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Biomedical subjects

M Gonzales

Publications and source records attributed to M Gonzales.

At least 73 records · Page 4Linked to original sources
PubMed1988

Interstitial gold and external beam irradiation for prostate cancer.

We treated 65 patients with prostatic cancer confined clinically to the prostate or periprostatic area during an 8-year period. Seven patients had stage A2, 38 stage B and 20 stage C disease. All 65 patients underwent staging pelvic lymphadenectomy and implantation of gold grains into the prostate (mean dose 3,167 rad). A total of 64 patients then completed a course of external beam irradiation to a mean total tumor dose of 6,965 rad. Complications of therapy were mild and limited (less than 3 months in duration) in most patients, and they included radiation cystitis (32 per cent), diarrhea (31 per cent), extremity lymphedema (7.7 per cent) and wound infection (3 per cent). Two patients suffered urinary incontinence after therapy and 2 (3 per cent) had diarrhea more than 3 months in duration. The actuarial 5-year survival rate for all patients was 87 per cent and the 5-year survival free of disease was 72 per cent.

Actuarial Analysis↗
PubMed1988

DDD pacemakers maximize hemodynamic benefits and minimize complications for most patients.

A 44-month retrospective analysis was performed on 666 pacemakers implanted at Mt. Sinai Medical Center. Mapping techniques and endocardial waveform analyses were used during lead positioning to ensure the best electrical environment. The optimal pacing lead type was selected based on the clinical situation. Follow-up evaluations were rigorous. Patient population ranged in age from 28 to 103 with a mean of 78 years at time of implant. Seventy percent of the patients received DDD pacemakers with an 81% survival incidence at 44 months. Of the VVI population (30% of the implants), there was a 62% survival incidence. Most problems associated with the pacing systems were related to the atrial channel. Loss of atrial sensing occurred in 7.5% of the population and was corrected noninvasively in 5.8%. Due to chronic loss of atrial sensing, 1.7% of the population remained programmed to DVI/VVI. A total of 7.7% were chronically reprogrammed from DDD to VVI, 5.6% secondary to atrial fibrillation. Reoperations were necessary in 1.2% of the malfunctioning systems that could not be corrected by reprogramming. The following conclusions were reached: (1) maximizing hemodynamic benefits and minimizing pacemaker complications permitted a survival rate equal to or better than that of the general population, and (2) chronic problems related to the atrial lead and malfunctions of the pacing system were minimized by careful patient selection, appropriate pacemaker and lead selection, endocardial waveform analysis, and thorough follow-up.

Adult↗
PubMed1988

Treatment of oligodendrogliomas with or without postoperative irradiation.

The authors have reviewed the treatment results in 42 patients with intracranial oligodendroglioma treated from 1940 through 1983 at the University of California, San Francisco. Two patients who died postoperatively were excluded from analysis. Eleven patients had mixed tumors, with a minor astrocytic component. The overall survival rates for the 29 patients with pure oligodendroglioma were 61% and 33% at 5 and 10 years, respectively; these rates for the 11 patients with mixed tumors were 57% and 38% at 5 and 10 years, respectively. The 10-year survival rate for 14 patients with pure oligodendroglioma who received greater than 45 Gy irradiation was 56% versus 18% for 11 patients who did not receive postoperative irradiation (p = 0.09). Nine patients with mixed tumor who received more than 45 Gy postoperatively had survival rates similar to those for the 14 patients with pure tumors irradiated with more than 45 Gy (p = 0.89). All patients who died of their tumor had evidence of intracranial recurrence. One patient, who did not receive initial postoperative irradiation, also had clinical and myelographic evidence of spinal seeding. All five patients examined postmortem had tumor recurrence at the primary site; one patient also had intraventricular seeding. Six of the 10 patients with pure oligodendroglioma who had a repeat biopsy at the time of tumor recurrence or at postmortem examination showed histological progression to an anaplastic astrocytoma or glioblastoma multiforme. Based on this study, adult patients with pure or mixed oligodendroglioma currently are treated with partial-brain irradiation to a dose of about 60 Gy. In general, children are treated with partial-brain irradiation to about 50 Gy.

Adolescent↗
PubMed1988

[Evaluation of the status of access to emergency care of subjects with myocardial infarction].

This study, undertaken in the Bas-Rhin area of France by the MONICA Register, presents the evaluation of the procedures followed for 323 subjects under 65 years old suffering from an acute myocardial infarction and subsequently hospitalized for this reason. We observe that 87.5% of the patients first consult a private practitioner -- for the most part a non specialist -- while 9% first contact a mobile coronary unit. 3.5% of patients go directly to hospital. Concerning delays in hospitalization, 35% of patients more than 6 hours to consult a doctor, while the median time between the onset of symptoms and the first call for medical aid is 2 hours. The median delay between the onset of symptoms and arrival at hospital is 5hrs 45 min., 28% of the subjects requiring more than 24 hours to be hospitalized.

Acute Disease↗
PubMed1987

Cardiovascular abnormalities in thoracopagus twins: embryological interpretation and review.

