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Biomedical subjects

L Morales

Publications and source records attributed to L Morales.

At least 19 recordsLinked to original sources

[Characteristics of cicatrization of wounds during the fetal period].

Recent clinical experience on open prenatal surgery in human beings, although scarce, suggests that skin wound healing in the fetus differs from that in adult life. This fact is supported by several experimental studies. Three types of skin wounds have been practiced in a group of thirty 23rd-gestational-day rabbit fetuses: sutured incision, non-sutured incision, and electrocautery burn. Seven days later, the resulting scars were assessed by mechanical and hystological studies. The results obtained were compared with those seen in 30 newborn rabbits and 30 adult rabbits in which the same wounds were carried out. In the fetuses, rupture tension of the sutured wound was 20% of that of the normal skin. A similar relationship was found in the group of adult rabbits. The sutured wounds in the fetuses showed a better macroscopic repair than in older rabbits. However, the non-sutured wounds and burns did not heal in the fetuses, on the contrary, their opening increased from the time of the lesion. These results seem to suggest that wound repair in the fetus is more like a remodeling process than in older ages.

Animals

[Role of the amniotic fluid in gastroschisis. An experimental study].

The short and thick bowel found in gastroschisis has been attributed to contact with amniotic fluid, among other factors. We designed an original animal model in order to isolate the effect of amniotic fluid on the fetal bowel. We created experimental gastroschisis in fetal rabbits. Extruded bowel was kept out of the amniotic sac in half of the operated fetuses. At term, seven days after surgery, 21 surviving fetuses--12 intra-amniotic (GIA) and nine extra-amniotic (GEA)--and 16 control littermates were harvested for study. Five parameters were measured in each animal: body weight, intestinal weight, intestinal length, bowel diameter and bowel wall thickness. We found no statistically significant difference in body weight, intestinal weight or bowel wall thickness. An enormous difference was found in intestinal length among the three groups. Bowel diameter was significantly different in the extreme groups (GIA and controls), with the intestine being more dilated in GIA than in GEA and controls. Gastroschisis in the absence of amniotic fluid has not been as damaging to the fetal intestine as "natural" intraamniotic gastroschisis.

Abdominal Muscles

[Otological assessment in patients operated on for cleft palate].

Tympanometry and otoscopy has been carried out to determine the presence of middle ear disease on patients with cleft palate and the influence of corrective surgery. This explorations have been evaluated preoperatively and at one and six months postoperative follow-up. There is a high incidence of otitis media with effusion in patients with cleft palate, almost 60 per 100 in our study. The influence of cleft palate surgery repair has not revealed as a mayor factor on its resolution, although a visible benefit has been observed in the long term controls. We recommend a otorhinolaryngological follow-up in these patients.

Acoustic Impedance Tests

Nurses' practice of breast cancer screening and early detection: results of a pilot survey.

Nursing has a professional responsibility to participate in cancer screening and early detection. Nurses represent the largest professional group in the health care workforce and are presently an underutilized potential resource for implementing breast cancer screening and early detection. Development of a reliable and valid instrument which could be used to evaluate the effectiveness of mechanisms designed to increase nursing's role in breast cancer screening and early detection is needed. The questionnaire tested in this pilot study represents an initial attempt at fulfilling this need. This questionnaire in its present form may be used to evaluate the results of intervention studies aimed at increasing nurses' practice of breast cancer screening and early detection. For example, the questionnaire could be used as an evaluation tool to examine the effectiveness of educational programs regarding breast cancer screening and early detection. It may also be used as an outcome measure to evaluate change in practice activities such as the effect on nursing practice of including questions on the nursing history and assessment form related to BSE, clinical breast exam and mammography. Results of nursing action in breast cancer screening and early detection could have a significant impact on the achievement of the NCI's year 2000 goal of a 30% reduction in breast cancer mortality.

Adult

[An experimental models in the evaluation of the effect of the amniotic fluid].

Fetal life develops in a fluid environment. Amniotic fluid is not inert. It contains proteins, hormones, fetal urine and electrolytes, known to interact with a variety of fetal processes such as wound healing, intestinal growth, etc. Interest in its study has been increasing recently. In order to determine the effect of amniotic fluid, intra-amniotic and extra-amniotic fetuses should be compared. We describe a model that allows isolation of a fetal portion from amniotic fluid. Sixty 23-day pregnant rabbits were operated on. Surgery was performed in two fetuses of each mother. One fetus was replaced into the amniotic sac; the other was sutured along its waist to the histerotomy orifice, leaving the caudal half of the fetus in an extra-amniotic position. The mothers continued their pregnancy and were sacrificed on day 30. Maternal survivance rate was 82 per 100. Twelve intra-amniotic fetuses (FIA) and nine extra-amniotic fetuses (FEA) were obtained, as well as 16 nonoperated littermates that served as controls. The average weight of FIA fetuses was 31 g, FEA fetuses weighed 37 g and controls 36 g. The difference was not statistically significant between any of the groups. This model allows the study of a variety of fetal conditions in the absence of amniotic fluid. The survivance rate of this technique of extrauterine fixation has been 75 per 100.

