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Biomedical subjects

E Hernandez

Publications and source records attributed to E Hernandez.

At least 109 records · Page 6Linked to original sources
PubMed1991

Balloon valvuloplasty for mild mitral stenosis.

Of a total number of 288 patients with mitral stenosis treated by percutaneous balloon valvuloplasty, 21 patients had a basal mitral area equal to or greater than 1.5 cm2, as measured hemodynamically. The immediate hemodynamic results of this particular group of patients with mild mitral stenosis are described, as well as the clinical and echo doppler findings at follow-up (22 +/- 12 mo). Patients with mild mitral stenosis (group I) had more pliable valves (p less than 0.01), as assessed by echo, and higher incidence of sinus rhythm (p less than 0.02) than that observed in the remaining 267 patients (group II). After valvuloplasty the valve area increased in group I from 1.7 +/- 0.2 to 3.1 +/- 0.7 cm2 (p less than 0.0001). This mean final area was significantly different (p less than 0.0001) than that observed in group II (1.98 +/- 0.6 cm2). No patients with mild mitral stenosis developed progression of mitral regurgitation, and none had any other major complications. Most of them reached a grade I final functional status. At echo doppler follow-up studies we did not observe significant changes in the mean mitral gradient as compared with the immediate hemodynamic results. These findings suggest that early mitral balloon valvuloplasty could be an alternative in trying to favorably influence the natural course of the rheumatic mitral disease in selected patients.

Adult↗
PubMed1991

Succinylcholine-stimulated muscle tensions following botulinum injection in the domestic cat.

Succinylcholine (SCh) selectively stimulates, and can therefore selectively assay, the multiple innervated (MI) fiber system of the extraocular muscles. Since botulinum-A toxin has been observed to induce changes in eye position in humans, SCh was used to assess the effect of botulinum-A on the SCh-sensitive MI fibers of extraocular muscles. Intravenous SCh infusion (40 micrograms-1 kg-1 min-1 was performed in the anesthetized domestic cat. Thirty-eight infusions were performed in 19 normal controls, measuring the peak tensions generated in the four horizontal and four vertical rectus muscles. Succinylcholine-stimulated muscle tensions (SSMT) were then repeated in nine animals, 4 weeks and 10 weeks following injection of botulinum-A toxin into both medial rectus muscles. Mean peak SSMTs were unchanged at 4 and 10 weeks following botulinum injection when compared to controls. We propose that botulinum chemo-denervation has no acute or chronic effect on the MI SCh-sensitive muscle fibers of the medial recti of the domestic cat. This lack of effect on the postsynaptic MI fibers indirectly supports light and electron microscopic studies which show changes predominantly in the singly innervated (SI), rather than the MI fibers following botulinum injection. Mean peak SSMTs were also greater for medial and superior rectus muscles compared to lateral and inferior recti respectively, suggesting a greater number or proportion of MI fibers in medial and superior recti.

Animals↗
PubMed1991

False tendon rupture simulating chordal rupture after percutaneous mitral balloon dilation. A report of two cases.

We describe two cases of ruptured false tendons following percutaneous balloon dilation of the mitral valve in one case, and combined mitral and aortic balloon valvotomy in the other, using in both the retrograde approach. The echocardiographic characteristics of this previously unreported complication of the procedure are presented with special emphasis on the differentiation with true chordal rupture. No short or mid term adverse effects were noted following this complication.

Adult↗
PubMed1991

Tubular dysfunction in nephrotic syndrome: incidence and prognostic implications.

Although some cases of tubular dysfunction (TD) associated with nephrotic syndrome have been described, the incidence and the characteristics of this complication remain unknown. We investigated the presence of TD (renal glycosuria, aminoaciduria, metabolic acidosis with normal anion gap, hypouricaemia, and throughout hypophosphataemia) in 36 patients with nephrotic syndrome. Ten patients (group 1) showed glycosuria at some time during the course of their illness, ranging from 2.5 to 11.2 g/24 h. In addition, seven of them had metabolic acidosis with normal anion gap, five aminoaciduria, and two hypouricaemia. Membranous glomerulonephritis was the most frequent aetiology in group 1 patients (7 of 10). Proteinuria and serum creatinine (SCr) were significantly higher in group 1 patients than in the 26 remaining patients without TD (group 2): 10.2 +/- 3.7 versus 6.7 +/- 2.9 g/24 h (P less than 0.01) and 3.2 +/- 1.9 versus 1.6 +/- 0.9 mg/dl (P less than 0.05) respectively. The appearance of TD coincided with a clear worsening of renal function in most of group 1 patients. In addition, at the end of follow-up, SCr had increased from 3.2 +/- 1.9 to 5.6 +/- 3.3 mg/dl (P less than 0.05) in this group. In contrast, SCr did not show significant changes in group 2 (1.6 +/- 0.9 versus 2.1 +/- 2.2 mg/dl). In conclusion, a significant proportion (27.7%) of patients with nephrotic syndrome present TD data at some moment of their course; the appearance of this complication appears to be a sign of poor prognosis.

