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Biomedical subjects

R Miranda

Publications and source records attributed to R Miranda.

At least 109 records · Page 6Linked to original sources

Selenium deficiency in cattle associated with Heinz bodies and anemia.

Cattle grazing St. Augustine grass growing on peaty muck soils in the Florida Everglades developed anemia associated with the presence of Heinz bodies and suboptimal concentrations of selenium in blood. Selenium supplementation corrected the anemia, prevented Heinz body formation, increased the body weight of cows and calves, and elevated blood selenium. This may be the first recorded example of widespread anemia in a population due to selenium deficiency.

Anemia, Hemolytic↗

Traumatic myocardial dysfunction.

Traumatic myocardial dysfunction is a frequently unsuspected, undiagnosed contributor to deaths from trauma. Electrocardiography, serum enzymes, and radionuclide myocardial scans are insensitive indicators of cardiac injury following blunt chest trauma. First-pass biventricular radionuclide angiography can accurately determine right and left ventricular ejection fractions and assess left ventricular segmental wall motion. Since August, 1980, we have evaluated 74 consecutive patients with blunt chest and multisystem trauma. Electrocardiograms and measurements of the myocardial band isoenzyme of creatine kinase were obtained at admission and repeated at 24 hour intervals for 3 days. Radionuclide angiography was performed 24 to 48 hours after admission. The electrocardiogram was abnormal in 21 patients (28%), levels of creatine kinase isoenzyme were elevated in six, and radionuclide angiographic abnormalities were present in 55 patients (74%). Electrocardiographic abnormalities correlated anatomically with angiographic abnormalities in 16 patients (76%). On follow-up radionuclide angiography, abnormalities had disappeared in nine of 12 patients restudied at 3 weeks. This study documents that the electrocardiogram and creatine kinase isoenzyme elevations are static, insensitive indicators of traumatic myocardial dysfunction. Radionuclide angiography with studies of left ventricular segmental wall motion demonstrate that traumatic myocardial dysfunction, although sometimes transitory, is a dynamic phenomenon that is more common than previously suspected. First-pass radionuclide angiography and wall motion studies are practical and valuable adjuncts to the management of the injured patient.

Adult↗

Myocardial dysfunction following blunt chest trauma.

We prospectively studied 35 patients with blunt chest trauma using ECG multi-gated and first-pass nuclear angiography. Radionuclide angiography (RNA) is a sensitive test of myocardial function demonstrating right and left ventricular ejection fractions. First-pass angiography, in addition, shows left ventricular segmental wall motion, a qualitative as well as anatomic indicator of left ventricular function. We saw RNA abnormalities in 26 patients (74.2%). Eight patients (22.8%) had ECG abnormalities, and these findings correlated with RNA, suggesting that this technique is a very sensitive indicator of myocardial dysfunction following trauma. These studies warrant further experimental and clinical evaluations to determine the cause, significance, and long-term prognosis of posttraumatic myocardial dysfunction.

Adult↗

A new button for retention suture fixation.

A button that may be snapped on and off the end of a retention suture has been described. It allows the tension on the suture to be adjusted easily, increases patient comfort, and avoids circumferential compression of the wound.

Abdominal Muscles↗

Effect of maternal nutritional status on immunological substances in human colostrum and milk.

Substances in colostrum and breast milk confer significant disease resistance to the breast-fed infant. The influence of maternal nutritional status on both immunological and nonimmunological milk factors was studied in a group of 23 Colombian women during the first 2 months of lactation. Maternal malnutrition was characterized by significantly lower weight/height ratio, creatinine/height index, total serum proteins, serum albumin, and serum IgG and IgA. The colostrum of malnourished mothers contained only one-third the normal concentration of immunoglobulin G and less than half the normal level of albumin. Significant reductions in colostrum levels of IgA and the fourth component of complement (C4) were also observed in the malnourished group. No differences were observed in colostral concentrations of lysozyme, C3 complement, or IgM. Titers of antibody in milk directed against respiratory syncytial virus were not influenced by maternal nutritional status. The differences noted above tended to disappear in mature milk, concomitant with improvement in the nutritional status of malnourished mothers during the first several weeks postpartum. We conclude that the protective qualities of colostrum and milk may be significantly influenced by maternal nutritional status.

Adult↗

Effect of healing on small internal diameter arterial graft compliance.

Porosity is an essential component for long term function of small internal diameter synthetic vascular prostheses. Theoretically, porosity is required for healing by providing a scaffold for ingrowth of periprosthetic tissues. Porosity may be required for transfer of fluids and ions in prostheses even if tissue ingrowth does not occur. Increased permeability of vascular grafts has been shown to enhance tissue incorporation. Implants with pore sizes greater than 10 microns but less than 45 microns become ingrown with fibrohistiocytic tissue and capillaries. Implants with pore sizes greater than 45 microns are ingrown with organized fibrous tissue and minimal histiocytic response. The phenomenon of differential ingrowth may have important functional significance. Prostheses which heal with organized fibrous tissue have the potential for long term contracture, strangulation of vascularity and calcification. Fibrohistiocytic tissue has low mechanical strength and does not appear to contract or calcify. Elastomeric microporous vascular prostheses which are minimally ingrown or ingrown with fibrohistiocytic tissue maintain compliance after months of implantation. This study was designated to determine the effects of healing on the compliance of small internal diameter vascular replacements and to correlate the compliance to patency rates.

