Thrombolysis in Stroke Patients with Isolated Aphasia.

BACKGROUND: Data about evolution of aphasia following stroke are rare and controversial especially following fibrinolysis. The aim of this study was to describe the early clinical patterns of isolated aphasia in consecutive stroke patients with or without thrombolysis. METHODS: Clinical and radiological data of consecutive stroke patients were routinely entered in prospective registry. Patients were considered aphasic when NIHSS (National Institutes of Health Stroke Scale) item 9 >0. 'Isolated aphasia' was defined by aphasic patients without motor limb deficit. We created a 'composite language score' obtained by summing the NIHSS items 1b, 1c and 9, which reflects language-processing ability. Recovery of functions was evaluated as measured by global NIHSS, composite language score and language screening test (LAST) at baseline, H24 and day 7 (D7). 'Mild deficit' was defined as global NIHSS <5. RESULTS: A total of 100 consecutive patients met study criteria for isolated aphasia. Twenty-five underwent thrombolysis and 75 did not. There was no difference between the 2 groups concerning demographic characteristics, involved territories and presence of arterial occlusion, initial median NIHSS, composite language and LAST scores at entrance. Evolution was significantly better in thrombolysed patient for the 3 testings: NIHSS, composite language score and LAST at D7 (respective p = 0.0002; p = 0.01 and p = 0.004). Similar results were found when we focused on the subgroups of patients with initial 'mild' deficits (p = 0.01; p = 0.0003 and p = 0.007). No symptomatic hemorrhagic transformation occurred following thrombolysis. CONCLUSION: These data strongly suggest that thrombolysis is safe and effective in patients with 'isolated aphasia,' even if the global NIHSS score is <5.

mRNA expression of MAGE-A3 gene in leukemia cells.

Leukemia-associated antigens such as proteins encoded by MAGE genes might provide tools for immunotherapy of leukemia. Positive and negative results of MAGE-A gene expression in hematological malignancies have been reported. This led us to study MAGE-A gene expression in human leukemias using RT-PCR. Among 115 leukemias from various subtypes, 14/34 (41.17%) AML were positive for one of the three genes analyzed (MAGE-A1 1/32; MAGE-A3 10/32; MAGE-B2 3/12). Expression was also detected in 23/76 (30.26%) B-cell ALL patients (MAGE-A1 2/53; MAGE-A3 20/53; MAGE-B2 1/32). One of these patients expressed both MAGE-A1 (weak signal) and -A3 (strong signal) genes. Other patient with CML were positive for MAGE-B2 (1/5, 20%). MAGE-A3 expression data were corroborated by real time RT-PCR through determination of MAGE-A3 transcript levels. We concluded that the MAGE-A3 gene is expressed at the mRNA level in a proportion of human leukemias.

[High-risk biliary surgery. Study of 108 patients operated using the tradition method]. / Cirugía biliar de alto riesgo. Estudio de 108 pacientes operados por el método tradicional.

This study is to inform the patients outcomes from biliary tract surgery, with surgical risk higher than normal, in a general hospital. It was observational, retrospective, longitudinal and descriptive study. Among 1989-1992 were studied 108 patients with a 30 days follow up, operated from one or more risk surgical factors, 63 cases were included because had one high risk factor, 31 had two factors, 11 with three and three with four or more. 88 patients (81%) had good outcomes, while 20 (19%) had bad outcomes, 18 were women and two men, with two deaths and two reoperations. The good outcomes were in majority of patients with one high risk factor (57/63 = 90.5%); there were statistic difference with the two, three or four high risk factors cases.

[Effects of polydioxanone and silk on normal cicatrisation of surgically injured myocardial tissue. An experimental model]. / Effecto de la polidioxanona y la seda en el proceso de cicatrización normal del tejido miocárdico lesionado quirúrgicamente. modelo experimental.

The wound healing is the principal process of tissue repair. In the heart this phenomenon is done under special circumstances, because of the constant movement of this organ. An experimental study was done in 15 dogs. By left anterolateral thoracotomy the free left ventricular wall was incised. This incision was done 1 cm long and 3 mm deep and afterwards it was repaired with silk (Group I) and with polydioxanone (Group II). The wound was allowed to heal during 5 weeks, then the scar area was analyzed by light microscope with Masson and HE technics. The results showed the presence of lymphocytes in the scar tissue of group II (p = 0.04).

Phenytoin serum concentration monitoring during pregnancy and puerperium in Mexican epileptic women.

