Biomedical subjects
F Cruz
Publications and source records attributed to F Cruz.
An ultrasonographically solid, tumor-like appearance of echinococcal cysts in the liver.
Explore the source record for details and available documents.
[Arterial embolization in the preoperative management of renal carcinoma].
Explore the source record for details and available documents.
Subselective embolization for non-neoplastic conditions of the kidney.
Three patients in our institution underwent subselective arterial embolization for treatment of intractable renal hemorrhage. In all three patients control of bleeding was obtained. The only complication encountered was a non-occlusive dissection of a segmental renal branch in one patient. Although some tissue infarction will result, less renal parenchyma will be lost than is the case with surgical treatment.
Effects of labetalol and methyldopa on renal function.
Renal function studies were performed in subjects with mild hypertension treated with labetalol (n = 5) and moderate to moderately severe hypertension treated in a random double-blind fashion with either labetalol (n = 6) or methyldopa (n = 6). Drugs were given in doses sufficient to reduce standing diastolic blood pressure to less than 90 mm Hg. This was achieved in all subjects without significant side effects. Inulin clearance, para-aminohippurate clearance, filtration fraction, free-water clearance, and maximal concentrating ability was assessed before and after 15 days of drug. No alterations in any parameter were noted with labetalol. Inulin clearance fell by 13% (p less than 0.05), and filtration fraction fell from 0.23 to 0.18 (p less than 0.02), but other parameters of renal function did not change with methyldopa.
Portosystemic shunts for extrahepatic portal hypertension in children.
Twenty-three children with prehepatic portal hypertension and hemorrhage due to ruptured esophagogastric varices had portosystemic shunts. Their ages ranged from two years and seven months to 15 years. Eleven were less than eight years of age. Twenty patients had portal vein cavernomatosis and three patients had double portal veins. In 21 patients, a mesocaval type of shunt was done. A splenorenal shunt was performed in two. There was no surgical mortality. Two shunts occluded, both in rather young infants--two years and seven months and three years of age. In all the others, there was no further bleeding, and the shunts remained patent, as shown by abdominal angiograms. Neuropsychiatric disorders, probably due to hepatic encephalopathy, occurred in only one patient. On the basis of this favorable experience, we believe that an elective portosystemic shunt should, in general, be performed upon children with prehepatic portal hypertension after one major variceal hemorrhage. We favor a mesocaval type of shunt in these children because of the larger diameter of the vessels involved in the anastomosis and because it preserves the spleen, maintaining defense against subsequent infection.
Adrenal macrotumors diagnosed by computed tomography.
UNLABELLED: Adrenal tumors larger than 6 cm are unusual but show a greater incidence of malignant etiologies than smaller adrenal tumors. The scarce information about adrenal macrotumors (AMT) induced us to study prospectively all patients who were seen in our clinic during the period 1984-1988 and were diagnosed by computed tomography (CT) to have an adrenal mass greater than or equal to 6 cm. The clinical characteristics, including the main complaint, tumoral secretory activity, CT findings and histologic diagnosis from 18 patients are described; they represented a 0.3% of the total amount of abdominal CT studies performed. Seventy-two % of AMT resulted to be non cortisol or catecholamines secreting masses, and from them, a 38% corresponded to malignant etiologies characterized by marked and rapid weight loss. Four out of five hormone secreting AMT corresponded to pheochromocytomas, while the fifth one resulted to be a bilateral macronodular hyperplasia secreting cortisol. In two cases AMT did not correspond to a genuine adrenal mass, resulting to be a malignant histocytoma in one case and a hydatidic cyst in other one. When performed in two occasions, a percutaneous needle biopsy was a valuable diagnostic tool, permitting to diagnose a lymphoma and a tuberculoma. IN CONCLUSION: 1) AMT correspond mainly to non cortisol or catecholamines secreting tumors, often malignant; 2) not all AMT diagnosed by CT correspond to true adrenal masses; 3) percutaneous needle biopsy can be a helpful procedure for diagnosing nonfunctioning solid AMT.