Adolescent↗
PubMed1991

Uterine papillary serous carcinoma: a review.

Uterine papillary serous carcinoma, a histologic subtype of endometrial cancer, is characterized by a propensity for deep myometrial invasion, upper abdominal spread, and poor prognosis. We reviewed its histologic and clinical characteristics and compared them to those of endometrial adenocarcinoma with papillary features.

Carcinoma, Papillary↗
PubMed1991

Tissue plasminogen activator treatment of experimental subretinal hemorrhage.

Previous investigators have suggested that subretinal blood damages the retina in part because of its solid fibrin meshwork. The role of fibrinolysis in facilitating the clearance of subretinal hemorrhage and preventing degeneration of the overlying retina was studied. Autologous whole blood (0.1 ml) was injected into the subretinal space of 20 rabbits. Twenty-four hours later, the animals were randomized to subretinal treatment with 2.5 micrograms of tissue plasminogen activator or a similar volume of physiologic saline. Mean subretinal hemorrhage thickness 3 days after treatment had decreased to 42% of pretreatment thickness in treated eyes and remained unchanged in control eyes (P less than 0.0005). By 7 days mean clot thickness was 9% in treated eyes and 60% in controls (P = 0.005). Light microscopy revealed severe progressive retinal degeneration in both groups. No histologic evidence of retinal toxicity was found in cat retina after subretinal injection of tissue plasminogen activator (50 micrograms/ml). Although treatment with tissue plasminogen activator accelerated the clearance of subretinal hemorrhage, it failed to prevent secondary retinal degeneration in this rabbit model.

Animals↗
PubMed1991

Cutaneous involvement by an ovarian serous tumor of low malignant potential.

The case presented is of a 67-year-old woman with multifocal ovarian serous tumor of low malignant potential with skin involvement. To our knowledge this is the first such case not preceded by abdominal surgery. The pathogenesis of her cutaneous lesions is discussed. We propose neoplastic transformation of cutaneous endosalpingosis as a possible explanation.

Adenocarcinoma↗
PubMed1991

Treatment of cervical carcinoma with ionizing irradiation using moving fields.

This study was designed to assess the effectiveness and risk of complications from radiotherapy delivered by the moving field technique as opposed to the more commonly used fixed field technique. Between 1975 and 1985, 131 patients were treated for cervical cancer with a combination of teletherapy and brachytherapy. For teletherapy, 4-MeV photons were used and delivered by moving field technique (120 degrees to 160 degrees arcs, or a 360 degrees rotation). Most patients received one intracavitary radium implant using Fletcher-Suit applicators and the Manchester technique. Twenty-two percent of the patients had stage I disease, 37% stage II, 25% stage III, 13% stage IV, and 2% were unstaged. The cumulative 5-year survival for all patients was 57%. The survival by stage was: stage I, 82%, stage II, 62%, stage III, 53%, and stage IV, 6%. Chronic complications developed in 10 (7.6%) patients. The survival and complication rate of patients treated for cervical cancer with radiation using moving fields compares favorably with that of patients treated with the conventional parallel opposed (AP-PA) fields or the four-field box technique. Further studies are necessary to definitively determine if the moving field technique offers advantages over other techniques.

Brachytherapy↗
PubMed1990

Factors influencing progression of mitral regurgitation after transarterial balloon valvuloplasty for mitral stenosis.

