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Biomedical subjects

J Alfaro

Publications and source records attributed to J Alfaro.

At least 37 records · Page 2Linked to original sources
PubMed1993

Successful management of a tracheo-innominate artery fistula following placement of a wire self-expandable tracheal Gianturco stent.

The authors report a case of tracheo-innominate artery fistula secondary to tracheal perforation in an 18-year-old patient who is tetraplegic following cervical trauma. The patient had a very long tracheal stenosis, secondary to tracheostomy, which was managed by laser resection and a Gianturco stent. One of the anterior struts of the stent had eroded the trachea and the posterior wall of the innominate artery. Surgical management consisted of arterial resection, a longitudinal tracheal split incision to withdraw the stent and placement of a Montgomery T-tube. The patient has no respiratory discomfort 7 months after surgery.

Adolescent↗
PubMed1993

[Chronic myeloid leukemia: cytogenetic and molecular study and its relationship with the disease course].

The aim of this study was to perform a cytogenetic and molecular study in patients with chronic myelogenous leukemia and to seek a possible relation between bcr gene break points and the clinical evolution of the disease. The cytogenetic study allowed to establish the presence of Ph chromosome and the molecular study localized the break point in bcr region of chromosome 22 using the Southern technique, hybridizing with bcr fragment derived probes bcr1 and bcr2. Forty eight patients were studied, 27 male (aged 46.5 years) and 21 female (aged 56). Forty seven patients were Ph +. A rearrangement in 3' bcr region was found in 25 patients and in 5' region in 23. During the follow up period 20 patients developed a blast crisis or accelerated phase. In 11 of these the rearrangement was in region'3 and their chronic phase lasted a mean of 33.1 months; in 9 the rearrangement was in region 5' and their chronic phase lasted 44.1 months. There were no differences in event-free survival between those with rearrangement in region 3' or 5', however these was a tendency towards a longer chronic phase duration in those with 5' breaks. The lack of correlation between the location of break points and the evolution of the disease may be due to a selection of patients with a better evolution and the exclusion of those with a rapid progression to blast crisis or accelerated phase.

Adult↗
PubMed1992

[Perioperative blood transfusion and prognosis in colorectal cancer. Analysis of a series].

The relationship between survival after surgical resection of colorectal carcinoma, and perioperative blood transfusion was studied retrospectively. "Curative" surgery was performed in 164 cases of colorectal cancer--stages B and C--, 72 of them received red-cell concentrates perioperatively. Multiple regression analysis did not show any deleterious effect of blood transfusion on the survival of the surgically treated patients (P = 0.941). The volume of the blood derivative received neither seems to influence their outlook. As it was expected a higher rate of transfusion occurred among rectal cancer patients. Mechanisms and factors involved in this controverted issue are discussed and literature is widely reviewed.

Actuarial Analysis↗
PubMed1992

Efficacy of liposome-encapsulated indomethacin in response against metastatic 3LL and B16F1 tumor cells.

The ability of large liposomes to be taken up by tissue phagocytic cells, e.g., macrophages, has made it possible to increase the efficacy of several drugs as immunomodulating agents. In the present work, we have evaluated the effect of indomethacin, a prostaglandin synthesis inhibitor, both free and encapsulated in liposomes, on the spontaneous metastatic potential of 3LL and B16F1 tumor cells. Liposomes containing either carboxyfluorescein, indomethacin, or carboxyfluorescein plus indomethacin, were made in order to evaluate their in vitro plasma stability and in vivo clearance from the blood. The liposomes showed a high stability after 6 hours of plasma incubation and they were rapidly cleared in vivo. Liposomes encapsulating propidium iodide, a fluorescent DNA binding dye, were mainly taken up in vivo by hepatic and spleen macrophages 1 hour after intravenous injection, but not by lung macrophages. When C57BL/6 mice were intravenously inoculated with 10(5) 3LL or B16F1 tumor cells previously incubated with indomethacin (10(-7) M) for 48 hours, the number of experimental lung metastatic foci was increased with respect to their respective control groups. Also, in 3LL or B16F1 tumor-bearing mice, treatment with indomethacin (0.5 mg/kg weight/day) for 10 days enhanced the number of lung metastases, but not significantly. However, when mice received indomethacin encapsulated in liposomes, the number of metastases was significantly reduced. In addition, encapsulated indomethacin (0.5 mg/kg weight/day) inhibits prostaglandin E2 production by peritoneal and spleen macrophages, whereas no significant inhibitory effect was observed with control-liposomes or equivalent doses of free indomethacin. We conclude that intravenous administration of liposome-encapsulated indomethacin has an antimetastatic effect on tumor-bearing mice. Use of indomethacin in liposomes may avoid the stimulation of metastases observed when the drug is administered alone.

Animals↗
PubMed1991

Antimetastatic effects of liposome entrapped indomethacin.

