Biomedical subjects
Publications and source records attributed to L Puig.
In this article 8 patients with ectopic features due to skin or prostatic deposition of ova of different schistosomal species are reported. The clinical, pathological and radiological features of these lesions are described. It is to be remarked that 7 patients had traveled to Mali and had bathed in the Bandiagara District, which is included in several tourist routes such as "Travel to Dogon country".
We evaluated the metabolism of exogenous arachidonic acid in polymorphonuclear leukocytes from psoriatic patients in comparison with those from normal subjects. The leukocytes were incubated with 10 microM labelled arachidonic acid and 5 microM A23187 for varying periods of time. We evaluated all the compounds derived from the 5-lipoxygenase activity, including the products of non-enzymatic transformation of leukotriene A4 and w-oxidized leukotriene B4. In the experimental conditions used, there was no significant difference in the formation of any compound at any time of incubation. These results indicate that there is no intrinsic alteration either in 5-lipoxygenase activity or in w-oxidation ability of circulating polymorphonuclear leukocytes in psoriatic patients.
Two cases of a hitherto undescribed special variant of dermatofibroma are reported. A man and a woman, aged 57 and 52 years, respectively, had slowly growing cutaneous tumors on the lower extremities. The tumors were exophytic and polypoid, 10 and 6 cm in maximal diameters, respectively; they were covered by rough nonulcerated skin and were joined by a short pedicle to an indurated base. Histologic examination showed some features of an otherwise conventional dermatofibroma, whereas the polypoid component was hypercellular and showed striking atypia and scattered mitotic figures. After 32 and 28 months' follow-up, the lesions did not recur after surgical excision. We suggest the term atypical polypoid dermatofibroma to summarize the special clinicopathologic features of these tumors.
The aim of the present study was to ascertain the relationship between in vitro hyper-aggregability and alterations in arachidonic acid metabolism in platelets from psoriatic patients. We have studied the response to several concentrations of ADP, collagen, and arachidonic acid of intact platelets from psoriatic patients and normal subjects, with and without irreversible inhibition of platelet cyclooxygenase by aspirin. Apparent kinetic constants (apparent Michaelis constant [Km] and apparent maximum velocity [Vmax]) of cyclooxygenase in platelets from both controls and psoriatic patients were also studied. The maximum percentage and slope of aggregation induced by collagen or sodium arachidonate were significantly greater (p less than 0.05) in platelets from psoriasis patients, whereas lag time was significantly shorter in the psoriasis group in response to arachidonic acid only when compared to controls. Cyclooxygenase pathway blockade inhibited the response to aggregation inducers in the following order: sodium arachidonate greater than collagen greater than ADP. When platelets were pre-treated with aspirin no significant differences were observed between controls and psoriasis patients. We also found a significant increase of the apparent Vmax value (p less than 0.05) for cyclooxygenase activity in platelets from psoriatic patients in comparison with controls. Our results indicate that platelet hyperaggregation in psoriatic patients is related to enhanced cyclooxygenase activity in their platelets.
The Labcor-Santiago pericardial valve has been designed to minimize mechanical stress and to avoid abrasion wear, at the same time preserving the concept of mounting the pericardium outside the posts for full orifice opening. The new design has preserved the traditional superior hemodynamic performance of pericardial valves, avoiding abrasion by careful padding of the stents and introducing a new concept of cusp attachment in order to increase mechanical durability. Since June 1990, 40 patients received 46 Labcor-Santiago valves: 29 in the aortic position and 17 in the mitral position. Mean age was 65.6 years. Eighty percent of the patients were women. New York Heart Association Functional Class III-IV was present in 76% of patients. Hospital mortality has been 12.5%, with 31% undergoing concomitant procedures. No anticoagulation was administered and there has been one thromboembolic event. Echo-Doppler assessment yielded the following in the aortic position: effective orifice area for 19-mm size = 1 cm2; for 21-mm size = 1.2 cm2. Mean systolic gradient for 19-mm size = 14.7 mmHg; for 21-mm size = 11.2 mmHg. In the mitral position: effective orifice area for 27-mm size = 2 cm2; for 29-mm size = 2.3 cm2. Mean diastolic gradients for 27-mm size = 4.6 mmHg; for 29-mm size = 3.3 mmHg. The low-profile flexible stent, the streamlined shape without outside prosthetic material, and the anatomical sewing rim allow a comfortable implantation of the Labcor-Santiago valve, particularly in the small aortic annulus. It is hoped that this new design will contribute to an increase in in vivo mechanical durability.
