Search PubMed⌕ Search

Biomedical subjects

L Casas

Publications and source records attributed to L Casas.

26 records · Page 2Linked to original sources
PubMed1989

Immediate breast reconstruction: reducing the risks.

One-hundred and sixty-five consecutive immediate breast reconstructions in 157 patients were reviewed. Reconstructions were performed with tissue expanders (53 percent) or immediate gel prostheses (47 percent). Immediate reconstruction was associated with an 18 percent rate of implant loss. Certain risk factors were identified at the p less than 0.05 level using immediate gel implants: failure to achieve complete muscle coverage of the implant, smoking at the time of surgery, initial gel implants of 400 ml or more volume, and age. Expander loss was increased by detaching the pectoralis major (p less than 0.05) and probably by lack of complete muscle coverage in general. Chemotherapy, history of previous smoking, and clinical stage of the carcinoma did not seem to affect reconstructive success. Smoking and patient age should be considered during patient selection for immediate reconstruction. Muscle coverage of the prosthesis should always be attempted. Muscle coverage is mandatory in the smoker. Gel implants of 400 ml or more volume are to be avoided at the initial operation. This approach should enable all surgeons to achieve lower rates of implant loss.

Adult↗
PubMed1985

Complete surgical revascularization: the treatment of choice in young patients with multivessel coronary disease.

Since the advent of coronary angioplasty, nonoperative techniques to manage coronary artery disease have become attractive alternatives to coronary artery bypass grafting (CABG). To provide a standard against which new procedures could be judged, 123 consecutive patients less than 45 years of age who have had CABG since 1978 were systematically followed. The indications for operation were unstable angina or postinfarction angina (60%), life-threatening coronary anatomy with stable angine (36%), and sudden death or uncontrolled ventricular tachycardia (4%). Seventy-five patients had documented preoperative myocardial infarction, 55% within 30 days of CABG. An average of 3.2 vessels were grafted per patient; only 10 had single CABG. Complete revascularization was accomplished in 91% of patients. Five patients (4%) had myocardial infarction within 30 days of operation. No operative deaths or strokes occurred. The 6-year follow-up was 94.4% (the 5-year actuarial survival rate, 87.4%). There were four late deaths; two were due to myocardial infarction, one to prosthetic valve failure, and one to sudden death. At 2.7 years, 88.1% of the patients were NYHA Functional Class I; 85.4% continued full-time employment, and 98% considered their quality of life the same or better than before CABG. Five patients suffered myocardial infarctions during the follow-up period. Nine patients required reoperation: eight for graft occlusion (three less than 1 year, five greater than 3 years), and one for disease progression. These data confirm that complete operative revascularization remains the standard of therapy for young patients with multivessel coronary artery disease as evidenced by the absence of early mortality, the low incidence of morbidity, the excellent functional recovery, and the high return to gainful employment.

Journal Article↗
PubMed1981

Symmetrical replication patterns and sex chromatin bodies formation of an idic(X)(p22.3::p22.3) chromosome.

The morphologic and staining characteristics of the sex chromatin bodies and the DNA replication patterns were studied in a patient with a 45,X/46,X,idic(X)(p22.3::p22.3) karyotype and in a normal woman. The analysis showed a relatively high frequency of bipartite Barr bodies as well as some variation of the distance, staining intensity, and size relationship between their halves. Regarding the DNA replication studies, in 71% of the cells the abnormal X chromosome showed a synchronous pattern, and in the remaining 29%, in which a slight asynchrony was present, an almost equal proportion of early and late functional and nonfunctional centric halves was observed. Furthermore, the atypical chromosome had a quite similar replication pattern to the late replicating X chromosome of the normal woman, suggesting that its sequence of DNA sythesis was not altered.

Child↗
PubMed1980

Late-appearing Philadelphia chromosome in two patients with chronic myelogenous leukemia.

We describe two patients with typical myelogenous leukemia, who at the beginning of the disease lacked the Philadelphia chromosome in bone marrow cells, and 90 and 42 days later, respectively, its presence was shown in all cells analyzed from that tissue. These findings are compatible with the possibility that at least occasionally Ph1 occurs secondarily in already leukemic cells. The rapid change form Ph1- to Ph1+ CML in one of the patients (42 days), suggests the possibility that in addition to Ph1+ cells enjoying marked selective advantage, this change is induced simultaneously in multiple bone marrow cells.

Adult↗