This study analyzes the clinical, echocardiographic and hemodynamic factors affecting progression of mitral regurgitation (MR) after transarterial balloon valvuloplasty in 200 consecutive patients with rheumatic mitral stenosis. After valvuloplasty, the mitral valve area increased in all patients, from 1.03 +/- 0.36 to 2.06 +/- 0.71 cm2 (p less than 0.0001). With regard to the basal stage, the mitral valve was competent in 139 patients and there was mild MR in 61 (grade I in 53, and grade II in 8). Three patients had progression of MR induced by a technical deficiency and they were excluded from analysis. Patients were classified into 2 groups on the basis of the degree of MR before and after valvuloplasty: group A--no progression of MR (n = 167; 85%) when the degree of MR did not change, disappeared after valvuloplasty, or increased from grade 0 to I; group B--progression of MR (n = 30; 15%) when the degree of MR increased to greater than or equal to grade II. Progression of MR was observed more frequently in older patients with presence of chronic atrial fibrillation, larger left atrial size and left ventricular volumes, baseline MR, more severe stenosis and a lower ejection fraction. Multivariate analysis selected age, left ventricular volumes and ejection fraction as independent predictors of progression of MR. All these factors suggest that progression of MR after balloon valvuloplasty could be related to a more advanced degree of disease.

Age Factors↗
PubMed1990

Retinal toxicity of recombinant tissue plasminogen activator in the rabbit.

We studied the dose-dependent retinal toxicity of the available commercial preparation of human recombinant tissue plasminogen activator in the normal rabbit eye. Tissue plasminogen activator was injected into the midvitreous cavity of albino rabbits in doses (per 100 microL) of 25, 50, 75, and 100 micrograms. Control eyes received 100 microL of balanced salt solution or tissue plasminogen activator vehicle. No evidence of a retinal toxic reaction was seen in eyes receiving 25 micrograms of tissue plasminogen activator. One of four eyes injected with 50 micrograms showed loss of photoreceptor cells by light microscopy. Severe retinal damage was seen by ophthalmoscopy, electroretinography, and light microscopy in three of four eyes receiving 75 micrograms of tissue plasminogen activator and in all eyes treated with 100 micrograms of tissue plasminogen activator or equivalent vehicle. These results suggest that the commercial recombinant tissue plasminogen activator formulation has a narrow margin of safety in nonvitrectomized eyes and that a component of the vehicle is the toxic factor.

Animals↗
PubMed1990

Encircling photothrombotic therapy for choroidal Greene melanoma using rose bengal.

The photosensitizing dye rose bengal in combination with an argon green laser (514.5 nm) operated at low power was evaluated in 49 rabbit eyes for treatment of experimental choroidal Greene melanoma by circumferential occlusion of the choroidal vasculature. The effects of no treatment, laser alone, and rose bengal alone were observed in 16 control eyes, all of which showed rapid tumor growth. Immediately following rose bengal injection, 3 minutes of continuous irradiation at 20.4 W/cm2 (500-microns spot, 40 mW) applied in three to four circumferential revolutions around the base of tumor nodules, without direct tumor irradiation, produced peripheral vascular occlusion and consequent tumor inhibition. Similar therapy at higher laser intensity (30.6 W/cm2) and with multiple retreatment sessions (28.0 to 30.6 W/cm2) resulted in increased tumor-inhibiting effect. Low-dose rose bengal phototherapy did not appear to directly damage ocular tissues adjacent to treatment areas; however, when multiple irradiation sessions were given within a short interval, an increased incidence of retinal detachment was observed.

Animals↗
PubMed1990

Retrorectal cystic hamartoma diagnosed by fine-needle aspiration biopsy.

A 17-yr-old postpartum female presented with a large multicystic mass posterior to the rectum, thought clinically to be an abscess. Fine-needle aspiration biopsy revealed numerous squamous cells. The diagnosis of retrorectal cystic hamartoma was considered and subsequently confirmed by the surgical resection specimen. The cytologic and histologic findings are presented along with a discussion of the entity "retrorectal cystic hamartoma," including a differential diagnosis of presacrococcygeal cysts.

Adolescent↗
PubMed1990

Balloon valvuloplasty for mitral restenosis after previous surgery: a comparative study.

We studied 203 patients with mitral stenosis treated by transarterial valvuloplasty. Forty two (group A) had undergone closed (n = 30) or open n = 12) surgical commissurotomy 15 +/- 5 years before. The remaining 161 had not undergone previous surgery (group B). There were no significant differences between both groups in terms of age, sex, functional class, left atrial size, two-dimensional anatomic features of the valve, incidence of mild basal mitral regurgitation, or ejection fraction. A comparative analysis of both groups showed no significant differences in terms of changes in the mean gradient, mitral valve area, and incidence of severe postvalvuloplasty mitral regurgitation (9.5% versus 5.5%). Echo-Doppler follow-up studies (11 +/- 7 months) showed persistent gradient relief in either group. We conclude that the immediate and short-term results of balloon valvuloplasty in patients who had undergone previous surgery are similar to those observed in patients who had not had commissurotomy.

Catheterization↗