Origin of the ammonia used for mitochondrial citrulline synthesis as revealed by 13C-15N spin coupling patterns observed by 13C NMR.
The sources of ammonia used by isolated, intact rat liver mitochondria in the production of citrulline have been investigated in situ using a novel methodology based on the analysis of 13C-15N heteronuclear couplings observed by 13C NMR. Isolated mitochondria from rat liver were incubated with ornithine, 13CO3H- and 15NH4Cl, using unlabeled glutamate or glutamine as alternative, intramitochondrial nitrogen donors. The production of (7-13C, 8-15N) or (7-13C, 8-14N) citrulline was determined in situ by 13C NMR and the relative proportions of 15N- and 14N-citrullines confirmed by high resolution 13C NMR analysis of the C-7 citrulline resonance observed in perchloric acid extracts prepared at the end of the incubations. The 15N fractional enrichment of the intramitochondrial NH3 pool was manipulated either by modifying the 15N enrichment of added 15NH4Cl, or by altering the concentration of the unlabeled nitrogen donors in the incubation medium. Fractional 15N enrichments measured in the N-8 nitrogen of the resulting (7-13C) citrulline closely paralleled those of the external 15NH4Cl with minor dilutions derived from the unlabeled nitrogen contribution from the alternative substrates. In the presence of 10 mM 15NH4Cl, 10 mM glutamate contributed 4% of the citrulline N-8 nitrogen. Under similar conditions, the contribution of nitrogen from 10 mM glutamine to N-8 citrulline was 6%. These results indicate that the primary source of ammonia used for citrulline synthesis by isolated, intact rat liver mitochondria is extramitochondrial, providing also an illustration of the use of 13C-15N spin coupling patterns observed by 13C NMR, as a new tool in the study of ammonia metabolism.
Metabolism of (1-(13)C) glucose and (2-(13)C, 2-(2)H(3)) acetate in the neuronal and glial compartments of the adult rat brain as detected by [(13)C, (2)H] NMR spectroscopy.
Ex vivo ¿(13)C, (2)H¿ NMR spectroscopy allowed to estimate the relative sizes of neuronal and glial glutamate pools and the relative contributions of (1-(13)C) glucose and (2-(13)C, 2-(2)H(3)) acetate to the neuronal and glial tricarboxylic acid cycles of the adult rat brain. Rats were infused during 60 min in the right jugular vein with solutions containing (2-(13)C, 2-(2)H(3)) acetate and (1-(13)C) glucose or (2-(13)C, 2-(2)H(3)) acetate only. At the end of the infusion the brains were frozen in situ and perchloric acid extracts were prepared and analyzed by high resolution (13)C NMR spectroscopy (90.5 MHz). The relative sizes of the neuronal and glial glutamate pools and the contributions of acetyl-CoA molecules derived from (2-(13)C, (2)H(3)) acetate or (1-(13)C) glucose entering the tricarboxylic acid cycles of both compartments, could be determined by the analysis of (2)H-(13)C multiplets and (2)H induced isotopic shifts observed in the C4 carbon resonances of glutamate and glutamine. During the infusions with (2-(13)C, 2-(2)H(3)) acetate and (1-(13)C) glucose, the glial glutamate pool contributed 9% of total cerebral glutamate being derived from (2-(13)C, 2-(2)H(3)) acetyl-CoA (4%), (2-(13)C) acetyl-CoA (3%) and recycled (2-(13)C, 2-(2)H) acetyl-CoA (2%). The neuronal glutamate pool accounted for 91% of the total cerebral glutamate being mainly originated from (2-(13)C) acetyl-CoA (86%) and (2-(13)C, 2-(2)H) acetyl-CoA (5%). During the infusions of (2-(13)C, 2-(2)H(3)) acetate only, the glial glutamate pool contributed 73% of the cerebral glutamate, being derived from (2-(13)C, 2-(2)H(3)) acetyl-CoA (36%), (2-(13)C, 2-(2)H) acetyl-CoA (27%) and (2-(13)C) acetyl-CoA (10%). The neuronal pool contributed 27% of cerebral glutamate being formed from (2-(13)C) acetyl-CoA (11%) and recycled (2-(13)C, 2-(2)H) acetyl-CoA (16%). These results illustrate the potential of ¿(13)C, (2)H¿ NMR spectroscopy as a novel approach to investigate substrate selection and metabolic compartmentation in the adult mammalian brain.
