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Biomedical subjects

R Barrios

Publications and source records attributed to R Barrios.

At least 55 records · Page 3Linked to original sources

Tru-cut needle biopsy of subcutaneous fat in the diagnosis of secondary amyloidosis in rheumatoid arthritis.

In order to investigate the presence of secondary amyloidosis in patients with rheumatoid arthritis (RA), we performed an abdominal subcutaneous fat biopsy with a tru-cut needle in 50 patients. The tissue was stained with Congo red and was observed with polarized light microscopy. We found amyloid deposits in 78% of our patients. We randomly selected ten patients with a positive biopsy and a second procedure was performed. Tissues were studied with electron microscopy. We found unbranched fibrils characteristic of amyloid in all of them. We found a direct correlation with rheumatoid factor titers: the more intense the amyloid deposit, the higher the rheumatoid factor titers (p < 0.001). We did not find any correlation between amyloid deposits and clinical manifestations of disease. Amyloid deposits in RA are more frequent than previously thought, and their clinical importance remains to be determined.

Adipose Tissue↗

Effect of hydralazine on vascular mechanics in a canine lobar preparation of pulmonary embolism.

We studied the effect of hydralazine (H) on pulmonary vascular mechanics in an isolated, in situ, canine lobe model of normal and increased pulmonary vascular resistance (Rp) produced by Gelfoam embolization (GE). Pulmonary pressure-flow (P-Q) curves from 24 lobes were obtained at baseline and after each intervention. Hemodynamic parameters for analysis included: the mean critical closing pressure (Ppai), vascular conductance (1/Rp), lobar flow (QL), and the pulmonary inflow pressure (Ppa) at different levels (50, 100, 200, 400, and 600 ml/min) of a fixed flow. After the preparation was stabilized, the 24 lobes were classified into 2 groups. For group 1 (n = 8) we studied the effect of H on the normal pulmonary vasculature. In group 2 (n = 16) we studied the effect of GE. Following GE, this group was further divided in half. For group 2A (n = 8) we followed the natural history of GE with measurements at 15 and 60 min. For group 2B (n = 8) measurements were done 15 min after GE and repeated again 15 min after the infusion of H. For group 1 lobes, H promoted a significant decrease (p less than 0.001) in Ppa at fixed flows of 200, 400, and 600 ml/min compared to baseline, with no change in Ppa for flows below 100 ml/min. QL and 1/Rp increased (p less than 0.01), and there was not any significant change in Ppai. In group 2A lobes, GE produced an increase in Ppa at all levels of flow (p less than 0.01), QL and 1/Rp decreased (p less than 0.05), and there was an increase in Ppai (p less than 0.05). These changes remained stable over the 60 min of observation. For group 2B lobes, GE produced the same hemodynamic changes as in group 2A, and the infusion of H caused a decrease in Ppa at flows between 100 and 300 ml/min. (p less than 0.01) with no change in Ppa at flows below 100 ml/min. QL and 1/Rp increased (p less than 0.01) and Ppai did not change compared to 15 min after GE. We conclude that in the normal canine pulmonary vasculature as well as in the model of GE, H decreased Rp and did not affect mean critical closing pressure, all of which may be explained by an increase in vascular conductance due to an increase in vascular distensibility.

Animals↗

Entamoeba histolytica: microtubule movement during mitosis.

The movement of microtubules (MTs) during nuclear division of Entamoeba histolytica was ultrastructurally studied. Regarding this MT movement, five stages of mitosis could be defined: prophase, metaphase, anaphase A, anaphase B, and telophase. In early stages of mitosis, chromatinic material appeared condensed, and MTs were detected in the center of the nucleus. Later, MTs seemed to grow from an electron-dense body located in the center of the nucleus. This body might be the microtubule organizing center, which organized the MTs, first in a lateral way, and later to form the mitotic spindle, which was made of a bundle of MTs joined by their ends. This junction of MTs to themselves could also be observed in cross-sections. The last stage of mitosis was the nuclear separation. Two different morphological types of intranuclear vesicles were also observed, which seemed to have different types of membrane. Both intranuclear vesicles were present during nuclear division, generally in clusters, and located close to the nuclear periphery.

