Biomedical subjects
Publications and source records attributed to L Flores.
A case of multinodular hypertrophic pyloric stenosis is described in a 57-year-old woman. Over a 3-month interval, there was progressive enlargement of several mucosal nodules overlying hypertrophied muscularis, and one nodule obstructed the pyloric opening. Diagnosis was made at operation and symptoms resolved after Billroth I gastrectomy.
Intra-aortic balloon occlusion (IABO) of the thoracic aorta was attempted in 21 consecutive hemodynamically unstable patients with missile injuries of the abdomen. Retrospectively, the patients fell into three groups. Group One consisted of five patients with a cardiac rhythm but no recordable blood pressure (BP). Group Two were six patients with refractory hypotension, that is, BP of 80 torr systolic or less. Group Three comprised ten patients who had hemodynamic deterioration to a BP of 80 torr systolic or less during preparation for or in the course of celiotomy. IABO was successful in occluding the thoracic aorta in 20 patients with a resultant rise of BP; one patient required thoracotomy for aortic clamping. Operative control of hemorrhage was accomplished in 11 patients; seven patients survived and were discharged in a functional status. There were no survivors in Group One, three in Group Two, and four in Group Three.
In the Valdivia (Chile) river basin 1,295 inhabitants of 6 riverside districts were examined between March and October 1987 and showed a 1.2% of prevalence by Diphyllobothrium in the districts of Riñihue and Las Huellas. Prevalence of 5.3% and 9.8% respectively were registered in dogs of the districts of Riñihue and Malihue. No cat or pig infection was observed in the different districts. The parasites recovered after the treatment were identified as Diphyllobothrium latum. Human infection by D. latum in the districts affected results from the consumption of smoked or insufficiently cooked fish. The investigation of 1,450 fish (4 exotic species and 11 autochthonous ones), caught in the Valdivia river basin in 1986 and 1987, showed the existence of plerocercoids of D. latum and/or Diphyllobothrium dendriticum in Salmo gairdneri and Salmo trutta among exotic fish and in some autochthonous species. Prevalence and mean intensity in the infection of fish as well as the degree of aggregation in the infrapopulations varied in the different districts. Some species of fish would act as intermediary hosts and others as paratenic hosts in the life cycles of Diphyllobothrium spp. in the Valdivia river basin. An improvement in the conditions of basic sanitation, in sanitary education and in the treatment of infected persons is proposed as a means for the control of diphyllobothriasis in the districts affected.
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Pyridoxal 5'-phosphate (PLP), the major coenzyme form of vitamin B6, is known to have antisickling properties in vitro. Recently, low plasma PLP levels were reported in a group of adults with sickle cell anemia. We measured the plasma PLP levels in a group of 55 asymptomatic nontransfused children with sickle cell diseases (SCD) to determine the prevalence of low plasma PLP levels in this population. Comparative studies were made with the measurement of PLP in three other groups serving as controls: Group A (black children, n = 36); Group B (white children, n = 37); and Group C (black adults, n = 13). PLP was measured directly in plasma by a radioenzymatic technique. The results of these comparisons showed that there was no statistically significant difference in plasma PLP of black children with SCD (10.7 +/- 10.0 ng/ml) as compared with black control children (group A, 9.0 +/- 12.3 ng/ml). The low plasma levels PLP in these two groups were significantly lower than that of the plasma PLP of white control children (group B, 15.85 +/- 15.92 ng/ml). This data suggest that a high prevalence of low PLP levels exists in black children seen at Grady Memorial Hospital, both with and without SCD.
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Three patients with iliac artery aneurysms were seen at our institution with the chief complaints owing to urological manifestations. Iliac artery aneurysms may present with a transrectally palpable mass, hematuria, bladder outlet obstruction, ureteral obstruction, retroperitoneal fibrosis or renal failure. Any such manifestations may bring the aneurysm to the attention of a urologist before diagnosis.