[Symptoms of the lower urinary tract which suggest cystitis].
Acute bacterial cystitis is a very common disease of the lower urinary tract, in particular among women with an active sex life. Symptoms include dysuria, frequency, nocturia and urgency. As these symptoms are nonspecific, acute bacterial cystitis should be distinguished from more severe urinary tract conditions by an appropriate medical history.
[A complete atrioventricular block during exertion].
Exercise-induced atrioventricular (AV) block in patients with normal electrocardiogram at rest is uncommon. We report the clinical features of two patients with AV block during treadmill test. The first patient was a woman of 54 years of age with presyncope on exercise. She developed complete AV block during exercise testing without evidence of ischemic myocardial disease. Electrophysiologic study documented distal AV block. The second patient was a man 31 years old who developed angina and third-degree AV block with depression of ST segment during treadmill test. Myocardial perfusion study suggested ischemic heart disease. He received anti-ischemic drugs with improvement of symptoms. A control exercise testing demonstrated normal AV conduction and electrophysiologic study was normal. In the first case, exercise AV block was probably due to abnormal His Purkinje conduction system refractoriness to autonomic modulation, while in second case AV block was secondary to ischemic heart disease. Third-degree AV block at exercise can be present in patients without conduction system abnormalities at rest. Exercise-induced infra-Hisian AV block must be treated with pacing until ischemic heart disease has been ruled out.
Use of the preoperative levels of CEA in patients with colorectal cancer.
BACKGROUND/AIMS: Preoperative carcinoembryonic antigen has been considered useful as a prognostic factor and recurrence indicator of colorectal neoplasms. However, its diagnostic ability related to some parameters such as resectability or tumor staging has been less studied. The aim of this study was to evaluate the use of this marker as a diagnostic test for these parameters of colorectal cancer. METHODOLOGY: In a sample of 283 patients operated on for colorectal carcinoma data were retrospectively recorded corresponding to preoperative carcinoembryonic antigen, type of surgery performed (curative vs. non-curative), tumor intramural spread, lymph node involvement, distant metastasis, TNM stage, tumoral differentiation, survival time and survival time free of disease. Bivariate analysis between carcinoembryonic antigen and the rest of the parameters was performed. Also, the sensitivity, specificity, positive predictive value, negative predictive value and diagnostic accuracy (efficiency) of the marker considered as a diagnostic test, were analyzed in relation to the tumoral resectability and tumoral spread. RESULTS: Preoperative level of serum carcinoembryonic antigen was statistically significantly associated with type of surgery performed (p < 0.001); tumoral intramural spread (p = 0.001); lymph node involvement (p < 0.001); presence of distant metastasis (p < 0.001); TNM staging (p < 0.001); overall survival period (p < 0.001) and disease-free survival time (p = 0.04). There was no relation between carcinoembryonic antigen and the degree of tumoral differentiation. The carcinoembryonic antigen's greatest sensitivity corresponded with the prediction for the type of the surgery performed and with the existence of distant metastasis, 80% and 70.9%, respectively. The negative predictive value was also high (> 90% in both cases). When considering the intramural spread, the specificity was 82% and its positive predictive value 93.1%. CONCLUSIONS: Preoperative levels of serum carcinoembryonic antigen, considered as a diagnostic test, are useful as predictors of resectability and tumor spread in colorectal carcinoma.
[Present day concepts of desquamative gingivitis].
Explore the source record for details and available documents.