Anaphase↗

Experimental pulmonary fibrosis induced by paraquat plus oxygen in rats: a morphologic and biochemical sequential study.

Changes in lung structure and collagen metabolism were studied at 1, 2, 3, 4, 6, and 8 weeks in a model of pulmonary fibrosis induced in rats with paraquat plus hyperoxia. Morphologic examination of the lungs revealed that the earliest lesions consisted of severe and irreversible endothelial and alveolar epithelial cell damage. Afterward, an inflammatory process took place, initially dominated by polymorphonuclear leukocytes and then by mononuclear cells, but with the constant presence of granulocytes. From the fourth week on there were fibroblast proliferation and a moderate increase of mast cells. In the early stages alveolitis was focal, but from the second week the lungs were diffusely affected with severe distortion of the architecture. Collagen content was moderately increased in the first 2 weeks and then showed a progressive increment until the end of the experiment. Collagen synthesis was significantly elevated from the fourth week, coinciding with interstitial fibroblast proliferation, although there were some animals that showed increased collagen production from the first week. Collagenolytic activity occurred in 3 stages: at 2 weeks there was increased collagen degradation, at 3, 4, and 6 weeks the values showed a trimodal behavior, and at 8 weeks almost all experimental rats presented an important decrease of collagenolysis. Thus, the development of lung fibrosis was associated first with increased rates of collagen synthesis and later with a decrease of collagen degradation.

Animals↗

[Guidelines for a fluoride prevention program].

The present work proposes the creation of a program for the prevention of caries and periodontal disease in schoolchildren, to be undertaken under the supervision of an odontologist; proper training of personnel to aid in this task is also proposed. Finally, it provides tabulated guidelines for the development of this program.

Adolescent↗

Prevalence and severity of coronary atherosclerosis in males living in Mexico City: the Mexico City project.

The current prevalence of coronary atherosclerosis was investigated in 174 necropsic studies performed on males who died violently between 1984 and 1986 in Mexico City. In young adults, coronary atherosclerosis was found in 35% of the cases, 5% of whom had significant obstruction in one coronary vessel. In subjects aged 50-69 years, coronary atherosclerosis occurred in 69% of the cases and obstructive disease in 24%. Current figures suggest an increase in the severity of coronary atherosclerosis in this population which may be linked with nutritional changes. This makes further investigations, as well as the design of a program for ischemic heart disease prevention in Mexico City imperative.

Adult↗

Subpopulations of T cells in lung biopsies from patients with pigeon breeder's disease.

Monoclonal antibodies were used to determine surface phenotypes of T cells in tissue obtained by open lung biopsies from patients with chronic hypersensitivity pneumonitis (pigeon breeder's disease). The results indicate that an increased number of suppressor/cytotoxic cells is present in these patients when compared with the number of helper/inducer cells. These findings, which were present within the interstitium, are consistent with those found in bronchoalveolar lavage of patients with this disease. In addition, in two-thirds of the patients there was a greater total number of helper and suppressor cells than the total count for Pan T cells. A possible interpretation of these findings might be the presence of both markers in the same cell.

Adult↗

Hemodynamic effect of hydralazine in interstitial lung disease patients with cor pulmonale. Immediate and short-term evaluation at rest and during exercise.

Hydralazine was administered short-term to 13 patients who had stable interstitial lung disease (ILD), pulmonary arterial hypertension (PAH); mean pulmonary arterial pressure ( [PAP]=26 +/- 9 mm Hg), and cor pulmonale (CP). All patients were studied at rest and during exercise. After intravenous hydralazine at rest, there were statistically significant increases in cardiac index (CI) (p less than 0.001), arterial oxygen saturation (SaO2) (p less than 0.01), and mixed venous saturation (S-vO2) (p less than 0.01). Pulmonary vascular resistance (Rp) (p less than 0.005) and systemic resistance (Rs) decreased (p less than 0.001), and PAP did not change. During exercise, PAP did not change; however, CI (p less than 0.01), PaO2 (p less than 0.001), and S-vO2 (p less than 0.01) increased further. The increase in Rp was significantly reduced (p less than 0.01). After continuation of oral hydralazine therapy in 12 patients for 7 days, PAP at rest was not statistically different from control; Rp and Rs remained decreased (p less than 0.001). The same results were found for CI, PaO2, S-vO2, and Rs during exercise. Although PAP did not change from control values, the drug significantly reduced the increase in Rp (p less than 0.005). Vasodilator therapy with hydralazine could be useful in patients with stable ILD who have inflammation with minimal to moderate fibrosis and PAH and might be used as an adjunct to conventional therapy for ILD and CP.