Phenytoin serum concentrations were evaluated in 88 epileptic women at different stages of pregnancy and 40 women during postnatal periods. In addition, concentrations were determined from the umbilical cords of 27 neonates. On average, the dose of phenytoin was increased by 130 +/- 54 mg in 67% of the patients in order to control seizures. In 76% of the women during pregnancy and 95% in the postnatal periods, dose adjustment was achieved for the control of the seizures. Therapeutic clinical concentrations ( < 9.9 micrograms/ml) were found in 64% of the patients, with an average of 7.2 +/- 1.8 micrograms/ml during pregnancy and 6.2 +/- 2 micrograms/ml in 90% of the women during the postnatal period. The average phenytoin concentration reached with doses of 100, 200, 300, 400 and 500 mg were 3.3, 5.7, 8.4, 10.8, and 14.1 microliters/ml, respectively, without statistically significant differences among the pharmacokinetic parameters measured during pregnancy, between pregnancy and the postnatal period. The proportion between fetal and maternal phenytoin concentration was 0.37 +/- 0.28. Hydantoin fetal syndrome was seen in 8% of the neonates, without a statistically significant difference among patients with or without seizures. No relation was found between the concentration of phenytoin during pregnancy and the hydantoin fetal syndrome. The study shows that low concentrations of phenytoin can control seizures during pregnancy and the postnatal period and the need to relate serum phenytoin concentrations with the clinical state of pregnant women who suffer seizures.

Estimulación de la proliferación de las células de leucemia aguda linfoblástica en cultivo / Stimulation of acute lymphoblastic leukemia cell proliferation in cell cultures

Para conocer los estimulantes mitógenos más adecuados para la iniciación de la actividad mitótica de los blastos se utilizaronultivos de 20 muestras de células de leucemia aguda linfoblástica (LAL). Se analizaron diferentes concentraciones de fitohemaglutinina (PHA), lectina (Phitolacca americana) (FL) y 2-mercaptoetanol (2-ME) mediante la estimulación de cultivos celulares de 20 muestras. La mucoproteina extraída de las plantas (PHA) resultó ser el mejor activador de la mitosis y de la proliferación. A una concentración de 2.5 mg/ml, ocurrió la división celular; en su ausencia, no se observó proliferación celular. Por otra parte, la FL tuvo un efecto menor de la activación de la mitosis en los cultivos; y el 2-ME no presentó efecto alguno sobre la proliferación de estas células. Además, se observó que la acción mitogénica de la PHA implica la activación de la replicación del ADN celular, tal y como lo demostró la incorporación de [3H]-timidina

[Mortality in geriatric patients in the Hospital General of Mexico]. / Mortalidad en pacientes geriátricos del Hospital General de México.

In order to define the main diseases of the elderly and a possible changes of mortality causes at Hospital General of Mexico, SSA, the authors studied 586 autopsy reports of individuals over sixty years old, deceased between 1960 and 1965 and of 625 individuals of similar characteristics deceased between 1981 and 1985. The analysis of diseases showed qualitative and quantitative changes in the ten principal causes of death at each period: some of the most frequent diseases in the 60's, for instance, amebiasis, were not included among the then principal causes of death in the 80's. On the other hand, malignant neoplasms persisted as one of the principal death causes in both periods, but the most frequent carcinoma in the 60's, gastric carcinoma, was substituted in the 80's by bronchogenic carcinoma. This study suggests that great technical and sanitary interventions are necessary to promote health of third age persons, an increasing but poorly protected population in our country.

[Behavior of nucleolar organizers in the normal cervix, human papilloma virus infection and cervico-uterine cancer]. / Comportamiento de los organizadores nucleolares en el cervix normal, infección por virus del papiloma humano y cáncer cervicouterino.

Thirty five cervical biopsies were divided into four groups: 5 cases normal cervix, 10 cases with papillomavirus without atypias (HPVIO), 10 cases with human papillomavirus with atypias (HPVIA) and 10 cases with squamous carcinoma. With the colloidal silver technique, the proteins associated with nucleolar organizers were stained; they were found to increase significantly in number in the groups studied being lowest in the normal cervix and highest in the biopsies with carcinoma. The number of nucleolar organizers in HPVIO in our study was found to be similar to that in cervical intraepithelial neoplasia I (CIN I), according to Egan and the number in HPVIA similar to that in CIN II, suggesting that HPVIO is a low risk lesion and HPVIA a high risk lesion for cervical carcinoma.

[The platelet response as a prognostic factor in invasive amebiasis of the liver]. / La respuesta plaquetaria como factor pronóstico en la amibiasis invasora del hígado.

A group of 96 patients with Invasive Hepatic Amebiasis, was studied in a prospective clinical trial. The platelet count was measured for each patient on admission and on the tenth day of treatment. The patient were classified into two groups: the first one for patients with unfavorable results and the second one for patients with favorable results. The presence of thrombocytosis was significant in the second group, with a sensitivity of 56% and specificity of 70% in the initial determination, and of 82% and 68% at the tenth day respectively. With this finding, it could be considered that thrombocytosis must be a good prognostic indicators in the Amebic Liver Abscess, and it could be possible to include it in a scale to elucidate the prognosis in a quantitative form, of this pathologic entity.