Transarterial mitral valvuloplasty in conditions of acute pulmonary edema.
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Acute Disease↗
Biomedical subjects
E Hernandez
Publications and source records attributed to E Hernandez.
Does an adequate control of blood pressure protect the kidney in essential hypertension?
We analyzed the clinical course of 120 patients who were diagnosed as having primary hypertension and subsequently given standard stepped-care therapy (diuretic, beta-blocker and vasodilator) for 9 years. At the end of the follow-up period, 21 patients (17.5%) had developed overt proteinuria. The initial study showed no difference in systolic blood pressure, age, sex, serum creatinine and its clearance, glucose, cholesterol and triglycerides between these patients and those who had not become proteinuric, but uric acid levels and diastolic blood pressure were higher (both P less than 0.01). An adequate control of blood pressure was obtained and maintained in all patients, who had similar therapeutic needs. During the follow-up period, uric acid levels remained significantly elevated (P less than 0.01) in the proteinuric patients, while changes in serum glucose, cholesterol and triglycerides were similar in all patients. These results indicate that long-term treatment of primary hypertensives does not fully protect kidney function and that initially elevated uric acid levels could be a predictor of a poor prognosis.
Adrenergic beta-Antagonists↗
Differentiation of Penicillium griseofulvum Dierckx isolates by enzyme assays and by patulin and griseofulvin analyses.
The production of patulin and griseofulvin by 49 different isolates of Penicillium griseofulvum Dierckx was analyzed by high-performance liquid chromatography. Eleven isolates were obtained from pistachio nuts, 37 were obtained from wheat seeds, and 1 was obtained from the American Type Culture Collection. Activities of 19 enzymes were also assayed by the API ZYM system. From these results it may be deduced that there are two different groups among the strains tested which cannot be distinguished by morphological and cultural characteristics. One group of isolates did not produce detectable amounts of patulin and griseofulvin when grown in sucrose-yeast extract and Wickerham media, while enzymatic activities were quantitatively distinct from the other group, which produced patulin and griseofulvin in variable proportions. Leucine arylamidase, phosphoamidase, and beta-D-glucosidase are the main enzymes with differing activities between the two groups. Differences in physiological characteristics among isolates of a single species reveal shortcomings in the classification of the penicillia based only on morphological criteria. Thus, determination of the ability to yield mycotoxins and antibiotics as well as determination of enzymatic activities appear to be very valuable tools in the taxonomy of these fungi and for food toxicology.
Chromatography, High Pressure Liquid↗
Recombinant enkephalinase effectively inhibits substance P-induced miosis in the rabbit eye cup model.
Enkephalinase (EC 3.4.24.11) is a naturally occurring, membrane-bound peptidase that degrades substance P in vivo and in vitro. Addition of this neutral endopeptidase to a rabbit eye cup model partially inhibits substance P-induced contraction of the iris sphincter muscle. Inactivation of substance P is reversed by thiorphan, a specific inhibitor of enkephalinase. These results show that enkephalinase degradation of substance P produces metabolites that are physiologically inactive in iris contraction. We also observed that atropine acts synergistically with enkephalinase to completely abolish substance P-induced iris contraction suggesting that the action of substance P on the iris contains an acetylcholine-stimulatory effect which is not lost by enkephalinase treatment.
Animals↗
Influence of long-term cyclosporine therapy on chronic liver disease after renal transplantation.
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Azathioprine↗
Cervical conization findings in women with dysplastic cervical cytology and normal colposcopy.
A review of 134 cervical conizations performed in a 36-month period showed that 18 were performed on patients with two or more cervical smears showing dysplasia but with essentially negative, satisfactory colposcopic evaluations, including normal colposcopically directed biopsies and endocervical curettings. A histologic diagnosis of cervical intraepithelial neoplasia (CIN) of various grades was established in 15 (83%) of the 18 conization specimens. Six (33%) of the 18 specimens harbored CIN 3. The histologic diagnosis of a more severe lesion than that indicated on cytology was rendered in five of the cases. Cervical conization should be performed when colposcopic evaluation of the cervix, vagina and vulva fails to identify the source of persistent CIN on Papanicolaou smears.
