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Biomedical subjects

S Serrano

Publications and source records attributed to S Serrano.

At least 109 records · Page 6Linked to original sources

Factors influencing the development of metabolic bone disease in primary biliary cirrhosis.

The prevalence, type, and factors that may influence the development of bone disease in primary biliary cirrhosis, have been investigated in 20 consecutive patients, who, in addition to liver function tests and mineral and vitamin D metabolism studies, were submitted to a transiliac bone biopsy after tetracycline double-labeling for quantitative histomorphometric examination. Intestinal calcium absorption was also assessed in 16 patients. Seven patients (35%) had reduced bone volume and were considered osteoporotic. Three also had bone mineralization impairment, but did not have criteria for osteomalacia. Bone formation was depressed in 15 patients, and bone resorption was low or normal in 19 cases. Eroded surfaces were reduced in all osteoporotic patients. Duration of primary biliary cirrhosis was significantly longer in patients with osteoporosis (6.3 +/- 0.6 yr) than in those without osteoporosis (2.6 +/- 0.6, p = 0.004). Moreover, osteoporosis was more prevalent in postmenopausal women, and in those who had intestinal calcium malabsorption, which was present in 80% of osteoporotic patients but in only 18% of nonosteoporotic patients (p = 0.03). Osteoporosis and mineralization bone impairment were unrelated to the severity of cholestasis. 25-Hydroxyvitamin D was significantly lower in those patients with intestinal calcium malabsorption. The results of this study indicate that osteodystrophy in primary biliary cirrhosis is characterized mainly by "low-turnover" osteoporosis, which is related to the duration of the liver disease, postmenopausal condition, and calcium malabsorption.

Adult↗

[Insulin and peptide C secretion after food ingestion and the interaction of insulin with its erythrocyte receptor in a family with MODY type diabetes mellitus].

In 12 members of a family with MODY, insulin and C-peptide release after intake of a test breakfast was measured as well as binding of insulin to its erythrocyte receptor. According to serum glucose concentrations, subjects were classified into: diabetic, carbohydrate intolerant, and normal subjects. The two diabetic patients had an insulin release pattern similar to that of non-insulin dependent diabetics. The two patients with carbohydrate intolerance presented hyperinsulinism either at base state and after stimulation. Of the eight normal subjects, three presented high concentrations of serum insulin either at base level and after stimulation; in the remaining five, base insulinemia was normal and the response after food intake was poor. Insulin binding to the receptor was decreased in diabetic patients and this anomaly was more evident in patients with carbohydrate intolerance. In the three patients with increased serum insulin concentration, no disturbances in insulin-receptor binding were detected; in the remaining five patients, insulin-receptor binding was significantly decreased. Our findings prove that these subjects present a disturbance of insulin release and an impairment of insulin-receptor binding with a predominance of one or the other alteration even before hyperglycemia is evident.

Adolescent↗

Inquiry between European thoracic surgeons and chest physicians about the mandatory examinations before operating a lung cancer.

The purpose of this inquiry is to try to attain a common opinion between European Thoracic Surgeons and Chest Physicians about the examinations which are mandatory or not mandatory but useful before to put the indication to lung cancer resection. The examinations proposed are divided from functional point of view and from oncological as well as technical point of view. A questionnaire specially conceived was sent to 78 Thoracic Surgeons and Chest Physicians in Europe. Answers obtained by 52 institutions are analysed.

Cost-Benefit Analysis↗

Osteodystrophy of diabetics in chronic dialysis: a histomorphometric study.

A decreased incidence of hyperparathyroidism in diabetic uremic patients has been reported, but comprehensive bone histomorphometric studies on uremic diabetic osteodistrophy are scarce. We present here the results of static and dynamic bone morphometry in 13 diabetic patients on dialysis (DCD) and their comparison with a pair-matched group of nondiabetic uremics with similar age, sex, and time on dialysis (NCDC), and with a group of 17 normals (N). Diabetic bone showed: (1) Low trabecular volume (Vt 9.9% in DCD and 22.8% in N), (2) Moderately increased remodeling values of intermediate intensity between N and NDCD values (Sf = 19.3% in DCD, 37.4% in NDCD, and 8.8 +/- 6% in N, Sr = 4.3% in DCD, 7.3% in NDCD and 2.04 +/- 0.9% in N), and (3) Moderate fibrosis (Sfib 1.2% in DCD, 12.9% in NDCD). Besides these confirmatory results, two suggestions emerged from the study: (1) The relative number of cells: osteoclast density (OI) and osteoblasts (Ob/OID) appears to be lower, not only than NDCD values but also lower than N values (OI = 0.04 c/mm. in DCD, 0.31 in NDCD, and 0.14 in N; Ob/OID = 5.58% in DCD, 14.6 in NDCD and 22.12 +/- 9% m N). (2) Dynamic behavior in tetracycline based studies disclosed the appearance of two populations of DCD: a subgroup of preserved calcification dynamics with values not quite different than the NDCD group and a subgroup with a significant derangement of mineralization with no measurable bone trabecular dynamics. This late subgroup also showed significantly lower number of Ob/OID values compared with the former with preserved calcification.(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗