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We present in this paper our experience in the routine use of an automatic reader for microtiter plates (IBG Systems). A total of 2044 samples from blood donors have been tested for ABO (haematic and seric) and Rh (D antigen) blood group typing. The red blood cell samples have been tested against monoclonal anti-A, anti-B, anti-AB and anti-Rh 1 (D) sera (using two different anti-D reagents). As a negative control, 3% albumin solution was employed. In order to determine the seric groups, the plasma samples were tested against A1, A2, B and 0 cells. In all cases the red cells were suspended in Ficoll 400R-Methyl cellulose (FMC), and 0.01 Bromelin was added to red blood cell samples to be typed. The obstacles in the automatic readings were mainly solved by visual reading of the microplates. In the 2,044 samples analysed with the automatic reader, 19 discrepancies (0.94%) were found in ABO typing. In all cases the error was in the seric blood group. Three false positive reactions were found with 0 red cells. Two false negative with B red cells, interpreted by the automatic reader as doubtful results. Three positive readings were detected, in one case the positivity was due to alloantibodies (C + D specificities), the other two cases were autoagglutinations. False negative reactions were found, in 11 cases, 8 of them due to lipaemia and the remaining three were haemolysed plasma samples. It should be stressed that out of 19 cases of discrepancy, only 5 (0.24%) were due to the automatic reader while the remaining were due, to sample troubles.(ABSTRACT TRUNCATED AT 250 WORDS)
The response to intensive plasmapheresis was evaluated in 13 patients (7 males, 6 females; median age 28 years) with microangiopathic thrombotic syndromes (MTS) who were treated at our center during the last 10 years. The most common initial clinical features were anemia, hemorrhage and neurologic abnormalities. Twelve patients had severe thrombocytopenia and 8 had renal failure. Fourteen plasmapheresis courses were carried out to treat 13 initial episodes and one relapse. The mean volumes of removed plasma and fresh frozen plasma infused at each exchange were 57 ml/kg and 41.7 ml/kg, respectively. Eight patients received antiplatelet drugs and/or corticosteroids. After a mean number of 10.6 exchanges per patient and course, complete remission (CR) was achieved in 7 cases (6 initial episodes and one relapse) and a partial response in 3. Four patients did not respond to therapy and died from progression of the disease. The early institution of plasmapheresis and the rapidity to respond were the only factors significantly associated with the achievement of CR.
We report a 42-year-old white bisexual man with disseminated Kaposi's sarcoma limited to the skin and gastrointestinal tract. Results of several serum tests for human immunodeficiency virus (HIV) antibodies have been negative. The CD4/CD8 ratio has remained normal, and his Kaposi's sarcoma has had a benign clinical course during 30 months of follow-up. Similar reports of disseminated Kaposi's sarcoma with a benign clinical course in homosexual or bisexual men without demonstrable HIV infection are reviewed. Some cellular immune impairment that might be more prevalent in the homosexual population may be implicated in the pathogenesis of this type of Kaposi's sarcoma.