Animals↗

Comparative cytogenetic studies in Macaca arctoides with other species of Macaca and man.

Chromosome studies of 5 males and 5 females of the species Macaca arctoides from Thailand were performed and the G, C and NOR banding patterns obtained for comparison with other species of the genus Macaca and with the human karyotype. The cytogenetic analysis showed a complement of 42 chromosomes. Of the 20 autosomal pairs, 15 are submetacentric and 5 almost metacentric. Pair number 9 presents a large secondary constriction, which corresponds to the only nucleolar organizer region of the whole genome, and has giant satellites in the short arms. In regard to the sex chromosomes, females have a pair of submetacentric chromosomes with a G banding pattern identical to that of the human X, while the males have one X and a very small Y chromosome.

Animals↗

Development of impaired cell-mediated immunity in mild and moderate malnutrition.

The development of moderate malnutrition and cell-mediated immune function was studied in 71 Colombian infants from birth through 2 yr of age. Based upon weight-for-age criteria 31 remained normal, 33 were classified as grade I, and seven were grade II malnourished at the end of their 2nd yr of life. Delayed hypersensitivity reactions to purified protein derivative were significantly reduced in all malnourished children 8 wk after Bacille Calmette-Guerin vaccination at birth, and also at 2 yr in the Grade II group. Nearly half of the latter group could not be sensitized to dinitrochlorobenzene at 2 yr of age. A 50% reduction in the blastogenic response of peripheral blood lymphocytes to phytohemagglutinin in vitro was detected in grade II children. Both mildly and moderately malnourished infants exhibited a significant reduction in tonsil size at 2 yr of age. These results indicate that a majority of newborns in this poor, urban setting will develop measurable malnutrition associated with impaired cell-mediated immune function before their 2nd birthday.

BCG Vaccine↗

Surgical treatment of the postgastrectomy dumping syndrome.

Fifteen patients were treated surgically for dumping syndrome at the University of Florida between 1972 and 1977. Five of them had a reversed jejunal segment interposed between the stomach and the Roux limb and 10 had simple 45 cm Roux-en-Y gastrojejunostomy. The reversed segment has been, in our experience, a uniform disappointment. Straight Roux-en-Y duodenal diversion, with the exception of temporary delay in gastric emptying in a few cases, has proved successful in treating the postgastrectomy dumping syndrome.

Adult↗

Peripheral blood flow in the neonate; 1. Changes in total, skin, and muscle blood flow with gestational and postnatal age.

Total peripheral blood flow and blood flow through the skin and muscle were measured in the calf with an electrocapacitance plethysmograph with counter pressure in a group of 62 "well" newborn infants (birth weight, less than 3500 g). Blood pressure in the contralateral leg was measured with an Arteriosonde 1010, and peripheral vascular resistance was calculated as mean blood pressure (mm Hg) divided by blood flow (ml per 100 ml tissue per min). The results show that total peripheral blood flow and blood flow through he skin and muscle correlated inversely with increasing birth weight and gestational age. Postnatally, total blood flow and blood flow through the skin and muscle decreased gradually during the first 7 days of life and in the rest of the neonatal period. Peripheral vascular resistance and resistance in the skin and muscle correlated directly with increasing birth weight and gestational age. Postnatally, peripheral vascular resistance and resistance in the skin and muscle increased during the first 7 days of life and the neonatal period.

Aging↗

Incidental appendectomy: frequency of pathologic abnormalities.

The incidence of pathologic abnormalities found in the appendix when it is removed incidentally at the time of jejunoileal bypass is reported. Thirty-one per cent of these appendices had significant histopathologic changes. In the authors' opinion these findings support the theory that the appendix may undergo bouts of acute inflammation that are self-limited and that the fibrosis observed in the appendix is a direct sequela of such episodes. In potentially contaminated primary procedures the addition of incidental appendectomy does not increase operative morbidity or mortality.

Adolescent↗

Immunization of rhesus monkeys with blood-stage antigens of Plasmodium knowlesi.

