Biomedical subjects
M Sandoval
Publications and source records attributed to M Sandoval.
Umbilical reconstruction with secondary abdominoplasty.
Umbilical loss is not an uncommon problem following primary abdominoplasty done by an improperly trained surgeon who either sacrificed the umbilicus or lost it through postoperative complications. Deep psychological trauma with mental depression is often the result of such an amputation and is also the main concern of the patient seeking help. There are usually other secondary sequelae, such as residual cutaneous and musculoaponeurotic flaccidity, asymmetrical scarring with dog-ears at either extremity, and fatty bulges that may not bother the patient. In the past, umbilical reconstruction has been handled as an isolated procedure. We have tried to alleviate this condition along with the other residual deformities by doing complete secondary abdominoplasty. Along with the technical details of umbilical reconstruction, 2 such case reports with preoperative and postoperative results are presented.
[Development of an oral health day in a school community].
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[Relation between cervical smears and endometrial biopsy in proliferative lesions of the endometrium].
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Comparison of two assays (EIA and EITB) and two samples (saliva and serum) for the diagnosis of neurocysticercosis.
The enzyme immunoassay (EIA), standardized with a crude extract, and the enzyme-linked immunoelectrotransfer blot assay (ETIB) with glycoprotein antigens, were compared by using saliva and serum in the search for specific antibodies against Taenia solium larvae, for the diagnosis of neurocysticercosis. Saliva was slightly more sensitive in EIA (82.1%) than serum (74.1%). In EITB serum was far more sensitive (100%) than saliva (70.4%). The use of EITB with serum is thus an excellent choice for diagnosis of clinical cases of neurocysticercosis, while EIA using saliva represents a useful combination for diagnosis and, especially, epidemiology, because saliva is easily obtained by a painless and non-invasive procedure and the technique is simpler to perform. Furthermore, cross-reactivity of EIA with Echinococcus does not interfere in countries like Mexico where human hydatid disease is not present.
Inhibition of intra-abdominal adhesions: a comparison of hemaseel APR and cryoprecipitate fibrin glue.
Our previous studies demonstrated fibrin glue (FG) prepared from cryoprecipitate (cryo) inhibits intra-abdominal adhesions in rats. A new FG, Hemaseel APR, is Food and Drug Administration (FDA) approved for hemostasis during cardiac surgery and splenic trauma. This study was undertaken to determine if Hemaseel FG prevents intra-abdominal adhesions, and to compare it to cryo FG. Forty-five rats underwent laparotomy. Bilateral peritoneal-muscular defects were created. Polypropylene mesh was sewn into each defect with a running silk suture. The bowel was abraded with gauze. The rats were then randomized to mesh covered with Hemaseel FG, cryo FG, or control. On postoperative day 7, the severity of adhesions were graded by percentage of mesh covered by adhesion (0-100%) and degree of adhesion (0-3). The mean percentage of mesh covered by adhesion was 9% for Hemaseel FG, 43% for cryo FG (p = .005), and 65% for the controls (p < .0001). The mean density adhesion score was 0.5 for Hemaseel FG, 1.2 for cryo FG (p = .04), and 2.1 for the controls (p < .0001). In the Hemaseel FG group, 77% of patches had no adhesions, compared with 37% in the cryo FG group (p = .004) and 13% in the controls (p < .0001). Thus, Hemaseel FG significantly decreases intra-abdominal adhesions, and is more effective than cryo FG.
Localization by immunoelectron microscopy of Schistosoma mansoni antigens in the glomerulus of the hamster (Mesocricetus auratus) kidney.
Adult worm antigen (AWA) and soluble egg antigen (SEA) were localized ultrastructurally by immunoelectron microscopy using two monoclonal antibodies in the glomeruli of hamsters infected with Schistosoma mansoni cercariae or injected with S. mansoni eggs. AWA was detected in all cercaria-infected groups from the 30th day on and was present mainly in cytoplasm of mesangial cells, mesangial matrix, and glomerular basement membrane, either as isolated gold particles or in small electron-dense deposits of probable immune origin. AWA was encountered also on the inner side of the glomerular basal membrane, close to endothelial cells, and in the foot processes of the glomerular epithelial cells. SEA was detected at similar sites, apparently in lesser amounts, in uninfected hamsters inoculated with S. mansoni eggs into the jugular vein. Schistosomal antigens are apparently processed mainly bymesangial cells which are considered to be critical in the pathogenesis of S. mansoni associated glomerulopathy. Mesangioproliferative glomerulonephritis, immunoglobulin (IgG and IgM), and C3 deposits were observed in hamsters in which AWA and SEA were visualized. During early phases of the infection and in hamsters in which granulomatous pneumonitis was induced by S. mansoni eggs, glomeruli were unchanged or showed a slight mesangial proliferation. Our findings suggests that egg antigens also contribute to the pathogenesis of experimental glomerulopathy in the hamster.
[Paraneoplastic syndrome as a manifestation of cancer of the hypopharynx].
A 45-year-old male patient had a squamous-cell carcinoma of the laryngopharynx (T1pN2bM0). The first clinical manifestation was polyarthritis of large and small joints and a skin rash. The symptoms were identified as paraneoplastic syndrome associated with squamous-cell carcinoma of the laryngopharynx. After treatment (surgery + radiotherapy), the articular symptoms, initially treated with conventional therapy for rheumatoid arthritis, disappeared. Paraneoplastic syndrome can be defined as a set of physiological signs and symptoms of malignant origin that occur remote from the tumor. Squamous-cell carcinoma is the most frequent malignant tumor of the head and neck that produces paraneoplastic syndrome. We reviewed the most common features associated with malignant tumors and the pathogenic mechanisms involved. We conclude that paraneoplastic disorders can be markers of treatment response and predictors of recurrence.