The "in vivo"administration of sized liposomes encapsulating indomethacin to mice bearing 3LL tumor, significantly reduced the incidence and/or number of superficial lung metastases. Also liposomes encapsulating indomethacin had significant inhibitory effects on the experimentally induced lung metastases. We conclude: i) indomethacin encapsulated in liposomes is more efficient than the free drug in mediating the antimetastatic effects and ii) liposomes are an valuable vehicle in evading the side metastatic effects of this drug during indomethacin treatment of tumor bearing mice.

Animals↗
PubMed1991

Glomus tumour of the trachea: report of a case with microscopic, ultrastructural and immunohistochemical examination and review of the literature.

A case of glomus tumour of the trachea is reported. The patient, a 58-year-old man, complained of dyspnoea, cough and occasional haemoptysis for many years and had been misdiagnosed as having chronic bronchitis. The diagnosis of glomus tumour in a tissue sample taken by bronchoscopy was useful in planning adequate surgery. Light and electromicroscopy of the excised tumour confirmed the preoperative diagnosis. Immunohistochemical examination showed vimentin and actin in the tumour cells, and negativity for high and low molecular weight keratins, desmin, neurofilaments, and factor VIII-related antigen, findings similar to glomus tumours of other sites.

Actins↗
PubMed1991

Undifferentiated carcinoma of parotid gland.

Two cases of undifferentiated carcinomas of the major salivary glands were studied using immunohistochemical techniques. Results showed that this entity was a high grade malignant neoplasm arising from the excretory duct. Despite the undifferentiated appearance multiple immunophenotypes were evident in both cases.

Carcinoma↗
PubMed1991

[Primary antiphospholipid syndrome: clinical experience of 6 patients].

Recently, the association between anti-phospholipid antibodies (false positive VDRL, lupus anticoagulant or anti-cardiolipin antibody) and diverse clinical manifestations has been termed antiphospholipid syndrome. We report 6 female patients with "primary" antiphospholipid syndrome, not related to connective tissue disorders. Their age ranged from 23 to 66 years and they were followed from 1 to 27 years (mean 9.2). Venous occlusion developed in 4, arterial occlusion in 4 (TIA, convulsive episode and cutaneous thrombotic microangiopathy). Three of 5 had fetal loss and 3/6 developed thrombocytopenia. Leg ulcer, migraine and mitral valvulopathy and peripheral facial paralysis were isolated manifestations in different patients. High titers for type IgG anticardiolipin antibodies were present in all patients. Low titers for IgM antibodies were present in 2. The pathogenesis of this syndrome is discussed.

Adult↗
PubMed1991

[Intravascular coagulation in acute promyelocytic leukemia: analysis of coagulation and fibrinolysis parameters].

Eight pts with acute myeloid leukemia were studied to assess coagulation and fibrinolysis disturbances as a cause of hemorrhages associated to thrombopenia. Fibrinogen, products of fibrinogen to fibrin degradation, D-dimer, antithrombin III, protein C, plasminogen and alpha-2 antiplasmin determinations were performed at admission, during and after chemotherapy. All pts were on heparin during induction chemotherapy. Coagulation activation, which increased with the onset of chemotherapy (increases in D-dimer) and a decreasing trend at the end of the antileukemic therapy (normalization of fibrinogen levels) was observed. During the whole observation period alpha-2 antiplasmin levels remained very low. No significant changes were observed in antithrombin III or protein C levels. In conclusion, disseminated intravascular coagulation with associated thrombopenia is an important event in acute leukemia and an increased fibrinolytic activity due to low alpha-2 antiplasmin levels may take part in the genesis of hemorrhage. These data suggest that both heparin administration and the use of antifibrinolytic drugs may have a therapeutic effect.

Adolescent↗
PubMed1987

Malignant clear-cell hidradenoma.

In this paper the authors present a case of malignant clear-cell hidradenoma developed on the dorsum of the hand. This is only the eleventh complete report in the literature, including follow-up, and only the third to include necropsy. It is the first to find both lung and myocardial metastases. The tumor was very invasive and was treated first by wide surgical excision and radical node dissection, and when the tumor recurred, amputation of the arm was done. The world literature was carefully reviewed and compared with this case. Owing to the already known failure of radiotherapy, and since chemotherapy was not successful in our patient, the authors advise early aggressive surgery, including block dissection of the regional nodes, and thereafter a careful follow-up.

Adenoma, Sweat Gland↗
PubMed1987

[Primary mediastinal seminoma (apropos of 2 cases)].

Two cases of primary mediastinal seminoma in patients aged 43 and 37 respectively are reported, with remarks on the pathogenesis, clinical features, diagnosis and treatment of the disease and a review of the literature. The favourable outcome in these two cases after 1 and 7 years respectively was remarkable. Emphasis is laid on the value of thoracotomy for the diagnosis and treatment.

Adult↗