Adult↗
Combined percutaneous mitral and aortic balloon valvuloplasty.
Between August 1987 and November 1988, combined mitral and aortic balloon valvuloplasty was performed in 10 patients (mean age 42 +/- 9 years), all of whom had symptomatic mitral and aortic stenosis. The procedure was performed using a transarterial approach with a multiballoon catheter and an exteriorized intracardiac long guidewire circuit. The procedure could be considered successful in 9 patients where significant increases in the mean mitral (0.97 +/- 0.19 to 1.80 +/- 0.26 cm2) and aortic (0.63 +/- 0.18 to 1.15 +/- 0.32 cm2) areas were achieved. Severe mitral regurgitation that required surgery developed in 1 patient in the following 24 hours. Femoral vascular surgery was necessary in 1 patient. Mid-term follow-up was available in 8 patients for a period averaging 8 +/- 3 months. The 9 patients in whom the procedure was successful showed persistent clinical improvement in functional class, Doppler echocardiography showed 2 cases of aortic restenosis and none of mitral restenosis. Combined mitral and aortic balloon valvuloplasty could be a valid alternative treatment in selected patients with both mitral and aortic rheumatic stenosis. Further experience and long-term hemodynamic follow-up are necessary to define the role of this mode of treatment.
Adult↗
Biodegradable mechanical retinal fixation. A pilot study.
Mechanical retinal fixation is a useful tool in the armamentarium of vitreoretinal surgeons. Unfortunately, the use of metallic retinal tacks on a permanent basic mandates a retained intraocular foreign body that poses some potential for long-range toxic effects. Herein, we report the results of our initial experience with a temporary, biodegradable mechanical retinal fixation device ("biopin") in rabbits. When compared with metallic tacks, the biopins appeared to be well tolerated intraocularly, with minimal damage detectable at the light microscopic level. Disinsertion of the biopins occurred in 46% of the eyes within two weeks and in all eyes by four weeks. Initial signs of degradation of the biopins were observed at six weeks (median) in the ensectomized/vitrectomized eyes and at 12 weeks (median) in the nonvitrectomized eyes. Differences were found in the occurrence of retinal detachment between animals that underwent lensectomy/vitrectomy with insertion of two metallic tacks and animals that underwent insertion of one biopin without vitrectomy. The biopin has a potential as a vehicle for sustained release of pharmacologic agents to inhibit directly the development of vitreoretinal proliferation, thereby retarding or preventing subsequent retinal traction and detachment.
Animals↗
Intravitreal tissue plasminogen activator treatment of experimental vitreous hemorrhage.
Intraocular recombinant DNA human tissue-type plasminogen activator (tPA) can promote rapid resolution of intracular fibrin clots and hyphema. The efficacy of intravitreal tPA in promoting the short-term clearance of vitreous hemorrhage was investigated. Five treatment groups with experimentally induced vitreous hemorrhage were studied. The extent of the vitreous hemorrhage was graded based on the visibility of retinal details in each quadrant. Two weeks following intravitreal tPA injection (50,000 IU), the nonvitrectomized group and gas vitrectomy groups, each of which received a single tPA injection, showed a statistically significant reduction of the vitreous hemorrhage, although this was thought to represent only a modest clinical effect. Tractional retinal detachments were noted to develop more frequently in tPA-treated eyes as compared with controls.
Animals↗
Paired Papanicolaou smears in the evaluation of atypical squamous cells.
