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Biomedical subjects

E Hernandez

Publications and source records attributed to E Hernandez.

At least 19 recordsLinked to original sources
PubMed2006

Routine use of auxiliary partial orthotopic liver transplantation for children with fulminant hepatic failure: Preliminary report.

Auxiliary partial orthotopic liver transplantation (APOLT) has been performed for both metabolic disorders and fulminant liver failure (FHF). When the native liver regenerates, the patients with FHF who undergo APOLT have a chance to withdraw immunosuppression. It may be most beneficial for children. This preliminary report describes our start to routinely offer APOLT as an option to standard OLT for children with FHF in 2005. Six children (ages 8 months to 8 years) received APOLT: 1 in 1996 and the others in 2005 and 2006. The donor ages ranged from 4 to 40 years. We used either a left lateral segment or a left lobe graft. The recipient left lobe, which was removed, showed submassive to massive necrosis at the time of transplantation. All children are alive and well. The first patient who received APOLT in 1996 is currently off immunosuppression with a fully recovered native liver; the grafted liver underwent complete atrophy. The 5 remaining subjects are receiving reduced levels of immunosuppression with close monitoring. Their serial liver biopsy specimens show slight to significant recovery. One developed hepatic artery thrombosis, requiring retransplantation. The native liver was retained at the time of retransplantation (redo APOLT). Other postoperative complications included a bile leak (n = 1), invasive mucomycosis of the arm (preexisting condition; n = 1), biliary stricture (n = 1), and acute cellular rejection (n = 3). Posttransplantation length of stay was 6 to 60 days (median, 15 days). In conclusion, APOLT can be safely performed in children with FHF displaying short-term outcomes comparable to standard transplantations.

Adolescent↗
PubMed2006

Pediatric liver transplant with Campath 1H induction--Preliminary report.

UNLABELLED: Since Campath 1H (C1H) has been successfully used in adult liver transplant recipients since 2001 in our program, we started to use it in children. PATIENTS AND METHODS: C1H induction was employed in 10 children with autoimmune hepatitis (AIH) (n = 6), primary sclerosing cholangitis (PSC) (n = 1), biliary atresia (n = 1), glycogen storage disease (n = 1), and Wilson's disease. Eight were primary transplants, and two retransplants. Patients ages ranged from 5 to 17 years. C1H was administered at a dose of 0.3 mg/kg on days 0, 4, and 7. Tacrolimus level was maintained at 5 to 10 ng/mL. No patient received maintenance steroids posttransplantation except two who were on steroid therapy at the time transplant. They were prescribed small doses of maintenance steroids. Median follow-up of C1H recipients was 679 days (range 115-1143). RESULTS: Postoperative courses were mostly uneventful except for one retransplant recipient who required prolonged hospitalization (40 days) for rehabilitation. Median hospital stay was 12 days (range 7-40 days). All 10 patients in the C1H group are currently alive and well with stable graft function. No opportunistic infection was observed in these patients to date. We compared six patients with AIH who received C1H to the historic control of 10 recipients with AIH who received conventional immunosuppression (tacrolimus + steroid). The patients treated with C1H showed significantly prolonged rejection-free survival. CONCLUSION: In our preliminary experience, C1H induction was well tolerated in pediatric liver recipients. Rejections-free survival was prolonged among recipients with AIH despite a low level of maintenance immunosuppression.

Adolescent↗
PubMed2005

Determination of enrofloxacin and its primary metabolite, ciprofloxacin, in pig tissues. Application to residue studies.

A simple and sensitive HPLC method has been developed for the simultaneous determination of enrofloxacin (ENR) and ciprofloxacin (CIP) in pig tissue using difloxacin (DIF) as internal standard. Tissue sample preparations were carried out by adding phosphate buffer (pH 7.4, 0.1 m), followed by extraction with trichloromethane. Fluoroquinolones were separated on a reversed-phase column and eluted with aqueous buffer solution-acetonitrile (80:20, v/v). The concentrations of CIP, ENR and DIF eluted from the column, with retention times of 2.20, 2.73 and 4.38 min, respectively, were monitored by fluorescence detection at lambda(ex) 276 and lambda(em) 442 nm. The detection and quantitation limit were 8 and 25 ng/g, respectively, for both compounds. Standard curves were linearly related to concentration in the range 25-400 ng/g. The consequences of the introduction of minor reasonable variations (ruggedness studies) have also been analysed. Finally, the measurement of the tissue levels of ENR and CIP in the pig tissues after oral administration confirmed the utility of the proposed method.