Amniotic Fluid

Effects of neonatal androgenization on the chromatofocusing pattern of anterior pituitary FSH in the female rat.

Anterior pituitary glands were removed from neonatally androgenized (100 micrograms testosterone propionate) female rats and normal controls at 5, 10, 18, 21, 30, 60 and 90 days of age, and the multiple forms of FSH present within them were separated by chromatofocusing (pH range 7.5-4.0). Additional pituitary glands from intact adult males (90 days old) were also studied for comparative purposes. All animal groups exhibited multiple forms of immunoactive FSH within a pH range of 7.5-4.0, as well as an additional FSH form obtained after the addition of 1.0 mol NaCl/l to the chromatofocusing column (salt peak). In animals 5-30 days old (controls and androgenized) the majority of FSH applied to the chromatofocusing columns was recovered within the salt peak (45-85% of total FSH immunoactivity recovered). However, as the animals aged, more FSH immunoactivity focused within less acidic regions (isoelectric point (pI) 5.9-5.0); pituitaries from animals 60 days old contained the greatest proportion of FSH focused within this pH range (controls, 39.2 +/- 0.6%; androgenized, 23.1 +/- 0.9% of total immunoactivity recovered; P less than 0.03 vs animals 30 days old for both experimental groups). This shift towards less acidic FSH was attenuated in androgenized animals compared with the controls (P less than 0.01). In control adult rats, the chromatofocusing distribution pattern of pituitary FSH varied according to the day of the oestrous cycle. Pituitary extracts from control rats decapitated during the morning of pro-oestrus, oestrus and day 1 of dioestrus exhibited the highest proportion of immunoactive FSH (23.2-28.8% of total) focused within a pH range of 5.9-5.0, whilst only 10.4-11.6% of FSH from androgenized rats and those on day 1 of dioestrus was recovered within this pH range (P less than 0.05). In control animals decapitated during the morning of pro-oestrus and oestrus, 10-26% of FSH focused within the most alkaline region (pI 7.5-6.0); the chromatofocusing pattern of pituitary FSH from the neonatally androgenized animals was characteristic, in that no more than one peak (1.5 +/- 0.5% of total) was detected in this alkaline region. In the adult male rats, the majority of pituitary FSH eluted from the chromatofocusing columns within a pH of 4.9-4.0 (52.4 +/- 1.2% of total FSH immunoactivity) and the salt peak (pH less than 4.0) (33.1 +/- 2.4 of total). All FSH isoforms obtained after chromatofocusing represented alpha and beta dimers as disclosed by size exclusion chromatography.(ABSTRACT TRUNCATED AT 400 WORDS)

Animals

[Fiber colonoscopy in children under 18. Our experience with 112 patients studied in the digestive endoscopy section of a general hospital].

The aim of the study was to evaluate the indications of colonoscopy, diagnostic accuracy and efficacy treatment of procedure in young patients aged less than eighteen years using standard forward colonoscopes Olympus CF LB2, CF LBw and CF HL20. Among 5,400 procedures done along eleven years, 112 (2.07 per 100) were performed in patients aged less than eighteen years, 37.6 per 100 of which were performed in children under ten years. In this group general anaesthesia was employed without complications. The most frequent indication of colonoscopy in young patients was rectal bleeding (62.5 per 100). Related to the frequency, in this series, the control of graft versus host disease in patients submitted to bone marrow transplantation was the second indication (11 per 100), followed by the study of chronic anaemia (4.2 per 100) and control of the chronic inflammatory bowel disease (4.2 per 100). Diagnostic accuracy reached 93.75 per 100. In 6 per 100 of the cases the exploration were considered unsatisfactory because inadequate cleaning of the colon. The most frequent diagnostic was "normal colon" (29.6 per 100 of the cases). Polyp was found in 21.2 per 100 of the cases. Polypectomy was performed in all indicated cases. One patient with multiple polyposis were submitted to surgery. Colonoscopy reached the right colon in 25.4 per 100 of the cases. In 54 per 100 of the procedures reached splenic angle and in 83.8 per 100 of the cases, all sigmoid colon was explored. From this experience we suggests that colonoscopy, using standard endoscopes, is a very useful diagnostic and therapeutic technique in child and in young people.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent

Lacrimal gland prolapse in craniosynostosis syndromes and poor function congenital ptosis.

Lacrimal gland prolapse is an important, though uncommon, feature found in craniofacial abnormalities as well as in cases of poor function congenital ptosis. It occurs secondary to a number of conditions, including increased posterior pressure secondary to decreased orbital volume; also, supportive structures of the gland often may be weak in conjunction with a poor function ptosis or as a result of trauma at the time of major reconstruction. Recognition of the prolapsed gland and its replacement into the lacrimal gland fossa in craniosynostosis syndromes, as well as in cases of poor function congenital ptosis in general, allows the temporal eyelid to approach a more normal position, yielding an improved functional and cosmetic result.

Blepharoptosis

[Biochemical profile of primary hyperparathyroidism. Comparative study with hypercalciuric renal lithiasis].