Evaluation of the efficacy of 3 nonviable blood-stage antigens-schizont Ag, merozoite Ag, and "French press" Ag-of Plasmodium knowlesi, emulsified in Freund's complete adjuvant (FCA), was carried out in a study involving 32 rhesus monkeys. After 2 immunizations, administered 6 weeks apart, monkeys were challenged with a variant of P. knowlesi different from that used for immunization. All 8 control monkeys that received either PBS or FCA developed a severe parasitaemia and died of the infection within 12 days after parasite challenge. In the group that received the freeze-thawed schizont Ag, 5 of the 8 monkeys died at the same time as the controls, 1 died a day later, and 2 survived the infection (maximum parasitaemia: 0.7%; 3.2%). In the freeze-thawed merozoite Ag group, 1 monkey died at the same time as the controls, 5 monkeys died between 14 and 17 days after challenge, and 2 monkeys survived the infection (maximum parasitaemia: <0.01%; 2.7%). In the lyophilized French press Ag group, 2 monkeys died at the same time as the controls, 2 died between 12 and 15 days after challenge, and 4 survived the infection (maximum parasitaemia: 1.2%; 0.4%; 0.9%; 0.07%).Immunized monkeys failed to gain weight during the period of immunization and abscess formation at injection sites was comparable in monkeys of the 3 Ag groups. Reticulocytosis and anaemia developed in all monkeys that survived longer than 12 days after challenge, even in monkeys with very low-grade levels of parasitaemia.Various tests were performed to assess humoral or cell-mediated immune responses during the period of immunization and after challenge. No clear-cut relationship could be established between the results of any of these tests and the survival of immunized monkeys after parasite challenge. Some of the results, however, suggest that there might be some relationship between cell-mediated responses and the survival of immunized monkeys beyond the survival time of control monkeys.

Animals↗

Concentration and separation of erythrocytes infected with Plasmodium falciparum by gradient centrifugation.

Concentration of infected erythrocytes was achieved in cell suspensions derived from long-term culture of Plasmodium falciparum growing asynchronously in human erythrocytes. This new procedure involves the slow centrifugation (at 33 g) of erythrocyte suspensions through 5% Ficoll solutions. Mature asexual erythrocytic forms are preferentially retained in the gradient solution (top fraction). After further gradient centrifugation of these parasitized cells, the concentration of mature forms is increased 15- to 31-fold and a mature form parasitaemia of 71-81% is obtained in the final erythrocyte suspension. Furthermore, at least 75% of the total number of the mature forms can be retrieved by this method. Parasitized cells that are not retained in the gradient are sedimented to the bottom of the tube (bottom fraction) and consist predominantly of ring forms. Parasites from both the top and bottom fractions are viable and have been used to initiate short-term synchronous cultures. By providing purified parasite preparations, this simple procedure will facilitate immunological, chemotherapeutic, and biochemical studies with P. falciparum.

Cell Separation↗

Harvest of Plasmodium falciparum merozoites from continuous culture.

Spontaneously released merozoites were harvested from cultures in which 42-90% of the erythrocytes had been infected with mature forms of Plasmodium falciparum at the start of incubation. The mature forms had been extracted from asynchronous cultures by the use of Ficoll and Plasmagel gradients. As the mature forms consisted of both trophozoites and schizonts, merozoites were released into the culture medium over a long period of time. The synchrony of merozoite release did not appear to be improved by prior exposure of parasites to sorbitol. Over this prolonged period of incubation, the yield of merozoites was disappointingly low in cultures containing 2.5% of erythrocytes. At erythrocyte concentrations of 0.01-0.25%, 3-10 times more merozoites were released into the medium; 0.4-2.3 merozoites per initial mature form were harvested over a 15-19-hour period. In addition to merozoites, contents of the culture medium included intact erythrocytes, ghost cells, and other cellular fragments. Only intact erythrocytes were effectively removed from the medium by simple or Ficoll gradient centrifugation. Merozoite preparations that are free from host cellular material are important in the development of a human malaria vaccine.

Animals↗

[Uptake of tryptophan and tyrosine in some cases of manic depressive psychosis and schizophrenia (author's transl)].

The uptake of tryptophan and tyrosine by the brain has been studied in 6 manic-depressive patients and in 8 schizophrenics. In an attempt to saturate the blood-brain transport mechanisms, this uptake has been evaluated by measuring the arteriovenous differences (arterial plasma-internal jugular plasma) of these two amino acids before and after perfusion with L-dopa and L-5-HTP. Considering a positive difference as an uptake and a negative one as an outflow, results show (1) in melancholia an uptake of tryptophan and an outflow of tyrosine; (2) in mania an uptake of tyrosine and an outflow of tryptophan, and (3) in schizophrenia an outflow of tryptophan accompanied with either an uptake or an outflow of tyrosine. In addition, the kinetics of tryptophan binding to plasma proteins and the ratio of tryptophan/tyrosine uptake are different in manic-depressive illness and in schizophrenia. These results support the view that a disturbance in the blood-brain transport mechanisms of tryptophan and tyrosine could be involved in the physiopathology of manic-depressive illness and schizophrenia.

Bipolar Disorder↗

[Clinical use of thiopental in post-ischemic encephalopathy; preliminary report].

Twenty patients suffering from post-ischaemic encephalopathy were treated with high doses of barbiturates during the period immediately following resuscitation. The duration of cerebral ischaemia was assessed retrospectively. The degree of ischaemic damage was evaluated on the one hand by the pupillary signs seen 10 minutes after the reestablishment of the circulation and secondly by enzyme levels in the CSF. This barbiturate load was not associated with major complications and the excretion of barbiturate continued for several days. The clinical signs seen 12 hours after ischaemia and continuous observation of the tracing of the cerebral function monitor made it possible to give an early favourable prognosis from a neurological standpoint. In all the patients (apart from one) in whom there was total cerebral ischaemia for less than 10 minutes, neurological recovery was complete.

Adolescent↗