Several reports have been published on platelet hyperaggregation in psoriatic patients, which might be related to alterations in arachidonic acid (AA) metabolism by platelets. We have studied the AA metabolism pattern, total eicosanoid formation and biosynthesis rate in platelet from psoriatic patients and from normal subjects after incubation with exogenous AA. We have found no difference in the metabolic pattern of platelets. Total formation of 12-HETE was higher in the control group (p less than 0.01). The rate of synthesis of cyclooxygenase products was higher in the psoriatic group, but only that of thromboxane B2 was statistically significant (p less than 0.02). There was a close correlation between thromboxane B2 formation rate and the lag time of platelet aggregation in response to 1 mM AA (p less than 0.01). The percentage of aggregation of platelets from psoriatics was significantly higher than that from normal subjects (p less than 0.05) and the lag time was lower in psoriatic group, but the difference was not statistically significant.
A potential therapeutic role of minoxidil in fibrotic or sclerotic conditions, such as keloids, has been suggested on the basis of its reported ability to inhibit the proliferation of human dermal fibroblasts. We have studied the effect of minoxidil on 3H-deoxythymidine uptake in cultures of human dermal fibroblasts derived from lesional and non-lesional skin from patients with keloids. The effect of the addition of fetal bovine serum, plasma and growth factors (insulin, EGF, PDGF, FGF and beta-TGF) to the medium has also been studied. Minoxidil, at concentrations ranging from 500 to 1,000 microM., caused an increase in DNA synthesis, which was proportional to the initial degree of fibroblast activation. Concentrations higher than 1,000 microM. caused a cytotoxic effect. Some reservations arise on the potential therapeutic use of minoxidil in conditions characterized by increased fibroblast proliferation, given the narrow margin between activation of DNA synthesis and cytotoxicity we have found in our experimental model.
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The concept of acute febrile neutrophilic dermatosis (Sweet's syndrome) has evolved and expanded to include, under the denomination of neutrophilic dermatosis (ND), both pyoderma gangrenosum and the intestinal bypass syndrome, with or without intestinal bypass, vesicular and pustular rash associated with ulcerative colitis (UC), and Sweet's syndrome itself. Among the skin lesions associated with UC several types of vesicular and pustular rash have been reported and, very rarely, the association of UC and Sweet's syndrome has been reported. We report a female with UC who developed a vesicular and pustular rash associated with an exacerbation of her colonic disease. Two years later she developed a characteristic Sweet's syndrome coincident with another exacerbation of UC. The concurrence of two different forms of ND associated with successive exacerbations of UC supports the concept of ND as an individual condition with several types of clinical presentation.
Lonapalene was studied as a topical antipsoriatic agent on the basis of its inhibitory effect on 5-lipoxygenase. We studied the effect of lonapalene on the metabolism of exogenous arachidonic acid in washed platelet suspensions by RP-HPLC. Lonapalene was shown to inhibit platelet cyclooxygenase, with substrate diversion towards 12-HETE production. The pattern of inhibition was similar to that of indometacin, although lonapalene was about 1,000 times weaker. The dual inhibition of lonapalene and concomitant deviation of arachidonic acid metabolism may have potential implications, with regard to therapeutic indications and side effects, which deserve further study.
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Increased levels of eicosanoids in lesions of psoriasis suggest activation of arachidonic acid metabolism in different cell types play a physiopathologic role. The contribution of each cell type present in psoriasis has been the subject of some controversy, which has led us to study the metabolism of arachidonic acid in human epidermal cells suspensions. 12-HETE was found to be the main product, followed by PGE2 and PGF2 alpha; no 5-lypoxygenase products were found. Thus epidermal cell contribution to LTB4 levels present in plaques of psoriasis appears to be irrelevant. Conversely, increased levels of 12-HETE probably do result from arachidonic acid metabolism by epidermal cells.
Two patients showed symmetrical sclerodermoid (morphea-like) skin lesions at sites of intramuscular phytonadione (vitamin K1) injections. The lesions appeared one and two years after the injections. A dense sclerosis involving the reticular dermis and subcutaneous fat was observed on histologic examination of biopsy specimens. Local adverse reactions to phytonadione are reviewed. Possible causative mechanisms for phytonadione-induced pseudoscleroderma are discussed.