Resolution of pancreatic pseudocysts: when should we wait?
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Adult↗
Biomedical subjects
J Rodriguez
Publications and source records attributed to J Rodriguez.
Carnitine metabolism during fasting in dogs.
During starvation, a series of changes in whole body fuel use occur that result in conservation of fuel, particularly protein. Use of fat stores for ketone production and direct oxidation of fat as a primary fuel are characteristic of starvation. However, the mechanism by which this change develops is unclear. Carnitine is an important compound in the control of fat metabolism, since long-chain free fatty acids must be coupled with it to cross the mitochondrial membrane. This study attempts to define, in the fasting dog model, the interaction between plasma and muscle carnitine, its acyl esters, and the energy substrates available. Eight adult beagle dogs were studied during an 8-day period of starvation. Muscle and plasma were analyzed for free carnitine (FC), acid-soluble fraction, and long-chain esters (LCE), as well as substrate hormone profiles. Total carnitine (TC) and short-chain esters (SCE) were calculated. Muscle was analyzed for carnitine palmityl transferase activity (CPT). These measurements were performed on days 3, 5, and 8. There was a significant (p less than 0.05) loss in weight on days 3, 5, and 8. TC and FC increased significantly (p less 0.05) only on day 8; this occurred simultaneously with a significant (p less than 0.05) decrease in CPT. It was preceded by a significant (p less than 0.05) and persistent increase in plasma TC, FC, and LCE that developed on day 3. During starvation there was an increase in plasma carnitine levels before changes in muscle. The increase in muscle carnitine occurred between days 5 and 8 of starvation and seemed to be associated with a fall in CPT. This may be responsible either for or secondary to the decrease in metabolic rate that occurs during prolonged starvation.
3-Hydroxybutyric Acid↗
Neuronal types of the cerebral cortex of the adult chicken (Gallus gallus). A Golgi study.
The telencephalic cortex of adult chicken (Gallus gallus) consists of two anatomical regions: the medial cortex (or hippocampal cortex) and the dorsal cortex (or parahippocampal cortex) which we have denominated "dorsomedial cortex" (DMC) as a whole. The dorsomedial cortex shows, with Nissl's technique, two main layers of lamination, besides the ependymal layer: plexiform layer and granular layer. In the plexiform layer, there is a sub-layer called periventricular. In Golgi impregnations, the plexiform layer of the DMC is filled with neurons of horizontal type and fibers. The granular layer of the medial region is mainly occupied with pyramidal and bipyramidal neurons, as well as some short-axon and long-axon multipolar neurons. In the granular layer of the dorsal region basically long-axon multipolar neurons are found and, to a lesser extend, short-axon multipolar ones are also seen. In the periventricular sub-layer of all the DMC are located the periventricular neurons. In general, we can say that the chicken DMC is a poorly developed cortical structure.
Animals↗
Hepatic resection for metastatic disease.
Hepatic resection for metastatic disease is reviewed in 30 patients (mean age 58.9 years). The primary site was the colorectum in 25; the other primary tumours were leiomyosarcoma, plasmacytoma, and adenocarcinoma (all of gastric origin), ocular melanoma and an unknown primary. Operative procedures included 7 wedge resections, 5 segmentectomies and 21 lobectomies (11 right, 4 extended right and 6 left). Major complications in seven patients included intraoperative hemorrhage in three, two of whom died, bile-duct injury in two, small-bowel infarction in one and cerebrovascular accident in one. Operative death rate was 6.7% (2 of 30). Thirteen patients were alive and free of disease a mean of 24 months after hepatic resection while 5 more were alive with disease at a mean of 36.9 months. Life-table analysis projected a 5-year survival of 50.3% for those with colorectal primaries, with no apparent difference in survival between patients with single (55.0%) and multiple (54.0%) metastases. Improved survival was projected for patients with metachronous (66.6%) versus synchronous (45.0%) tumours, primary Dukes' class A or B (66.1%) versus Dukes' class C (46.0%) tumours and those having wedge resection or segmentectomy (66.6%) versus lobectomy or extended lobectomy (48.0%). Hepatic resection for metastatic disease can be done with acceptable morbidity and mortality and the expectation of substantially prolonged survival particularly in patients with metachronous lesions or Dukes's A or B colorectal primary lesions.
Actuarial Analysis↗
[Carcinomas of the posterior pharyngeal wall. Experience of the Institut Curie. Analysis of the results of radiotherapy].