Adipose Tissue↗
PubMed2004

Antibiotic susceptibility of 65 isolates of Burkholderia pseudomallei and Burkholderia mallei to 35 antimicrobial agents.

OBJECTIVES: Fifty isolates of Burkholderia pseudomallei and 15 isolates of Burkholderia mallei were tested for their susceptibilities to 35 antimicrobial agents, including agents not previously tested against these bacteria. METHODS: MICs were determined by agar dilution in Mueller-Hinton medium. RESULTS: Among the antibiotics tested, lower MICs were obtained with imipenem, ceftazidime, piperacillin, piperacillin/tazobactam, doxycycline and minocycline. Fluoroquinolones and aminoglycosides had poor activities. A single clinical isolate of B. pseudomallei was resistant to ceftazidime, co-amoxiclav and doxycycline but remained susceptible to imipenem. CONCLUSIONS: Although B. mallei MICs are often lower, the overall results underline the importance of resistance in both species. The susceptibilities measured are consistent with the current recommendations for the treatment of B. pseudomallei and B. mallei infections.

Animals↗
PubMed2004

Perforin knockout mice, but not mice with MAIDS, show protection against experimental cytomegalovirus retinitis after adoptive transfer of immune cells with a functional perforin cytotoxic pathway.

Adoptive transfer studies were performed to test the hypothesis that the perforin cytotoxic pathway is more important than the Fas/FasL cytotoxic pathway in protection against experimental murine cytomegalovirus (MCMV) retinitis. Splenic immune cells from donor MCMV-immunized normal mice or gld mice deficient in Fas/FasL-mediated cytotoxicity significantly reduced the frequency and severity of MCMV retinitis following subretinal MCMV challenge when transferred into recipient PKO mice deficient in perforin-mediated cytotoxicity. In sharp contrast, splenic cells from donor MCMV-immunized PKO mice failed to provide protection against MCMV retinitis when transferred into recipient PKO mice. Protection was not achieved, however, in recipient mice with retrovirus-induced immunodeficiency (MAIDS), even when splenic cells originated from MCMV-immunized normal mice.

Adoptive Transfer↗
PubMed2002

[Transfusional record and blood grouping methods: essential factors of transfusion safety].

The clinical and biological control of the whole transfusion process is a major preoccupation for everyone dealing with blood transfusion. Specially when the patient is a female recipient or belongs to a group with a high prevalence of alloimmunisation. This case report points out the outstanding importance of the immune compatibility, which must be strongly maintained to prevent any harmful consequences. The transfusional record transmission and a simple and sensitive blood grouping test are essential to increase transfusion safety.

Blood Group Antigens↗
PubMed2002

Wethinks the author doth protest too much: a reply to Esterson (2002).

A Esterson (2002) responded to the authors' analysis of recent reformulations of Freud's seduction theory and alleged sexual abuse discoveries. Esterson gave several additional examples of the same type of problematic writing the authors discussed in their original article. His commentary is largely a repetition of several already-published arguments, and his numerous criticisms of the article are, in the authors' opinion, without merit. The authors address confusion over inferring abuse from symptoms, treatment of symptoms versus resolution of cases, and fathers as perpetrators of abuse. It is clear that, as long as the topic of child sexual abuse elicits heated debate, so will Freud's seduction theory, but there may be times when one needs to step back to allow a debate to move forward.

Child Abuse, Sexual↗
PubMed2002

[Action of venoms on blood coagulation: diagnosis of hemorrhagic syndromes].