Phenotypic and genetic analysis of HLA class I and HLA-DR antigen expression on human melanomas.

Class I and HLA-DR antigen expression were studied with histochemical techniques involving monomorphic monoclonal antibodies in 49 cases of human malignant melanomas, 20 primary and 29 metastatic. A large percentage (90%) of primary melanomas were positive for HLA class I, while those primary lesions showing lowest levels of class I antigen expression were at the upper end of the range of invasiveness and possessed a higher metastatic potential. Expression of HLA-DR molecules on primary melanomas was low (25% of all cases) and HLA-DR-positive melanomas were among the most aggressive. In metastatic melanomas, HLA class I expression was less common than in primary lesions. The lowest percentage of cases positive for HLA class I was found for cutaneous metastases. HLA-DR molecules were more frequently expressed by lymph node metastases than on primary melanomas. The comparison of the expression of HLA class I and HLA-DR molecules by primary melanomas and their autologous metastases revealed a high degree of heterogeneity. Class I genes were further studied by Southern blot assays. No differences were found in restriction fragments for class I genes among 4 melanomas and their autologous lymphocytes, 2 of which were positive and 2 negative for class I expression.

Blotting, Southern↗

Surgical treatment of active prosthetic valve endocarditis. Results in 66 patients.

The results of combined medical and surgical management of 66 patients with active prosthetic valve endocarditis (APVE) are analyzed. Between 1970 and 1985, 3510 patients were operative survivors of mitral, aortic or double mitral-aortic valve replacement. Cumulative follow-up was 15,640 patient-years (mean 4.4 years). The overall annual incidence of reoperation for APVE was 0.42 +/- 0.05% (0.34 +/- 0.08% for biological and 0.46 +/- 0.06% for mechanical prostheses, p = n.s.). Early APVE occurred in 21 patients and 45 patients had late APVE. Indications for surgery were heart failure in 92%, systemic emboli in 5% and persistent sepsis in 3% of patients. Overall operative mortality (less than 30 days) was 38% (25/66). (Early APVE 52% and late APVE 31%). Anatomical location, valve design and number of prostheses implanted did not correlate with a higher operative risk. Overall endocarditis-related mortality was 56% (37/66). Uni and multivariate stepwise logistic regression analysis identified: 1) date of surgery (p = 0.01), 2) renal failure (p = 0.03) and 3) early APVE (p = 0.03) as predictors of endocarditis-related death. Actuarial survival at 1, 5 and 10 postoperative years was 41 +/- 6%, 30 +/- 6% and 24 +/- 7% respectively. This study confirms the high lethality of APVE. However, with adequate and aggressive combined medical and surgical management, some patients can be saved.

Adult↗

Endocrine aspects of pituitary stalk enlargement.

Four patients with various endocrine deficiencies of a predominantly hypothalamic nature are described, in whom computed topographic scans demonstrated pituitary stalk enlargement. In one, a disseminated papular skin eruption with regional pleomorphism and spontaneous regression appeared 4 years after the development of the initial symptoms of diabetes insipidus, and led to a diagnosis of xanthoma disseminatum, a rare type of histiocytosis. It is suggested that this patient's endocrine dysfunction is also due to histiocytic involvement of the hypothalamus and/or pituitary stalk. In view of the prolonged lapse of time between the initial endocrine manifestations and the eventual diagnosis, even though no cause is apparent in the other three patients, it is suggested that close follow-up be carried out to rule out such a possibility in patients with this endocrine-radiological entity.

Adolescent↗

[Anderson-Fabry disease. Current status. Apropos of a case].

After submitting a typical case of Anderson-Fabry disease in a 38 years old male, we discuss the eminent aspects of this metabolic disorder and, above all, the clinical, biochemical and ultrastructural problems of diagnosis in the heterozygotic relatives.

Adult↗