major gag proteins of these viruses cross-react immunologically. The specificity of this cross-reactivity was demonstrated by absorption using purified viral proteins, virus lysates and extracts of infected cells. The data strongly suggested that the cross-reacting epitope(s), referred to as CE, differs from those responsible for cross-reactions between the major gag proteins of HTLV-I, HTLV-II and STLV-I, and between those of BLV and HTLV-I reported previously. The prevalence of antibodies to CE was low, even amongst infected hosts with high titres to other epitopes present in the major gag proteins of the homologous viruses. CE was not detected in any of the other C- or D-type retroviruses, or lentiviruses examined. Therefore, it is likely that CE can be used to define serologically a subgroup of C-type retroviruses, the genomes of which display unique features and functional activities.

Animals

[Cavernostomy].

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Adult

Combination chemotherapy with cisplatin and 5-fluorouracil 5-day infusion in the therapy of advanced gastric cancer: a phase II trial.

Fifty-six patients with measurable or evaluable advanced gastric cancer were treated with cisplatin, 100 mg/m2 in continuous infusion of 24 hours, and 5-fluorouracil, 1000 mg/m2/day (by continuous 5-day infusion) every 4 weeks. Three patients were found ineligible for the study. A response rate of 41% (22/53) was obtained (95% confidence interval: 28%-54%), with a median duration of remission of 10.2 months and an overall median survival time of 10.6 months. Leukopenia and thrombocytopenia were mild. Nausea and vomiting were common, and 23.5% of the patients had grade 3 stomatitis. Peripheral neuropathy and renal insufficiency increased with the number of cycles, representing the cumulative dose-limiting toxicity. This study indicates that the combination of cisplatin plus 5-fluorouracil is synergistic or at least has additive antitumor activity. We think that this association of 2 drugs should be considered for further phase III clinical trials.

Adult

[Bladder endometriosis].

Although uncommon, vesical endometriosis is considered an important disease entity due to the diagnostic difficulties it presents and the different therapeutic options that are available. A case of long-standing vesical endometriosis that caused considerable suffering to the patient is reported. The foregoing condition was refractory to hormone therapy and late radical surgical treatment by partial cystectomy and hysterectomy failed to achieve good results. The clinical and therapeutic aspects of the present case are compared with those reported elsewhere. We underscore the importance of biopsy by transurethral resection in its diagnosis as well as the need for a more effective therapeutic approach.

Adult