The cardiovascular abnormalities of two sets of thoracopagus twins with conjoined heart and liver are described and compared with 27 well documented cases. An embryological interpretation of the cardiovascular abnormalities is suggested. The common heart in both sets showed a common atrium and two ventricles. In case 1 the great arteries were L. malposed in twin A. In case 2 the great arteries originated from their respective double outlet single ventricle. The systemic and pulmonary veins drained directly into the common atrium in case 1 and indirectly via systemic veins in case 2. The type of cardiovascular abnormalities are complex and discordent from one set to another and in the same set. However among 27 published cases of thoracopagus twins, cardiac union, including atrial union with separate ventricles, or atrial and ventricular union, was encountered in 16 cases. Approximately 90% of them are not suitable for surgical separation because of the high degree of cardiac union and the complexity of cardiovascular abnormalities. Surgical separation could be attempted in only two cases, but at the cost of the life of one of the twins.

Aorta↗
PubMed1987

Pachymeningitis cervicalis hypertrophica. Case report.

The authors present the case of a 25-year-old man with idiopathic pachymeningitis hypertrophica that caused cervical radiculopathy. Decompressive surgery produced significant neurological improvement. The etiology and management of the condition are discussed and the literature is reviewed.

Adult↗
PubMed1986

VIP and histamine H2 receptor activity in human fetal gastric glands.

Vasoactive intestinal peptide (VIP, EC50 = 6.4 X 10(-10)M) and histamine (EC50 = 3 X 10(-6)M) activated the cyclic AMP generating system in gastric glands isolated from two human fetuses at 23 weeks gestation. Histamine antagonism by the H2 receptor blockers cimetidine (Ki = 0.35 X 10(-6)M) and ranitidine (ki = 0.51 X 10(-7)M) clearly characterized the histaminic activation as being of the H2 type. It is suggested that these two vasoactive hormones may operate as neurocrine/paracrine regulators of the differentiation and/or function of the human gastric mucosa in utero.

Cimetidine↗
PubMed1986

Sexual and marital relationships after radiotherapy for seminoma.

Questionnaires on sexual function, marital status, and fertility were returned by 84 men who received radiotherapy for seminoma (Stage I, II, or III). The mean length of follow-up was ten years. Although 93 per cent were married, 19 per cent had low rates of sexual activity, 12 per cent reported low sexual desire, 15 per cent had erectile dysfunction, 10 per cent had difficulty reaching orgasm, and 14 per cent had premature ejaculation. The most common problems were reduced intensity of orgasm (33%) and reduced semen volume (49%). Twenty-one men remained childless, and 30 per cent of men worried at least occasionally about infertility. Thirteen children were conceived after cancer therapy. The data suggest that sexual dysfunction and infertility are important concerns for a subgroup of men treated for seminoma.

Adult↗
PubMed1986

Pacemaker clinic evaluations: key to early identification of surgical problems.

The pacemaker center evaluation was responsible for the timely reoperation of 341 pacemaker patients over the last three years. The most common indication for reoperation was battery end-of-service (46.3%). Battery testing and maintenance of accurate records for trend analysis ensures prompt generator replacement. Atrial and/or ventricular lead malfunction was the second largest indication (26.3%). Lead malfunction detected by bracketing capture and sensing thresholds included: dislodgement, penetration, exit block, fracture, insulation failure, and abnormal sensing. The third largest indication for reoperation was pacemaker pocket erosion and/or infection (15.5%). Examination of the pacemaker pocket site is an integral part of an evaluation. In conclusion, the three largest indications for reoperations can be best demonstrated in a pacemaker center where evaluations are personal and thorough, and accurate record keeping is maintained.

Adult↗
PubMed1981

Anatomy of the lamina cribrosa in human eyes.

Light microscopy of specimens of human eyes cut in cross section at the level of the lamina cribrosa showed variation in structural anatomy, as demonstrated previously in certain primate eyes. Connective tissue and glial cell structural elements were greater in nasal-temporal as compared with inferior and superior quadrants of the disc. This regional variation suggests a hypothesis for the specificity of early patterns of optic nerve dysfunction characteristic of glaucomatous optic neuropathy. In glaucomatous eyes, nerve head regions with relatively less structural tissue elements may yield early to detrimental effects of persistent pressure elevation.

Connective Tissue Cells↗
PubMed1980

Size and weight study of human kidney growth velocity during the last three months of pregnancy.

Increase in kidney size and weight was studied in 392 kidneys from 196 dead pre- and full-term infants. The kidneys, whose three main dimensions were measured with Vernier calipers, were rigorously chosen: premature infants from pathological pregnancies or born with developmental defects and stillbirths were excluded from this study. All the kidneys used were normal. The three-dimensional reference curves for kidney growth as a function of size, weight and age of the fetus had not been established before, and should allow a better quantification of anomalies of renal development.

Birth Weight↗
PubMed1978

Reproductive factors and risk for breast cancer in Iceland.

A previous publication has shown that there has been a great increase in the incidence of breast cancer in Iceland. The present study was undertaken to evaluate the importance of known risk factors connected with the reroductive history of the women. In a prospective investigation of a cohort of 31,453 women we confirmed previous findings of the increased risk following higher age at first pregnancy and for nulliparous women. The age at first pregnancy and the proportion of nulliparous women have decreased with time in the Icelandic population so that these factors should have tended to decrease the risk, making the found increase still more important. The effect of parity is that the risk decreases with larger number of children and this effect is independent of the effect of age at first pregnancy. Lower age at menarche increases the breast cancer risk, but the contribution of that factor to the overall risk is negligible.

Adult↗