Between 1960 to 1982, 98 patients with squamous cell carcinomas of the posterior pharyngeal wall were treated at the Curie Institute by radiotherapy alone. The absolute survival is 30% and 18% at three and five years. The major cause of death is loco-regional failure. 95% of the local failures arrived within the 18 first months. The 2 years control rate ranged from 80% for T1, 64% for T2, to 36% for T3 and 22% for T4. The local control is so depending on the radiation induced regression of the primary. The 2 years control rate is 71% for the patients with complete regression and 12% for the patients with not complete regression at the end of the treatment. The improvement of these results by adjunction of other treatments (surgery, chemotherapy, hyperthermia) is discussed.
Carcinoma, Squamous Cell↗
Delayed wound healing after radial keratotomy.
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Adult↗
Epidemiologic features of diabetes mellitus among Indians in northwestern Ontario and northeastern Manitoba.
This descriptive epidemiologic study of diabetes mellitus among Indians in northwestern Ontario and northeastern Manitoba provided estimates of the prevalence of diagnosed cases: 28/1000 overall, 46/1000 for those aged 15 to 64 years and 96/1000 for those aged 65 years and over. Diabetes was more prevalent among women than men but was rare in children. More than half of the existing cases had been diagnosed within the last 5 years studied (1978-82). Comparisons with Canadians nationally and other North American Indian groups were made with caution owing to the different methods of case ascertainment. Duration of disease and pre-existing hypertension were found to be statistically significant risk factors for the development of complications of diabetes in this population.
Adolescent↗
Morphometric studies of normal sural nerves in children.
Quantitative histologic studies of biopsies of normal sural nerves were performed on nine children aged 4 days to 17 years. Stereologic computerized procedures were used to determine total endoneurial area, size distribution and number of myelinated, unmyelinated fibers and Schwann cell nuclei per nerve and per square millimeter, and the ratio of myelin thickness to axonal diameter. There was an inverse linear relationship between the number of myelinated fibers per square millimeter and increasing age. A stronger correlation was found between the number of Schwann cell nuclei per nerve (P less than 0.01) and per square millimeter (P less than 0.001) and the logarithm of age. The slope of myelin thickness/axon diameter regression lines (P less than 0.001) changed with age in linear relationship (correlation coefficient: P less than 0.001). There were no age-dependent changes in the number and density of unmyelinated fibers, but the number of unmyelinated axons per Schwann cell subunit decreased with age. Size distribution histograms for myelinated fibers showed a unimodal profile in the newborn. A second peak at 6-7 micron appeared at age 3 months, shifting progressively to 9-11 micron at 14 years. The distribution of unmyelinated fibers was unimodal, with a peak around 0.8 micron, irrespective of age. There were marked individual variations in endoneurial area.
Adolescent↗
Is choledochoduodenostomy in the treatment of stones in the common bile duct an obsolete technique?
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Adult↗
Unusual staining property of human Y-chromosome.
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Chromosome Banding↗
Congenital 11 beta-hydroxysteroid dehydrogenase deficiency associated with juvenile hypertension: corticosteroid metabolite profiles of four patients and their families.
Four children with 11 beta-hydroxysteroid dehydrogenase deficiency are described. All patients had severe hypertension, hypokalaemia, and low plasma aldosterone and renin activities. Two of the patients were siblings and two were unrelated. The most noticeable biochemical feature of these individuals was the extremely low excretion of cortisol metabolites containing an 11-carbonyl group compared to the excretion of the 11 beta-hydroxyl containing metabolites. Although this condition is readily diagnosed in affected individuals by urinary steroid analysis, carriers of the defect do not differ from normal in their urinary steroids. Both parents of the affected siblings had normal 11-oxo-steroid/11 beta-hydroxysteroid ratios under baseline conditions and the lesions could not be revealed by ACTH administration.
11-beta-Hydroxysteroid Dehydrogenases↗
A possible clinical implication of homozygous inversions of 9qh regions with Cornelia de Lange syndrome (CLS).
Several investigators have attempted to correlate chromosomal abnormalities with Cornelia de Lange Syndrome (CLS), but none of them have been conclusive. The homozygous inversion of 9qh found in the present case has not been found previously. It remains to be clarified whether the presence of this finding in CLS was simply a coincidence or whether homozygosity for such inversions may result in CLS.