Venoms from Viperidae, Crotalidae, some Australian Elapidae and few Colubridae are a mixture of enzymes which impact on blood coagulation in several ways. These proteins can be classified as haemorragins which induce disorders of the capillary permeability, disintegrins and related proteins which disturb the clotting time while acting on plate adhesion, and proteases which cleave peptides. Venoms contain molecules directed against several targets of the coagulation system. The same molecule may present different activities. Components of snake venoms are used in diagnostic coagulation tests, fundamental research and as drugs against infectious agents, cancer or haematological disorders. The structural differences between proteins from snake venoms and natural coagulation factors and the target diversity of the venom components explain why it remains illusory to treat bleedings when acting just at symptom level. Conversely, antivenom, whose components are directed against the venom proteins, is the only aetiological therapy effective against snake envenomations.

Animals↗
PubMed2001

Ovarian endodermal sinus tumor in a postmenopausal woman.

BACKGROUND: Ovarian endodermal sinus tumor is rare in postmenopausal women. CASE: We report the case of a 75-year-old woman with a pure endodermal sinus tumor of the ovary. CONCLUSION: We believe this to be the oldest patient reported with an ovarian endodermal sinus tumor. The histogenesis of this entity in older patients may be different than when it occurs in young women.

Age Factors↗
PubMed2001

Endometrial adenocarcinoma: a primer for the generalist.

Endometrial cancer is the most common gynecologic malignancy in the United States. The mean and median age of women with endometrial adenocarcinoma is 61 years. Most endometrial cancers are type I estrogen-dependent endometrioid adenocarcinomas. Most women with endometrial adenocarcinoma have stage I disease. Patients with stage I disease endometrial adenocarcinoma can be treated with a simple hysterectomy, bilateral salpingo-oophorectomy, peritoneal lavage, and periaortic node dissection in selected cases. The probability of survival according to international statistics is as follows: stage IA, 91%; stage IB, 88%; stage IC, 81%; stage IIA, 77%; stage IIB, 67%; stage IIA, 60%; stage IIIB, 41%; stage IIC, 32%; stage IVA, 20%; stage IVB, 5%.

Adenocarcinoma↗
PubMed2001

Role of DNA ploidy analysis in endometrial adenocarcinoma.

Endometrial adenocarcinoma is the leading cause of malignancy of the female genital tract. Prognosis of this tumor, which has implications on patient management, is determined by evaluation of the stage of disease, architectural grade, nuclear grade, myometrial invasion, and peritoneal cytology. These parameters have inherent subjectivity and, therefore, the search for an objective reliable parameter to determine prognosis is required. DNA ploidy is under investigation as an objective and reproducible prognostic parameter. This study will evaluate the role of DNA ploidy and its relationship to the traditional parameters as predictors of prognosis in patients with endometrial carcinoma. Fifty-eight patients were evaluated by two observers for architectural grade according to the International Federation of Gynecology and Obstetrics classification, nuclear grade, and depth of myometrial invasion. DNA ploidy was evaluated using flow cytometer (FACscan, Becton Dickinson, San Jose, CA). Histologic parameters were than compared with DNA ploidy. Survival data were obtained from the tumor registry. Results of patient survival were compared with histologic parameters and DNA ploidy. Higher nuclear grade and aneuploidy correlated with poor survival rate (P <.05). Higher nuclear grade correlated with aneuploidy. The survival of patients with architectural grade 2 (moderately differentiated) endometrial adenocarcinoma is poorer if the tumor is aneuploid as compared with diploid as determined by flow cytometry. In conclusion, aneuploidy and nuclear grade correlates with poor patient survival. The poorer survival rates with aneuploid architectural grade 2 endometrial adenocarcinoma may have an impact on clinical management.

Adenocarcinoma↗
PubMed2001

Cytokine response and oxidative stress produced by ethanol, acetaldehyde and endotoxin treatment in HepG2 cells.

