Biomedical subjects
M Montes
Publications and source records attributed to M Montes.
Non-Hodgkin's lymphoma after chemotherapy for Hodgkin's disease.
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Large volume freezing in experimental hepatic cryosurgery. Avoidance of bleeding in hepatic freezing by an improvement in the technique.
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The use of steroids as a potentiator of hypothermic myocardial preservation in man.
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Coronary venous hypertension: a potentiator of myocardial ischemic injury.
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Freezing the canine thoracic aorta in situ.
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Benign prostatic hyperplasia in an XX man.
A sixty-nine-year-old white phenotypic male who was being investigated for a myeloproliferative disorder, was found to have an XX karyotype in all cells examined in bone marrow, lymphocytes, and skin fibroblast cultures. Despite essentially no testosterone in the plasma, he also suffered from severe prostatic hyperplasia, a finding not reported previously in patients with this genotype. While endocrine studies showed normal follicle-stimulating hormone, the luteinizing hormone level was twice the upper limit of normal and estrogens were in the normal female range. Except for complete absence of Leydig cells, testicular histology resembled that usually found in Klinefelter syndrome. The patient died of the combined effects of the myeloproliferative disease and urinary tract obstruction. The mechanism of occurrence of the sex chromosome anomaly as well as the cause and implication of the unusual finding of prostatic hyperplasia are discussed.
Derivation and determination of a human prostatic epithelial index.
The approximate percentage of epithelium (Iepith) in a sample of human prostate tissue can be estimated by assaying the specific activity of epithelial marker enzymes, beta-glucuronidase or arginase. There is a good correlation between epithelial density and beta-glucuronidase activity per unit of tissue protein.
Ultrastructure of cerebellar hemangioblastoma.
Light and ultrastructural features of a cerebellar hemangioblastoma in a 56-year-old man are described in detail. The neoplasm was composed of three major cell types: endothelial cells, pericytes, and stromal cells. The endothelial cells lined the fenestrated vascular channels. The pericytes were ensheathed by their own basal lamina which separated them from the basal lamina covering the endothelium. The stromal cells contained, in addition to the conventional organelles, numerous membrane-bound lipid inclusions, annulate lamellae, and nuclear bodies. There were also present transitional cells which shared the fine structure of all the three major cell types. Histogenetically, the tumor was considered to be of vascular origin. The stromal cells represented the stem cells which, under the neoplastic influence, continued to proliferate and differentiate into "vasoformative" elements (pericytes and endothelium) which formed new blood vessels. The transitional forms between the stromal cells and the "vasoformative" elements suggested that the cellular components of a hemangioblastoma shared a common ancestry, most likely of an angioblastic lineage.
Histology of human tubulo-interstitial nephritis associated with antibodies to renal basement membranes.
Twenty-seven patients with diffuse "crescentic" glomerulonephritis (CSGN) were identified in 1,174 renal biopsies from nephritic patients. Patients were assigned to three groups on the basis of the immunofluorescent study of renal biopsy specimens and serologic findings. Group I included eight patients with antibodies to glomerular (anti-GBM) and tubular (anti-TBM) basement membranes; group II had eight patients with only anti-GBM antibodies; and group III had eleven patients with CSGN unassociated with antibodies to either GBM or TBM. Patients with anti-GBM/anti-TBM antibodies (group I) had severe tubulointerstitial (TI) nephritis, as characterized by the infiltration of polymorphonuclear leukocytes and macrophages along the TBM and peritubular vessels. In some patients, focal proliferation of epithelial cells of proximal convoluted tubules (PCT), gaps or extensive destruction of TBM, lesions in the walls of small peritubular vessels, and interstitial giant cells were also observed. Patients with anti-GBM antibodies (group II) had mild to moderate interstitial cellular infiltration and mild tubular changes. Five patients with CSGN not associated with antibodies to renal basement membranes (group III) had mild to moderate interstitial cellular infiltration and tubular changes. A sixth patient, with Wegener's disease had severe granulomatous TI lesions. The results of this study show that TI nephritis is most frequent and severe with anti-TBM antibodies are demonstrable and suggest that anti-TBM antibodies contribute to the development of TI lesions.
Endocarditis in hemodialysis patients with systemic disease.
The presence of systemic disease may further increase the risk of bacterial endocarditis in the patient on chronic hemodialysis. Three patients are described; one with primary amyloidosis, a second with insulin dependent diabetes mellitus, and a third with heroin nephropathy who developed S.B.E. While the presence of the uremic state may hinder the recognition of endocarditis, the development of transient neurologic deficits, recent access infections and recurrent bacteremic episodes should be looked for as early clues to the diagnosis in this patient population.
Does potassium potentiate profound hypothermic cardioplegia for myocardial preservation?
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Experimental hepatic cryosurgery.
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Comparison of myocardial preservation techniques for aortocoronary bypass surgery.
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Clara cell adenocarcinoma. Light and electron microscope studies.
A 52-year-old black man was found to have a round density in the right lower lung field. An exploratory thoracotomy disclosed a tumor in the right middle lobe, which by light microscopy was composed of malignant Clara cells. The electron microscopic studies confirmed the Clara cell nature of this neoplasm.
Lymphoid interstitial pneumonia.
A 19-year-old man presented with dyspnea, cough and chest pains; he also complained of nausea, anorexia and postprandial vomiting and reported a 10-kg weight loss. Generalized lymphadenopathy and some rales over both lung bases were noted and a chest radiograph showed bilateral nodular lesions. Persistent leukocytosis, thrombocytosis, proteinuria and anergy to a series of natural antigens were found. The diagnosis of lymphoid interstitial pneumonia was made from material obtained at open lung biopsy. Rapid but incomplete clearing of the lung lesions resulted from steroid therapy; the other abnormalities were corrected gradually, except for the proteinuria, which persisted. The clinical improvement and the ability to work and play have been maintained for the past 20 months.
Selective intracavitary and coronary hypothermic cardioplegia for myocardial preservation.Clinical, physiologic, and ultrastructural evaluation.
Intraoperative myocardial protection was evaluated in two groups of patients undergoing coronary surgery in whom different techniques for cardiac arrest were utilized. In group A, profound selective myocardial hypothermic (15 to 18 C) arrest was achieved by perfusing a coolant (7 to 10 C) into the left ventricular cavity and the coronary circulation. The average anoxic arrest time was 82.5 +/- 27 minutes. In group B, ventricular fibrillation and moderate hypothermia were used. Group A patients showed rapid physiologic recovery, low average myocardial creatinine phosphokinase (MB-CK) isoenzyme levels (7.8 IU) , and a well-preserved myocardial ultrastructure. In group B, three patients showed abnormal physiologic recovery; six patients needed postoperative inotropic support; and in seven patients, electron-microscopy revealed irreversible focal changes. The average MB-CK isoenzyme level was 85.6 IU. Analysis of our data demonstrates that when myocardial protection during coronary bypass grafting is achieved by selective profound intracavitary and coronary cooling, there is physiological, ultrastructural, and biochemical evidence of less intraoperative myocardial damage than when ventricular fibrillation is applied.