Abnormalities, Multiple↗
Structural organization of ribosomal cistrons in human nucleolar organizing chromosomes.
The variable morphology of nucleolar organizer regions (NORs) of human acrocentric chromosome 13 was studied in detail by the N-banding technique. It was demonstrated that NOR may become further segmented and several hypotheses have been proposed for structural variability. The polymorphic nature of NORs may have an important significance in human evolution.
Blood Cells↗
Characterization of the opioid receptor binding and animal pharmacology of meptazinol.
Meptazinol is a unique opioid analgesic. Binding studies suggest a relative selectivity for mu 1 sites, as opposed to the other opioid receptor binding sites. This binding selectivity is consistent with meptazinol's supraspinal site of action and its sensitivity to the mu 1-selective opiate antagonist naloxonazine. Furthermore, at equianalgesic doses, morphine depressed respiration to a greater degree than meptazinol.
Analgesia↗
Right hepatic lobectomy for primary and metastatic tumour: experience in a community teaching hospital.
The first eight patients who required either a total or extended hepatic lobectomy for malignant tumour at a community teaching hospital are reviewed. Two patients had primary liver tumours and six had metastatic adenocarcinomas, five from colorectal and one from an unknown primary tumour. There were no deaths perioperatively, morbidity was minimal and survival was encouraging. Three patients died of disseminated disease 9, 16 and 18 months respectively after hepatic resection. However, five patients were free of disease 19, 27, 52, 63 and 80 months after operation. The authors' initial experience compares favourably with that of others and demonstrates that major hepatic resection can be done safely and can offer prolonged survival of good quality to a selected group of patients, even when the tumour load is large.
Adult↗
[Prognostic factors and results of external irradiation of cancers of the base of the tongue].
At the Curie Institute, between 1958-1980, 166 patients were treated for squamous cell carcinoma of the base of the tongue, by external radiotherapy alone. The absolute survival was 45%, 39%, 26% at 2, 3, 5 years. 95% local and loco-regional failures arrived within the first two years; the nodal failures isolated were rare (4%). Unfavorable prognosis features are: the size of the tumor and the clinical radiation-induced regression of the primary. A new therapeutic approach is discussed: an additive curietherapy for some T1-T2 and a surgical excision (total glossectomy with or without neck dissection) for some T3-T4 of which the regression is unsatisfactory at 50-55 Gy are proposed.
Carcinoma, Squamous Cell↗
Pars plana lensectomy and vitrectomy by ultrasonic fragmentation: Part III--Results in eyes without other ocular pathology or an implant.
The records of 320 eyes without other ocular pathology undergoing pars plana lensectomy and vitrectomy by ultrasonic fragmentation for routine cataract extraction without an implant were reviewed retrospectively. Three hundred two (302/320-94.4%) had vision between 20/20-20/40. Reasons for vision less than 20/40 in 18/320 (5.6%) eyes included 5/320 (1.5%) with retinal detachments, 11/320 (3.4%) with clinically apparent cystoid maculopathy, 1/320 (0.3%) with a macular hole, and 1/320 (0.3%) with retained lens material. Comparison was made between 184 lensectomies performed by the original technique and 136 pars plana lensectomies performed by the modified technique. Vision between 20/20-20/40 was achieved by 168/184 (91.3%) of the original technique group versus 134/136 (98.5%) of the modified technique group. In the latter group, there was one retinal detachment (0.7%), one macular hole (0.7%) and no clinical cystoid maculopathy. Fluorescein angiography performed three months postoperatively in eyes having vision of 20/20-20/40 of the modified lensectomy group showed cystoid maculopathy in one eye which had undergone trauma-induced wound dehiscence.
Aged↗
[Total glossectomy without laryngectomy for recurrence after initial irradiation (2 year follow-up)].
In our experience of 171 glossectomies for recurrence, salvage partial glossectomy yields 50% of local control. Myo-cutaneous flap allows wide total glossectomy without total laryngectomy. This procedure may improve the local control. Of 25 patients treated by this technique, 2 deceased before the 45th post-operative day, 15 swallow correctly and 11 have a good speech. The survival rate is 10/21 at 6 months, 7/16 at 12 and 6/13 at 18. A local failure was observed in 7 and 6 have a second primary in the upper respiratory and digestive tract. Total glossectomy without total laryngectomy is only indicated for patients with bulky tumor, without spread of the vallecula and with no palpable cervical node.
Adult↗