Primary hyperparathyroidism (PH) is now considered a common condition. Its frequency and the deleterious long-term effects of hypercalcemia make a correct diagnosis mandatory. We attempted to evaluate the usefulness of the indexes of parathyroid function and hormone measurements more commonly used in the diagnosis of PH. To this end we studied 64 patients, distributed in three groups: group with PH, group with hypercalciuric renal lithiasis (HRL) and control group (CG). The results were evaluated with a test of comparison of means and a stepwise discriminating regression analysis. The 8 most useful measurements to differentiate PH from HRL and CG were serum calcium, corrected serum calcium, serum phosphorus, fasting calcium excretion (FCE), maximal tubular calcium reabsorption (MTCR), maximal tubular phosphate reabsorption (MTPR), osteocalcin, PTH half molecule (PTH-HM) and 1,25-dihydroxyvitamin D. The 3-variable and 4-variable groups with a highest discriminating ability were: serum calcium, FCE and PTH-HM, and serum calcium, FCE, PTH-HM and MTPR. We think that the measurement of these four variables is the most adequate strategy for the diagnosis of PH.

Adult

Adrenocortical tumors in childhood: a report of four cases.

In the last 10 years, four children with adrenocortical tumors were treated in our hospital. Three of them had symptoms of adrenogenital virilizing syndrome, and another, nonfunctional, was found during a routine examination. A diagnosis of adrenocortical tumor was established given the symptoms, hormonal tests, and radiologic studies. Two of the tumors were located in the left side, and the histologic diagnosis was pleomorphic cortical adenoma; the ones that affected the right side were adenocarcinomas. All the patients were treated by surgery and none received chemotherapy. At both presurgical and postsurgical stages, the patients were treated with cortisol. All four children have had a favorable course, with normal growth and the disappearance of public hair and hirsutism; however, macrogenitals still persist.

Adenoma

Agenesis of the trachea.

We report a case of agenesis of the trachea type III of Floyd that survived for 2 days with an esophageal intubation. Surgical treatment consisted of a distal esophageal binding, cervical esophagostomy in double-barrelled shotgun, and gastrostomy. Death occurred on the third day after surgery.

Esophagostomy

Segmental dilatation of the duodenum.

In this article two cases of idiopathic duodenal dilation are described. These cases meet the present criteria for segmental dilations of the intestine. The onset of the clinical features was acute in one case and chronic in the other. However, the radiological images were similar in both cases and provided the diagnosis. Surgical treatment consisted of duodenal resection and tapering and was curative in one case. The other patient died shortly after surgery. The duodenal specimens showed normal three-layer duodenal architecture in the pathology study. The intramural nervous plexi were unimpaired. Angiodysplasia was found in one case. Vascular abnormalities were also found in 10 other segmentary intestinal dilatations reported in the literature. The surgical implications of this new localization of segmentary intestinal dilatation are analyzed.

Dilatation, Pathologic

Treatment of an enteric fistula with somatostatin in a premature.

The authors present the case of an extremely premature baby affected by severe Necrotizing Enterocolitis (NEC) needing intestinal resection and ileostomy. An enteric fistula developed 3 days after ostomy closure. The baby was started on Total Parenteral Nutrition (TPN), and 7 days later the fistula output remained constant. Somatostatin (SM) was then given intravenously (3.0 micrograms/Kg/hr) and the fistula closed on the 3rd day of treatment. Since SM was introduced in 1986 as an adjunct treatment to TPN in enteric fistulas, the authors believe that theirs is the first report of a successful SM treatment in a premature.

Enterocolitis, Pseudomembranous

[Usefulness and indications for Port-a-Cath in children with acute leukemia].

Duration of treatment for acute leukemia is as long as 2 years. During this time, venous punctures are repeated every few days. The Port-a-Cath system allows a long-lasting but intermittent venous access. Since March 1987, 11 Port-a-Cath systems have been implanted in 11 children (age 3 to 14) with the diagnosis of high risk acute leukemia (9 ALL and 2 AML). The facial vein has been used in five instances, the external jugular vein in five, and the jugular vein in one case. Ten systems have had a good function. Seven are still in use, and the duration ranges from 450 to 47 days. Two children died because of their disease, their catheters still functioning. Two systems have been withdrawn, one for incorrected location and the other for cutaneous necrosis of the puncture site. Two more children developed reversible thrombosis. The Port-a-Cath system is useful in children affected by high risk acute leukemia, ameliorating their life quality and avoiding the need for repeated vein punctures.

Acute Disease

[Villous adenoma: clinical, endoscopic and histopathologic aspects].

A ten years retrospective study of villous adenomas at the Arzobispo Loayza Hospital was carried out. 24 patients with this problem were found, the mean age was 62 years, clinical symptoms were: rectal bleeding (87.5%), mucus diarrhea (58.2%) and abdominal pain (37.5%). According to the Histopathologic study, there were 14 (58%) adenomas with carcinoma and the existence of carcinoma was proportional to the adenoma's size, we didn't find carcinoma in the adenomas smaller than 2 cm. The endoscopy was useful to detect invasive carcinoma in the 88% of cases meanwhile the endoscopic biopsy detected only 27% of cases. The endoscopic polipectomy was suitable when the adenomas were smaller than 3 cm.

Adenoma