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Biomedical subjects

J Estrada

Publications and source records attributed to J Estrada.

63 records · Page 4Linked to original sources

Metastatic cell attachment to and invasion of vascular endothelium and its underlying basal lamina using endothelial cell monolayers.

Cellular interactions during blood-borne transport of malignant cells, including the interactions of tumor cells with themselves, platelets, lymphocytes, blood components, and the vascular endothelium, can play important roles in metastasis formation. Since blood-borne metastasis often occurs to specific organ sites in vivo, recognition must occur between the circulating malignant cells and the vascular endothelium. We have used vascular endothelial cells and their underlying basal lamina-like matrix as targets for tumor cell interactions. Our findings indicate that highly metastatic tumor cells attach more rapidly and avidly to the endothelial basal lamina-like matrix than to the apical surfaces of the endothelial cells. Since the former contains cell adhesive molecules such as fibronectin and laminin, these molecules, as well as collagens and proteoglycans, may be collectively responsible for the higher rates of malignant cell binding to the basal lamina. Glycoproteins present on malignant cell surfaces are also important in these interactions, because inhibiting their biosynthesis with tunicamycin blocks blood-borne implantation and experimental metastasis formation and prevents malignant cell binding to endothelial cells or their basal lamina-like matrix. Invasion of blood vessel walls requires that malignant cells penetrate the endothelial cell layer and underlying basal lamina. Metastatic cells appear to perform these activities using degradative enzymes such as proteases and glycosidases that solubilize the major basal lamina components: glycoproteins, collagens, and proteoglycans. We have examined the degradation of basal lamina proteoglycan side chain glycosaminoglycans using purified tissue glycosaminoglycans as substrates. B16 melanoma cells of high organ colonization capacities possess higher levels of endoglycosidase activity against heparan sulfate than B16 cells of lower organ colonization potentials. The highly malignant B16 cells were capable of cleaving the heparan sulfate molecules at specific intrachain glucuronoside sites, producing intermediate molecular weight products.

Animals↗

Infantile hypoventilation syndrome, neurenteric cyst, and syringobulbia.

Hypoventilation syndrome was observed in an infant with a neurenteric cyst. She died at 9 months of age following episodic bradycardia and the loss of voluntary as well as autonomic respiratory control. There was a mediastinal neurenteric cyst with anterior spina bifida and extension into the upper thoracic spinal cord. Secondary syringomyelobulbia was present at necropsy. The syringobulbia involved the hypoglossal nuclei, the dorsal motor nuclei of the vagus in the lower medulla, the right nucleus ambiguus, the right fasciculus and nucleus solitarius, the right mediolateral reticular formation, and the right dorsal motor nucleus of the vagus at the level of the obex. This morphologic distribution is attributed to the intraspinal rupture and upward extension of the mucinous contents of the cyst, and appears to be responsible for the hypoventilation syndrome.

Brain↗

[Penile and urethral lesion caused by metallic ring. Reconstruction with radial free flap].

We report a case of a man with a severe penile injure caused by a metallic ring placed in the penile shaft for 48 hours, it coursed with partial urethral section and ischemia of the whole penile skin and dartos. It was solved with surgical excision of all death tissue and posterior reconstruction using a forearm free flap, the vascular supply came from epigastric vessels, we used hair-free skin from forearm for the urethroplasty. Ethetic and functional results obtained are successful.

Foreign Bodies↗

[Detection of occult malignant melanoma by 18F-FDG PET-CT and gamma probe].

Malignant melanoma has a high relapse rate, and PET is very useful for its detection, above all when its size is small or it is in locations that are difficult to resect. The radioguided surgery being implanted in many sites, new expectations are opening in these situations--the intraoperative location of the lesions by 18F-FDG and detection probe. This is a case report of a 44 years old woman diagnosed of malignant melanoma in her left leg 12 years ago. At present, she has a tumor in her left thigh, which was no longer palpable after a fine needle puncture was performed. This was reported as a mesenchymal tumor. Due to the possibility of recurrent melanoma, need for excision was suggested. In order to locate it, a PET-CT study with 18F-FDG was performed and the lesion was marked on the skin with the help of metallic points. The lesion was located in surgery with a gamma probe, showing relapse of melanoma. The importance of the case is found in the fact that it is the first step to extend the indications of radioguided surgery with the use of PET, a technique that offers a ride range of possibilities.