Between February 1985 and April 1988, 360 women were seen at Tripler Army Medical Center's cervical clinic as part of a prospective study to assess the value of paired Papanicolaou smears in the follow-up of atypical squamous cells in a cervical cytologic smear. The evaluation consisted of paired repeat Papanicolaou smears and colposcopy. Colposcopically directed biopsies and/or endocervical curettage were performed in 86% of the subjects. The results of the paired Papanicolaou smears were negative/negative in 202 patients (56%). Cervical intraepithelial neoplasia was diagnosed histopathologically in 16% of all patients and in 10% of those with negative/negative repeat smears. We conclude that the presence of atypical squamous cells in a Papanicolaou smear should be considered abnormal and that colposcopy and colposcopically directed biopsies should be performed for these patients.
Adolescent↗
Photothrombosis of corneal neovascularization by intravenous rose bengal and argon laser irradiation.
Management of corneal neovascularization by photocoagulation has been limited and rarely successful. We evaluated the efficacy and safety of the novel technique of photothrombosis to occlude corneal neovascularization. Sixteen rabbit corneas with previous ocular surface wounds that had healed with 360 degrees extensive neovascularization (persistent for 20 months) were used. After an intravenous injection of rose bengal solution (40 mg/kg of body weight [BW]), each vessel on the upper half of the cornea was occluded with a photochemically induced thrombus within ten shots of argon laser irradiation (514.5 nm, 130 mW, 63 microns, 0.2 s); those on the lower half were used as an internal control. Throughout the four-month study period, the treated vessels remained occluded, as evidenced by corneal fluorescein angiography. Corneal clarity was improved after treatment. A single injection of rose bengal at a dose of 8 mg/kg of BW or higher was sufficient for successful photothrombotic occlusion of corneal vessels within one hour of experimentation. Transient elevations of serum urea nitrogen, aspartate aminotransferase, alanine aminotransferase, alkaline phosphatase, and total bilirubin levels and decrease of serum phosphorus level were noted on the first day after injection with 40 mg/kg of BW of rose bengal solution.
Animals↗
Fluorouracil therapy of intraocular Greene melanoma in the rabbit.
We evaluated the efficacy of intraocular and periocular fluorouracil treatment in an experimental iris tumor of the rabbit (Greene amelanotic melanoma). Four consecutive intravitreal injections of 1 mg of fluorouracil given twice weekly completely suppressed tumor growth in all treated eyes for six weeks if treatment was initiated 24 hours after tumor implantation. In contrast, all control eyes implanted with an equal number of Greene melanoma cells but treated with intravitreal saline developed massive tumor invasion of the iris within two weeks. Additional subconjunctival therapy following intravitreal therapy for two weeks was only slightly more effective than intravitreal therapy alone. If therapy was delayed for one week, the iris tumors became macroscopically visible and subsequent treatment with intravitreal and subconjunctival fluorouracil was of limited value in suppressing growth.
Animals↗
Relationship between content and intake of bean polyphenolics and protein digestibility in humans.
The purpose of this study was to determine the effect of bean polyphenolics on bean protein digestibility in humans. Steam pressure cooking decreased tannic acid in beans by: 38.2 (white), 23.9 (red), 38.5 (white:black mixture, 50:50), 20.5 (Ipala black) and 44.4% (Jalpatagua black). The reduction in catechin was: 57.5, 97.6, 83.0, 78.7 and 88.4%, respectively. The content of tannic acid in dried cooked beans was: 284.9 in white, 834.5 in red, 620.2 in the white:black mixture, 1,021 in Ipala black and 1,009 mg/100 g in the Jalpatagua black bean. These percentages correlate significantly with fecal nitrogen (r = 0.29, p less than 0.05). Catechin of the dried cooked beans was 7.5 in white, 27.4 in red, 25.4 in the white:black mixture (50:50), and 60.1 and 55.5 mg/100 g in each of the black cultivars, and correlated significantly with fecal nitrogen (r = 0.34, p less than 0.01), absorbed nitrogen (r = -0.37, p less than 0.01) and protein digestibility (r = -0.35, p less than 0.01). It was concluded that one of the factors that reduces bean protein digestibility is the polyphenlic compound.
Adult↗
Malignant fibrous histiocytoma of the pelvis.
