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Biomedical subjects

A Lechi

Publications and source records attributed to A Lechi.

At least 145 records · Page 8Linked to original sources

Meningiomas. A light and electron microscopy study.

A morphological and ultrastructural study was undertaken from a personal series of meningiomas. Especially the fine structure of the tumour has been described by the electron microscopic study of 16 meningotheliomatous and 4 fibroblastic meningiomas. In all cases, it was possible to distinguish certain cells with epithelial features such as desmosomes, microfilaments and interdigitating extensions. Also the cytological patterns of fibroblastic meningiomas usually were similar to the meningotheliomatous type, anyhow the intercellular space between the interdigitating extensions of adjacent cells was occupied by collagen-fibers. At present, it has been impossible to demonstrate the capability of the tumour cells to synthetize collagen. Since the tumour cells of both the meningiomas are substantially similar to the subarachnoid space meningocyte, it is concluded that the neoplasm rises from a cell with double potentiality for fibroblastic and epithelial differentiation.

Female↗

"Thalamic" dementia in herpes encephalitis: clinico-pathological report.

Herpes zoster (HZ) primary affections of the CNS are rare and, in most of the reported patients, are representing variously extended forms of ascending myelitis. Our examination concerns a man who at the age of 37 developed apathy after a feverish episode with iridocyclitis. Six months later an ophthalmic HZ was diagnosed and thenceforth the patient showed a dementia with Korsakow's syndrome, apathy and a right hemipalsy, and diplopia appeared; the later symptoms remitted after steroid therapy. Post-mortem examination revealed a slowly progressive encephalitis with symmetrical impairment of the anterior ventral, medial, and centrum medianum of the thalamus. The HZ origin of the lesions and the relation between their site and the peculiar form of dementia, to be ascribed to the "thalamic" ones, are discussed. A vasculitis process can be hypothesized considering both the symmetrical localisation and the microscopical aspects of the lesions.

Adult↗

Facial myokymia in the course of a pontine tumor.

A patient with facial myokymia, suffering from an infiltrating grade II astrocytoma originating within the pons with vegetations invading the cerebellopontine angle, was studied clinically and electromyographically from 1973 to 1979. The myokymias started in the muscles of the right side of the face and later spread to the left side. The latter point is worth noting because the myokymias of the left side were detectable by EMG but not by inspection. They preceded clinical and instrumental evidence of a contralateral spread of tumoral damage to the brainstem. From the physiopathogenetic angle they point up the importance of a mechanism of hyperexcitability and release of the facial motoneuronal pool. The results of the EMG study suggest that the persistence of myokymia, its association with an ingravescent neurogenic impairment of the facial musculature and its polymorphism in the course of pontine tumors are more reliable features than their discontinuity and rhythmicity.

Adult↗

Meige syndrome: a clinical and EMG study.

2 patients showing oral-facial asymptomatic dyskinesia are reported. Clinically observed involuntary movements are the same as those described by Henry Meige in 1910 for the first time. An outstanding EMG feature is the recording of spontaneous potential bursts, both short and long in duration, that show synchronism when activity is registered from different facial muscles at the same time. Clinical and EMG data allow close comparison between involuntary movements in the course of Meige syndrome and idiopathic hemifacial spasm.

Blepharospasm↗

Intravenous labetalol in severe hypertension. Effects on blood pressure, plasma renin activity and catecholamines.

2-Hydroxy-(1-hydroxy-[(1-methyl-3-phenylpropyl)amino]-2-ethyl)-5-benzamide (labetalol), a new alpha- and beta-adrenergic blocking agent, was employed in 21 patients with severe hypertension by slow (6 patients) and rapid (15 patients) i.v. infusion. A marked and significant fall of blood pressure was observed in both groups, though more gradual in patients treated by slow infusion. A rapid blood pressure fall with cardiac output decrease was observed by passing from supine to standing position in the first hours after infusion. Therefore, it is advisable to keep a supine position for a few hours. Plasma renin activity decreased after labetalol infusion, but basal plasma renin levels were not related to hypotensive effect of labetalol. In slow infusion patients, plasma noradrenaline levels increased and no changes of plasma adrenaline levels were observed during infusion. The most likely explanation of these variations is an increase of sympathetic activity secondary to hypotension, caused by labetalol, whereas a technical interference seems to be excluded. The simultaneous blockade of alpha- and beta-receptors can inhibit, in this case, the pressor effects of the sympathetic reflex.