[Mitral valve replacement in children and in adolescents. Surgical indication and long-term results in 86 cases].
1. The authors present 86 children and adolescents with rheumatic heart disease of the Pediatric Cardiology Service of the Instituto Nacional de Cardiologia who received valve replacements in the period between September, 1964 and April, 1973, a series which is more numerous and of longer follow-up than any published up to the present 2. In order to obtain comparable results, patients with mitral heart disease of other origen and aortic replacement as well as those subjected to double or triple exchange, were omitted from the study. 3. The symptomatology, the presence of compensated heart failure, the progression of cardiomegaly, the radiologic and electrocardiographic changes, the presence of atrial fibrillation, the mean venocapilary, pulmonary arter, and left right ventricle telediastolic pressures, the pulmonary resistence figures and the results of cineangiocardiography were the fundamental elements used to establish the surgical indication. 4. None were operated with clinic or laboratory data suggesting rheumatic activability. The shortest period between the last bout of rheumatic fever and surgery was 10 months. 5. The clinic improvement was remarkable. Half of the cases receiving digitalis and diuretics were released without this prescription and only 10% continue to take digitalis. With the exception of five patients, the physical capacity is normal and most play sports. The postoperatory radiologic and electrocardiographic changes were remarkable, most were obtained a few months after surgery. With the exception of one case, atrial fibrillation disappeared (in 58% before six months in a group of 31 patients). 6. The later complications attributed to the valve replacement as well as the 15 deaths in the total lot were analyzed. It was pointed out that the hospital death rate was 12.6% and the later was 5.3%, extraordinarily low figures if it is taken into account that the material corresponds to nine years of work and the problems inherent to the initial period are included. It gains still greater importance if compared to the series published up to the date. The global mortality rate of 17.9% is small in relation to the only comparable publication, -30 and if only the results of the last three years are compiled (61 cases equals 70 of the series), the global death rate was 9.8%. 7. It was noted that the results are due to the system adopted for establishing the surgical indication, to the good state of the myocardial fiber...
Evaluation of the hypothalamic-hypophyseal axis in patients with hypertensive hydrocephalus due to neurocysticercosis.
Four patients with hydrocephalus secondary to neurocysticercosis, were evaluated making a comparative analysis of their pre- and post-operative state. The results showed that intracranial hypertension "per se" does not generate changes in the hypothalamopituitary axis function. The cortisol response to its appropriate stimulus was subnormal indicating that the intracranial hypertension affects the adrenocorticotrophic or the ACTH system.
Valvular dysfunction due to the obstruction of the ventricular catheter caused by cysticercus cyst.
Five patients were studied with the diagnosis of secondary hydrocephaly to neurocysticercosis. Valvular dysfunction was observed due to the obstruction of the ventricular catheter caused by cysticercus cysts. The Biomed System was used in four cases and the Hakim System in one. Valvular dysfunction was observed in patients within a period of 18 to 24 months after derivation, they also had a history of several valvular dysfunctions. The diagnosis was made upon extraction of the catheter where the cyst was found to be attached to the ventricular brush. Subsequent evolution has not been satisfactory. The reasons for this complication are of a hydrodynamic and pharmacological nature and are also due to the growth of the cyst. This complication is not often suspected, therefore we recommend that in cases of frequent valvular dysfunction and asymmetrical hydrocephaly, studies like iodine-tomography or magnetic resonance be carried out in order to rule out this factor.
Obstruction of the ventricular catheter of a CSF shunt system due to the own cyst of Taenia solium.
Five patients were studied who suffered secondary hydrocephalus due to neurocysticercosis. Shunt dysfunction was due to the obstruction of the ventricular catheter caused by the own cysticercus cysts. The Biomed system was used in four cases and the Hakim system in one. Valvular dysfunction was observed in patients within a period of 18 to 24 months after surgery, they had a history of several valvular dysfunctions. The diagnosis was made upon of extracting the catheter where the cyst was found to be attached to the ventricular brush. Subsequent evolution has not been satisfactory. The reasons for this complication are of a hydrodynamic and pharmacological nature and are also due to the growth of the cyst. This complication is not often suspected, therefore we recommend that in case of frequent valvular dysfunctions and asymmetrical hydrocephalus, studies like iodinetomography or magnetic resonance imaging be carried out in order to discard this possibility.
[Minor salivary gland tumor in nasopharynx].
Pleomorphic adenoma, or mixed tumor, is the most common tumor of the salivary glands, being responsible for 47% of minor salivary-gland neoplasms. The palate is the most frequent location, but the nasopharynx is a rare site. The case of a 64-year-old man diagnosed as pleomorphic adenoma of the nasopharynx is reported. The recent literature was reviewed and the anatomopathological and clinical features were analyzed, as well as the differential diagnosis.
[Malignant peripheral nerve sheath tumor. Vagus nerve sarcoma].
A young man was seen for a mass on the left side of the neck. Computed tomography revealed a round mass suggesting a lymph node metastasis with a necrotic center. Fine needle aspiration found mesenchymal cells. The tumor excised from its location on the Xth left cranial nerve was found to be a malignant peripheral nerve sheath tumor. Treatment was complemented by regional irradiation. After concluding complementary treatment in April 1996, the patient currently is disease-free. This type of soft-tissue sarcoma is reviewed. Survival depends on tumoral size and cellular differentiation.