A case of a 33-year-old Caucasian female with a malignant fibrous histiocytoma arising in the left ischiorectal fossa just under the left posterolateral vaginal wall is presented. Transvaginal simple excision of the tumor was followed by 5000 rad external beam whole pelvis irradiation and 6000 rad to the tumor bed. The patient is without evidence of disease 24 months after therapy and maintains normal vaginal function.
Adult↗
Burkitt's-like lymphoma presenting as a gynecologic tumor.
A case of Burkitt's-like lymphoma presenting with vaginal bleeding, pelvic pain, a 6-cm cervical mass, and a pelvic mass the size of a 16-week gestation is presented.
Adolescent↗
Tissue plasminogen activator treatment of postoperative intraocular fibrin.
Intraocular recombinant tissue-type plasminogen activator was used for treatment of postoperative intraocular fibrin clots. Using a rabbit vitrectomy and cyclocryotherapy model of postoperative fibrin, rabbits were randomized on the first postoperative day to receive either an anterior chamber injection of lactated Ringer's solution or 25,000, 50,000, or 100,000 IU tissue plasminogen activator (tPA). An intraocular dose of 25,000 IU of tPA produced marked resolution of the fibrin clot 24 hours later. A 50,000 and 100,000 IU dose produced slightly more resolution of the fibrin. No ophthalmoscopic or histologic evidence of intraocular toxicity was seen.
Animals↗
Induction of conjunctival transdifferentiation on vascularized corneas by photothrombotic occlusion of corneal neovascularization.
Previous studies have established that conjunctival transdifferentiation (transformation into cornea-like morphology) is inhibited by corneal vascularization. Conversely, occlusion of corneal vessels may induce conjunctival transdifferentiation on vascularized corneas. To test this hypothesis, the corneal epithelia of New Zealand albino rabbits were debrided 3 mm beyond the limbus with n-heptanol. Sixteen corneas healed by conjunctival epithelium, with vascularization persisting for 20 months, were used in this study. Photochemically induced occlusion of the corneal vessels was achieved by intravenous administration of rose bengal-saline solution (40 mg/kg body weight) with subsequent argon laser irradiation of the vessels (514.5 nm, 130 mW, 63 micron and 0.2 sec). The treated vessels remained occluded in an 18-week study, as confirmed by corneal fluorescein angiography. Corneal clarity and epithelial integrity were improved after treatment. Goblet cell loss and morphologic transformation into a cornea-like epithelium were verified by flat-mount preparations, histology, impression cytology, and immunofluorescence studies using a mucin-specific monoclonal antibody. These results indicate that conjunctival transdifferentiation can be induced on vascularized corneas after occlusion of corneal vessels by photothrombosis.
Animals↗
Uptake and clearance of 5-fluorouridine following subconjunctival and intravitreal injection.
Described are some pharmacokinetic parameters for 5-fluorouridine, a potentially useful intermediate metabolite of 5-fluorouracil (5-FU), following subconjunctival and intravitreal injection in the pigmented rabbit. Immediately following a 500 microgram intravitreal injection of 3H-5-fluorouridine, a peak ipsilateral vitreous concentration of 308 micrograms/ml was measured. This decreased to 199 micrograms/ml at 2 hours, 33 micrograms/ml at 12 hours and 4.4 micrograms/ml at 24 hours, indicating that 5-fluorouridine is cleared from the vitreous at a rate similar to 5-fluorouracil. Aqueous concentrations in the ipsilateral eye reached a maximum at 6 hours (9.6 micrograms/ml) and decreased to 0.8 micrograms/ml at 24 hours. Following subconjunctival injection of 5 mg 3H-5-fluorouridine (0.5 ml), peak ipsilateral anterior chamber concentration of 10.7 micrograms/ml was measured 1 hour after injection and decreased to 2.4 micrograms/ml after 12 hours. Maximum vitreal concentrations of 1.7 micrograms/ml were measured 12 hours after injection.
Animals↗