BACKGROUND: Inflammatory mediators, including cytokines and reactive oxygen species, are associated with the pathology of chronic liver disease. Hepatocytes are generally considered as targets but not producers of these important mediators. OBJECTIVES: To investigate whether cells of hepatocellular lineage are a potential source of various cytokines we estimated the expression and secretion of tumor necrosis factor alpha, transforming growth factor beta 1, and interleukins 1 beta, 6 and 8 in the culture of well-differentiated human HepG2 cells treated for 24 hours with ethanol, acetaldehyde and lipopolysaccharide. Lipid peroxidation damage, glutathione content and glutathione peroxidase, catalase and superoxide dismutase activity were also determined. METHODS: HepG2 cells were treated for 24 hours with ethanol (50 mM), acetaldehyde (175 microM) and LPS (1 microgram/ml). TNF-alpha, TGF-beta, IL-1 beta, IL-6 and IL-8 mRNA were determined by reverse transcriptase polymerase chain reaction and secretion by enzyme-linked immunoassay. Lipid peroxidation damage, glutathione content and antioxidant enzyme activities were determined spectrophotometrically. RESULTS: Exposure to ethanol for 24 hours induced the expression of TNF-alpha and TGF-beta 1, secretion of IL-1 beta and TGF-beta 1 and decreased catalase activity. Acetaldehyde markedly increased TNF-alpha and IL-8 expression, stimulated IL-1 beta and IL-8 secretion, increased lipid peroxidation damage and decreased catalase activity, while LPS exposure induced the expression of TNF-alpha, TGF-beta 1, IL-6 and IL-8, the secretion of TGF-beta 1, IL-1 beta, IL-6 and IL-8, and a decrease in catalase activity. No change in GSH, GSHPx or SOD was found in any experimental condition. CONCLUSIONS: The present studies confirm and extend the notion that hepatocytes respond to ethanol, acetaldehyde and LPS-producing cytokines. Oxidative stress produced by the toxic injury plays an important role in this response through up-regulation of inflammatory cytokines.

Acetaldehyde↗
PubMed2001

[Evaluation of the OptiMal test in the diagnosis of imported malarial outbreak].

The OptiMal test is an immuno-chromatographic dipstick test that permits indiscriminate detection of Plasmodium falciparum and other species of human malaria. The purpose of this study was to evaluate the efficacy of the test for diagnosis of imported malaria. A total of 244 patients with a presumptive diagnosis of imported malaria in France were included during the study period. The reference test, i.e., combined thick and thin blood films, demonstrated infection by Plasmodium falciparum in 58 cases, Plasmodium vivax in 12, P. ovale in 8 and Plasmodium malariae in 2. The OptiMal test detected only 46 of the 55 Plasmodium falciparum cases. The sensitivity of the test for diagnosis of that species was 80%, its specificity was 98%, and its positive and negative predictive values were 95 and 93% respectively. Parsitemia studies showed poor test reliability for densities lower than 150/ul. Detection of other species was accurate in 21 out of 22. The results of this study demonstrate that the current version of the OptiMal test should be used with great caution for the diagnosis of malarial infection in hospital practice.

Chromatography↗
PubMed2001

Evaluation of a cervical cytology device (cell-sweep) based on comparison to colposcopic findings.

A new cytology sampling device, the CellSweep, identifies squamous intraepithelial lesions with a sensitivity of 75%. The purpose of this study was to evaluate the accuracy of cervical cytology using a new sampling device combining an endocervical brush and ectocervical spatula into one unit (CellSweep, patented by R. Mohajer, Troy, Michigan). From April 1995 to July 1995, 71 patients referred to the Allegheny University Hospitals Colposcopy Clinic had cervical cytology obtained with the CellSweep and underwent colposcopic evaluation of the cervix. The ability of the CellSweep to detect an abnormality confirmed by colposcopic evaluation was studied. Colposcopically directed ectocervical biopsies were obtained only in patients with identifiable lesions (n = 32). No random biopsies were obtained. The cytology smear was unsatisfactory for interpretation in one case. The remaining 70 Papanicolaou smears were read as normal in 17 (24%) cases and atypical squamous cells in 19 (27%). A squamous intraepithelial lesion (SIL) was detected in 34 (48%) smears. The colposcopic evaluation was normal in 50 patients who had satisfactory Papanicolaou smears, whereas SIL was detected in 20 cases. In 31 patients, SIL was not present in either colposcopy or cytology. In this preliminary study, the CellSweep identified SIL with a sensitivity of 75% and a specificity of 62%. The CellSweep, which combines an endocervical brush and an ectocervical spatula into a single unit, seems to be an acceptable device for obtaining cervical cells for cytologic screening.

Adolescent↗