Administration, Oral↗

Peripheral airways obstruction in idiopathic pulmonary artery hypertension (primary).

The mechanical properties of the lung were studied in ten nonsmokers with idiopathic pulmonary artery hypertension (IPAH) (mean pulmonary artery pressure 65.7 +/- 30 mm Hg). In the routine lung test, residual volume was found to be abnormal (greater than 120 percent of the predicted) in seven patients, and measured airway resistance was normal in eight out of the ten patients. A decreased FEF 75-85 percent, abnormal values for the helium-air flow ratios and increased closing capacities were documented in eight of ten patients in whom lung elastic recoil was normal (six of ten) or increased (four of ten). These features suggest peripheral airways obstruction (PAO) which was also supported by histopathologic findings in three cases (one biopsy and two necropsies). The observed changes in lung compliance could be related to the behavior of the coupling of the air-space and vascular compartments. The etiology of PAO in IPAH patients is not known, but our results indicate that both the peripheral airways and the pulmonary circulation are affected. The knowledge of PAO in IPAH patients could help to better understand the observed V/Q inequality in this entity.

Adolescent↗

Hypersensitivity pneumonitis in man. Light- and electron-microscopic studies of 18 lung biopsies.

Light- and electron-microscopic changes produced by hypersensitivity pneumonitis were analyzed in open lung biopsies taken from 18 patients with chronic forms of the disease. The main changes observed were: alveolitis (both luminal and mural), granulomas, intraalveolar buds, and interstitial fibrosis. The cells infiltrating the alveolar walls were mainly lymphocytes. Occasionally these lymphocytes presented irregularities in the contours of the nuclear membranes and resembled Sézary cells. In one patient, a few lymphocytes were found that resembled "hand-mirror" cells. Intraalveolar macrophages often had a foamy appearance. Granulomas, present in two-thirds of the patients, differed in several respects from those in sarcoidosis: they were smaller, more loosely arranged, and poorly limited; they had a higher content of lymphocytes; and they were located more frequently in alveolar tissue than in the vicinity of bronchioles and vessels. Intraalveolar buds, also present in about two thirds of the patients, were composed mainly of fibroblasts, myofibroblasts, and macrophages in a loose connective tissue that was rich in proteoglycan material. Capillaries and epithelial cells were rarely seen in buds. Alveolar buds appear to develop by a process of disruption of the epithelial lining layer, due to alveolitis, followed by intraalveolar exudation and by subsequent intraalveolar migration of connective tissue cells interacting with macrophages. Severe fibrotic and alveolar epithelial changes were observed in four patients; milder changes were frequent in most other patients. It is concluded that hypersensitivity pneumonitis usually has distinctive morphologic features; these may help to distinguish the resultant pulmonary fibrosis from that due to other causes.

Adult↗

Extrinsic allergic alveolitis caused by pigeon breeding at a high altitude (2,240 meters). Hemodynamic behavior of pulmonary circulation.