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Management of massive exsanguinating hemorrhage is a major challenge in acute trauma care. The value of military antishock trousers (MAST) in this setting is controversial. In selected instances, thoracotomy with aortic cross-clamping may be effective and often is used as the "gold standard" to which new experimental therapy is compared. Previous animal research with an occluding aortic balloon catheter (Percluder) has shown this technique to be physiologically similar to aortic cross clamping. The Percluder was more effective than the MAST plus volume replacement in controlling hemorrhage and prolonging four-hour survival from blunt splenic trauma in an animal model. We have used the Percluder in 23 patients with life-threatening hemorrhage. There were 15 trauma cases, five cases of ruptured abdominal aortic aneurysm, and three others. Only nine of 23 patients (39%) had vital signs when the balloon was inserted; all showed an increase in arterial blood pressure of about 50% to 100% (P less than .0001). Two of 15 trauma victims (13%) and four aneurysm patients in whom the balloon was used were long-term survivors. One trauma victim lived for two weeks before dying of ischemic complications after 90 minutes of balloon aortic occlusion. Overall survival rate was 26%. This study was uncontrolled and occlusion therapy was not randomized. Eleven of 12 attempts to place the catheter by femoral cutdown were successful. Seven of 12 attempts (58%) to place the catheter percutaneously were successful. The six insertion failures were due to an inadequately small introducer, inability to identify arterial pulses in moribund patients, or difficulty in cannulating the femoral artery because of proximal occlusion.(ABSTRACT TRUNCATED AT 250 WORDS)
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Double immunofluorescence assays of fixed sections of tissues from Pekin ducks congenitally infected with duck hepatitis B virus were carried out to score cells reactive to antiserum elicited either to viral DNA synthesis complexes (immature cores) purified from liver of infected ducks or to viral surface antigen particles and virions purified from sera of viremic ducks. Subpopulations of doubly fluorescent cells were detectable in liver (hepatocytes and bile duct epithelia), in kidney (proximal tubular epithelia), and in pancreas (acinar-associated cells and endocrine alpha and beta cells); all cells reactive with one antiserum were reactive with the second antiserum. Competition assays established that the cell-associated antigens recognized by the two antisera were mutually non-crossreactive. The cell-associated antigen recognized by the antiserum elicited to the purified immature cores appears to be crossreactive with a 35,000-Da polypeptide fraction associated with immature cores.
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Replication of milker's node virus (MNV) DNA begins 4 to 8 h postinfection, continues to 30 to 36 h postinfection in the cytoplasm of infected, primary bovine embryonic kidney cells, and is accompanied by an inhibition of host nuclear DNA synthesis. Between 20 and 24 h postinfection, newly replicated genomes are incorporated into particles which cosediment with purified MNV. These biochemical measurements could be correlated with the development of MN virions as revealed by electron microscopic analysis of thin sections prepared from infected cells. Analysis of the DNA in purified MNV showed that the virions contained a double-stranded DNA molecule with a molecular weight of 85 x 10(6) to 87 x 10(6) and a guanine-plus-cytosine content of about 63%. After denaturation and sedimentation analysis of MNV DNA in alkaline sucrose gradients, three major DNA species were resolved. These species appeared to represent intact, terminally cross-linked genomes (approximately 75 to 80S); genomes bearing one nick (or with one cross-link removed) (60 to 65S); and complementary, denatured DNA strands released from cross-linked genomes bearing two nicks (or with both cross-links removed) (52 to 55S). Forty [35S]methionine-labeled polypeptides, ranging from approximately 200,000 daltons to 10,000 to 15,000 daltons, were detected by radioautography after polyacrylamide gel electrophoresis of the proteins present in detergent-solubilized MNV preparations. Treatment of MN virions with Nonidet P-40, beta-mercaptoethanol, and sonication released 10 polypeptides, which were apparently located on the surface of virions. Further fractionation of these released polypeptides, followed by electron microscopy and polyacrylamide gel electrophoresis, indicated that a 42,000- to 45,000-dalton polypeptide is a major component of the threadlike tubule structure present on the surface of MN virions.
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Pretreatment DNCB skin testing and absolute lymphocyte counts were studied in 85 consecutive head and neck cancer patients. All patients were treated primarily with radiation therapy alone or combined radiation plus surgery. The results of DNCB testing and absolute lymphocyte counts were not sufficiently predictive of outcome, (no evidence of disease after 2 years) to be useful in making treatment decisions on an individual patient. This applied to the good prognosis (T1, T2, N0-N3) and poor prognosis (T3, T4, N0-N3) groups.
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