Adult↗

[Necrotizing fasciitis after varicella].

Necrotizing fasciitis is a rare and severe infection characterised by extremely rapid progressive involvement of the superficial fascias and deep dermal layers of the skin, with resultant vasculitis and necrosis. The authors present three clinical cases of necrotizing fasciitis; all three patients previously had varicella rash, rapid progressive spreading erythema with severe pain and toxic shock syndrome. Two patients had positive cultures of b-haemolytic streptococcus. Early stage differential diagnosis with celulitis, aggressive antibiotic treatment and pediatric intensive care support are essential. However, the main therapy is early extensive surgical approach involving all indurate areas, down to and including the muscle fascia.

Chickenpox↗

Neurotransmitter control of growth hormone secretion in children after cranial radiation therapy.

Cranial radiation for childhood cancer can cause growth hormone deficiency (GHD), usually due to hypothalamic rather than pituitary dysfunction. To investigate whether this hypothalamic dysfunction is secondary to altered neurotransmitter input from other brain centers, we used neurotransmitter-excitatory substances to study the GH secretory response in 17 children who had received 12 to 60 Grey (Gy) to the cranium and 40 short children with normal endocrine function. As expected, the irradiated children had decreased mean GH secretion in response to insulin-induced hypoglycemia and arginine infusion, and decreased mean 24 hour GH concentrations, compared to the control group. In contrast, the two groups had similar GH secretory responses to GHRH stimulation and somatostatin suppression. Assessment of neurotransmitter pathways in the irradiated children revealed significantly lower mean peak GH concentrations in response to 5 of the 6 substances tested compared to control children: alpha-adrenergic stimulation (clonidine), beta-adrenergic blockade (propranolol), cholinergic stimulation, dopaminergic stimulation (L-dopa), and GABA-ergic stimulation (valproic acid). Results of serotonergic stimulation (L-tryptophan) were not statistically significant. Eleven patients who had abnormal GH secretion underwent 4 or more tests with neurotransmitter-stimulatory agents; 3 patients had peak GH concentrations of < 2.5 micrograms/l to all tests, whereas 4 patients had a peak GH concentration of > or = 7 micrograms/l to one or more tests but < 5 micrograms/l to one or more other tests. These observations suggest that radiation damage may sometimes spare growth hormone-releasing hormone (GHRH) and somatostatin secretion while affecting neurotransmitter pathways. We postulate that the hierarchy of sensitivity to radiation damage may be hypothalamic and extra-hypothalamic neurotransmitters > hypothalamic GHRH and/or somatostatin secretion > pituitary GH secretion.

Adolescent↗

The seroprevalence of cysticercosis, malaria, and Trypanosoma cruzi among North Carolina migrant farmworkers.

A seroprevalence study of cysticercosis, Trypanosoma cruzi, and plasmodia species and screening for active malaria was conducted among a randomly selected group of 138 Hispanic and Haitian migrant farmworkers. A random sample of labor camps in eastern North Carolina was selected. Blood samples were tested by Indirect Fluorescent Antibody techniques for plasmodial antibody and by enzyme-linked immunosorbent assay (ELISA) for cysticerci and T. cruzi antibodies. Questionnaires collected demographic data and medical history of the workers and family. Blood films stained with Leukostat stain were examined for plasmodia species. The seroprevalence of cysticercosis was 10 percent, T. cruzi 2 percent, and plasmodia species 4.4 percent. One case of active malaria (Plasmodium vivax) was demonstrated. The clinical significance of seropositivity was not determined, but these results suggest that a small but significant number of farmworkers are infected with cysticercosis, T. cruzi, and malaria. Migrant health clinicians should be aware of the possible presence of these infections. Greater observance and enforcement of sanitation regulations in farmwork is needed to prevent transmission of cysticercosis.

Agriculture↗

[How our pediatric services work].

The results of a questionnaire sent by the College of Pediatrics of the Portuguese Doctors Association (Ordem dos Médicos) to the pediatric departments all over the country are presented. From the answers of fifty-one services, physical conditions, equipment, human resources, assistancial and scientific activities developed are characterized.

Child↗