The hemodynamic characteristics of the pulmonary circulation were examined in 10 patients with proved extrinsic allergic alveolitis caused by pigeons (EAA-P) raised at a high altitude. All patients had lung biopsies that showed an interstitial inflammatory response with vascular lesions. At rest, all patients had mean pulmonary pressures (PAP) greater than 16 mmHg; the average PAP was 22 +/- 12 mmHg for the whole group. Pulmonary vascular resistance was high and the mean for the whole group was 225 +/- 25 d.s.cm-5. The pulmonary artery diastolic-pulmonary wedge pressure (PAd-PWP) difference was elevated and averaged 8.5 +/- 2 mmHg. All patients were hypoxemic with elevated AaDO2. With exercise, both PAP and PAd-PWP increased abnormally. While breathing oxygen (FIO2, 99.6%) PAP decreased an average of 7 mmHg (p less than 0.05) and PAd-PWP decreased an average of 5 mmHg (p less than 0.05) without a significant change in PWP. The calculated compliance of the elastic pulmonary arteries in EAA-P was not different from that in normal subjects. Alveolar hypoxia produced mainly by EAA-P and presumably enhanced by living at a high altitude appeared to be the factors in the genesis of pulmonary hypertension, because pulmonary artery diastolic pressure and PAd-PWP difference were correlated with arterial oxygen saturation.

Adult↗

Zymosan-induced experimental hypersensitivity pneumonitis in rabbits.

An experimental model of hypersensitivity pneumonitis is presented. New Zealand white rabbits, previously immunized against yeast-derived zymosan, reacted to intratracheal challenge developing extensive pneumonitis. The lesions healed in a few weeks. Control animals challenged with inert particulate material (latex beads) or suspending fluid (PBS-Mg++) did not show pulmonary inflammation. Nonimmunized rabbits developed only transient pneumonitis after zymosan challenge. This reaction was clearly different from that seen in the group of immunized animals. The model reveals that biologically active substances such as zymosan, which is able to activate the alternate pathway of complement and mononuclear phagocytes, requires an active immune state in order to cause significant tissue damage. Isolated exposure to this kind of substance may not be sufficient to cause lung disease.

Alveolitis, Extrinsic Allergic↗

Intercellular junctions in "shock lung". A freeze-fracture study.

Intercellular junctions in the alveolar epithelium and in the capillary endothelium in lung from five dogs after hemorrhagic shock (mean blood pressure, 40 mm. Hg for 3 hours) and from five control dogs were observed in the electron microscope using the freeze-fracture technique. Following shock zonulae occludentes (tight junctions) in the alveolar epithelium showed alterations in substructure that were not present in control animals. These changes were morphologically similar to those reported in junctions altered after exposure to osmotic gradients with marked degradation and disappearance of junctional strands. The appearance of tight junctions in the capillary endothelium, which were of a rather poorly organized "leaky" type in control animals, was generally unaltered after shock. Disintegration and disappearance of junctional strands in "focal" regions, however, were occasionally observed. The increased pulmonary capillary permeability observed physiologically after hemorrhagic shock could be explained by such alterations of endothelial zonulae occludentes.

Animals↗

Cardiac sympathetic-parasympathetic balance in rats with experimentally-induced acute chagasic myocarditis.

To clarify the mechanism responsible for the transient sinus tachycardia in rats with acute chagasic myocarditis, we have examined the cardiac sympathetic-parasympathetic balance of 29 rats inoculated with 200,000 parasites (Trypanosoma cruzi). Sixteen infected animals and 8 controls were studied between days 18 and 21 after inoculation (acute stage). The remaining 13 infected animals and 9 controls were studied between days 60 and 70 after inoculation (sub-acute stage). Under anesthesia (urethane 1.25 g/kg), all animals received intravenous atenolol (5 mg/kg) and atropine (10 mg/kg). Acute stage: The baseline heart rate of the infected animals was significantly higher than that of the controls (P < 0.0001). The magnitude of the negative chronotropic response to atenolol was 4 times that of the controls (P < 0.00001). This response correlated with the baseline heart rate (r = -0.72, P < 0.001). The heart rate responses to the beta-blocker and to atropine, of the infected animals studied during the sub-acute stage, were not different from controls. These findings suggest that cardiac sympathetic activity is transiently enhanced and cardiac parasympathetic activity is not impaired, in rats with acute chagasic myocarditis. The transient predominance of cardiac sympathetic activity could explain, in part, the sinus tachycardia observed in the acute stage of experimentally-induced chagasic myocarditis.

Acute Disease↗