Adult↗

Diagnostic value and biological significance of antibody-coated bacteria in urine.

The incidence of antibody-coated bacteria (ACB) in the urinary sediments as an indication of the site of urinary tract infections (UTI) was investigated in 103 adult subjects with persistent bacteriuria by means of a direct immunofluorescence technique.ACB were found in 49 of 58 (84.5%) subjects with long-standing upper urinary tract obstruction and in 5 of 45 (11.1%) with lower UTI; this difference was statistically significant (X(2) = 51.79; P<0.001). The group with upper UTI was further subdivided according to renal function (patients with renal insufficiency had both bilateral obstruction and bilateral renal damage); 21 positive results were obtained in 27 (77.8%) patients with normal renal function, whereas 28 positive cases were observed among 31 (90.3%) patients with chronic renal insufficiency. Thus the degree of renal involvement also seemed to influence the outcome of the test. Within the group of lower UTI, a higher rate of ;false-positive' results was obtained in 14 patients with symptomatic long-standing infection (21.4%) than in 31 subjects with asymptomatic bacteriuria (6.4%). The three major immunoglobulin classes and the secretory component were studied in 42 cases. Of these, 29 were found to be positive for ACB. The constant presence of IgA and secretory component on the surface of ACB suggests that the secretory immune system plays an important role in UTI.

Antibody-Coated Bacteria Test, Urinary↗

[Incidence and antibiotic-sensitivity of gram-negative bacteria in the urinary infections (author's transl)].

Urinary tract infections due to low-grade pathogenic Gram-negative bacteria show an increasing prevalence. The frequency of isolation from urinary samples of some of these pathogens (Alcaligenes, Citrobacter, Acinetobacter, Providencia, Serratia) was detected in a group of adult patients. The role of local and systemic predisposing factors was investigated. These bacterial agents accounted for 21% of 1,354 isolated strains. Systemic predisposing factors were found in most patients. Moreover, a high proportion of the isolates was found in the urinary samples of patients receiving prolonged antibacterial therapy. Sensitivity to several antibacterial drugs was examined for each strain. A high degree of drug resistance was commonly found.

Anti-Bacterial Agents↗

Transient hemiballismus and subclavian steal syndrome. Case report.

Transient hemiballismus was observed in a 74-year-old man, displaying subclavian steal syndrome. Such a correlation has not been previously reported in the literature. In this case, transient hemiballismus seemed to depend on hemodynamic factors, but other mechanisms possibly explaining early recovery of the hyperkinesias are discussed. In particular, stress is laid upon the role of preexisting pathological changes of the central nervous system (diffuse cerebral atrophy) associated to the "releasing" lesion.

Aged↗

[Results of the use of a new aminoglycoside antibiotic, sisomicin, in gram negative bacterial respiratory infections].

Clinical efficacy of a new aminoglycoside antibiotic, sisomicin, was evaluated in 14 patients with acute chest infections (12 cases with pneumonia and 2 with bronchitis). They were selected taking into account the isolation of sisomicin-sensitive Gram-negative bacilli in a sputum specimen collected prior to therapy. Local predisposing factors were present in 4 patients whereas general predisposing factors were present in 4 patients whereas general predisposing factors were recognizable in 9. Klebsiella was isolated in 5 cases, E. coli in 5 cases, Proteus in 4 cases, P. aeruginosa in 2 cases, Ct-trobacter and Providencia each in one. In all patients the bacteriological finding was negative after the cycle of therapy; clinical outcome was uniformly favourable (11 patients healed, 3 got better). No significant adverse effects due to the antibiotic was noted.

Adult↗

Multicentre comparative trial of tienilic acid and hydrochlorothiazide in hypertensive patients.

To compare the clinical and metabolic effects of a new diuretic uricosuric agent, tienilic acid, with those of hydrochlorothiazide, a multicentre double-blind trial was performed in 56 hypertensive patients. Twenty-eight patients were randomly assigned to take tienilic acid and 28 to take hydrochlorothiazide. The diuretic and anti-hypertensive actions of the two compounds were similar. No significant differences were observed between tienilic acid and hydrochlorothiazide in their effects on urinary and serum electrolytes, hepatic and renal function tests, and fasting lipids. The patients who received tienilic acid showed a significant fall in serum uric acid, mediated by the uricosuric effect. The availability of an agent combining diuretic, antihypertensive and hypouricemic effects offers promise in the treatment of arterial hypertension.

Adolescent↗