The neurologically intact brain injured (2 degrees to missiles): an approach to treatment.
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Adult↗
Biomedical subjects
J Davila
Publications and source records attributed to J Davila.
Cerebrospinal fluid and plasma dopamine-beta-hydroxylase activity in human hypertension.
Cerebrospinal fluid (CSF) and plasma dopamine-beta-hydroxylase (DBH) activity was measured in 22 normotensive (NT), 31 essential hypertensive (EH), and 11 renal hypertensive (RH) patients. Although no differences were observed in their plasma DBH, the mean CSF-DBH activity and specific activity of EH were significantly lower than those of NT and RH patients. Very low CSF-DBH (less than 0.15 units/ml of CFS or less than 0.5 units/mg of CSF protein) was found only in EH (26% of EH). Of the 31 EH patients, 19(60%) had CSF-DHB activities lower than 0.5 units/ml, whereas only 5 of 22 NT (23%) and no RH fell within this range. Nevertheless, 20% of EH, 55% of NT, and 40% of RH patients had CSF-DBH activities above the mean value for NT (less than 0.9 units/ml). NT subjects with very low plasma DBH (less than 50 units/ml) had CSF-DBH activities that fell within normal range. With the exception of these subjects, the specific activity of CSF-DBH was always lower than that of the plasma enzyme. The concentration of albumin, alpha 1, beta, and gamma globulins was measured in plasma and CSF obtained from the last five NT, four EH, and two RH patients. A positive linear relationship was obtained when the log of the plasma/CSF concentration ratio for these proteins was plotted against their molecular weight. Similar slopes and intercepts were obtained for these patients, suggesting that no major differences seem to exist in their blood-brain-barrier permeability to proteins. The results suggest that measurements of CSF-DBH could be of help in the differential diagnosis of human hypertension and in the neurochemical characterization of EH. If CSF-DBH reflects central noradrenergic activity, its reduction might indicate the existence of a central catecholaminergic defect in a subgroup of EH patients.
Adolescent↗
[In situ tumor excision of a renal neoplasm].
The present work reviews the conservative surgical options to treat renal tumor formation in patients who still have both kidneys, and tries to clarify the diagnostic aspects, indications and therapeutical alternatives. The controversial items are analyzed versus treatments advocating a radical surgical approach, establishing a parallelism with current trends of surgical non-intervention in renal traumatism of moderate to severe condition (grade II). A case is presented where these two pathological circumstances are concurrent: Renal traumatism with complete parenchymatous rexhis and contralateral solid renal mass, both treated conservatively. Pre-surgical diagnosis was left renal traumatism grade II and righ renal neoformation and was based in findings with CAT and arteriographia. Histology of the piece from tumorectomy was renal angiomyolipoma. After a post-surgical evolution of twelve months, therapeutical results were assessed as excellent, with no evidence of either immediate not late complications. Considering data recently communicated by most authors, the concept of simple tumorectomy or renal tumoral enucleation is suggested as valid. However, arguments both clinical and surgical, in order to confirm its indication, require very rigorous criteria and a careful selection of patients.
Adolescent↗
Experimental studies of the anatomical and functional characteristics of kangaroo aortic valve bioprostheses.
In many tests done in vitro and in vivo on porcine aortic valve grafts, high pressure gradients were found under normal as well as under stress conditions. The transvalvular pressure difference is due to the immobility of the right aortic porcine leaflet that is fixed tightly to the muscular septum of the ventricle. Our own studies of 24 kangaroo hearts show different anatomical features: the right leaflet is practically free in this movement. Thus the maximum orifice area of the kangaroo aortic valve is reduced by only 24.2 per cent, whereas the porcine valve shows a reduction of 36.5 per cent. This difference proved to be highly significant (P less than 0.001). Therefore, in cooperation with Hancock Laboratories, kangaroo aortic valve grafts were tested as xenotransplants, using a pulse duplicator. The first results show that larger orifice areas are achieved by kangaroo valves one or two sizes smaller than their porcine counterparts.
Animals↗