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Biomedical subjects

J Hildebrand

Publications and source records attributed to J Hildebrand.

At least 91 records · Page 5Linked to original sources
PubMed1990

Neuroradiologic findings in leptomeningeal carcinomatosis: the value interest of gadolinium-enhanced MRI.

Four patients with leptomeningeal metastases documented by neuroradiological examinations are reported. All had central nervous system or systemic neoplasms and showed clinical signs of carcinomatous meningitis. Gadolinium-enhanced MRI (Gd-MRI) disclosed for each patient pathological foci, allowing delineation of the extent of meningeal disease. Although non-specific, these findings, combined with the clinical context and CSF analysis, may lead to a rapid diagnosis and treatment of carcinomatous meningitis, even when malignant cells are not detected in the cerebrospinal fluid.

Adult↗
PubMed1990

Sarcoidosis. Report of two cases with oral involvement.

Sarcoidosis is a multisystem granulomatous disease in which pulmonary involvement is the most characteristic feature. Even though extrapulmonary manifestations occur infrequently in the area of the head and neck an occasional patient will have oral involvement. As we will demonstrate in these case reports, sarcoidosis should be included in the differential diagnosis of oral and perioral papular lesions noted on examinations of the head and neck.

Adult↗
PubMed1990

Reproducibility of monoamine metabolite measurements in human cerebrospinal fluid.

The levels of homovanillic acid (HVA), 5-hydroxy indoleacetic acid (5HIAA), and 3-methoxy-4-hydroxy phenylglycol (MHPG) were determined in the cerebrospinal fluid (CSF) of 28 patients with cognitive disorders on Day 1 and Days 8 or 15. During that period all patients were kept hospitalized under strict standard conditions, did not develop any acute CNS lesion, had no changes in their treatment and no acute systemic disease. The mean levels found in the first and second determinations were almost identical for the 3 metabolites; respectively 37.8 ng/ml and 36.3 ng/ml for HVA, 27.8 ng/ml and 27.9 ng/ml for 5HIAA, and 12.9 ng/ml and 12.3 ng/ml for MHPG. Thus, the mean values of these metabolites in CSF are reproducible at least during a 15-day hospitalization. However statistically significant individual changes in metabolite levels were found between the two samples in 82% of patients for HVA, 32% for HIAA and 48% for MHPG. The number of patients required to detect a significant change in the mean levels of each monoamine metabolite has been calculated taking into account the extent of intraindividual variations.

Adult↗
PubMed1990

[Long-term survival after surgery of solitary cerebral metastasis of lung cancer. Clinical case and review of the literature].

In cases of solitary brain metastasis of lung cancers other than small cell lung carcinoma, which has an even poorer prognosis, long-term patient survival over 1.2 years is rare. One case with a 12 year survival is presented. The authors review the other 18 cases with a minimum 5 year survival described in the literature. It is concluded that surgical aggressivity is justified in these cases.

Brain Neoplasms↗
PubMed1989

Effect of L-dopa on dementia-related rigidity.

L-dopa 100 mg plus benserazide 25 mg versus placebo were given 3 times daily to 14 consecutive patients with dementia and rigidity. The treatment was crossed over to the alternative therapy after a 7-day period. Despite a mean 60% raise in CSF-HVA during L-dopa administration, no patient responded to the treatment. These data suggest that dementia-associated rigidity differs, at least, pharmacologically from parkinsonian rigidity.

Aged↗
PubMed1989

Signs, symptoms, and significance of paraneoplastic neurological syndromes.

Neurological lesions attributed to the remote effect of cancer on the nervous system are protean, involving any part of the central and/or peripheral nervous system including the muscles. These paraneoplastic neurological syndromes are relatively uncommon in cancer patients, their relative frequency is variable, and their pathogenesis remains largely unknown. All forms of PNNS have been seen both in patients with and without cancer, and, unlike the paraneoplastic endocrinopathies, tumor removal is not necessarily followed by the remission of PNNS. For some PNNS, specific pathogenic mechanisms have been established or are highly probable. Thus, certain metabolic encephalopathies or the carcinoid myopathy are due to production of hormones or hormonelike substances by the tumor. The discovery of the most "typical" forms of PNNS justifies a careful search for an underlying neoplasia.

Autoimmune Diseases↗
PubMed1988

Effect of HECNU in malignant supratentorial gliomas--a phase II study.

Forty adults with recurring brain gliomas were treated with HECNU 130 mg/m2, given i.v. every 5 to 6 weeks (mean 5.4) and corticosteroids. According to the response to treatment, patients were divided in 3 groups: 1. Group 1 included 8 pts (20%) with objective remission, defined as a clear-cut clinical improvement persisting at least 4 weeks after the complete discontinuation of corticosteroids. 2. Group 2 included 14 patients (35%) who improved or remained stable yet stayed corticosteroid-dependent. 3. The 18 patients (45%) of group 3 failed to respond. There was a fair correlation between clinical and radiological response. Thus sequential CT-scans showed a 50 to 100% tumour reduction in all patients of group 1, and in 5 of group 2. CT-scans remained unchanged in 8 patients of group 2 and in one of group 3, and showed tumour progression in 10 patients of group 3. Drug toxicity appeared mild, reversible and was not cumulative. The better tolerance of HECNU could represent a real advantage of this drug over the commonly used nitrosourea derivatives such as BCNU and CCNU.

Adult↗
PubMed1988

Inflammatory demyelinating polyradiculoneuropathy associated with human immunodeficiency virus infection.

Five patients infected with immunodeficiency virus who were suffering from chronic polyradiculoneuropathy were investigated during evolution of the disease. Four of them were immunodeficient. The prominent neurological feature was distal and symmetrical weakness of the legs. After 5 months only one patient had improved. All patients had an increased protein level in the cerebrospinal fluid and pleocytosis. Electrodiagnostic studies and sural nerve biopsies indicated demyelination. Sural nerve viral cultures, including human immunodeficiency virus, were negative. The presence of circulating anti-peripheral nerve antibodies and of immunoglobulin deposits in nerve biopsy specimens was investigated by immunofluorescence techniques but failed to demonstrate any immunoreactivity.

Acquired Immunodeficiency Syndrome↗
PubMed1988

Neuropeptide Y, somatostatin, and cholecystokinin neurone preservation in anaplastic astrocytomas.

Using immunohistochemistry, well-preserved neuronal cell bodies and fibres containing neuropeptide Y, somatostatin, and cholecystokinin immunoreactivity have been identified in all seven supratentorial anaplastic astrocytomas studied. These neurones have been shown not only on the edge but also in the depth of the neoplastic tissue. These neuropeptides were not present in 18 other intracranial tumours (3 astrocytomas, 1 subependymoma, 8 glioblastoma multiformes, 1 meningioma, and 5 metastases). In all 25 intracranial tumours studied, no immunoreactivity was found for vasoactive intestinal polypeptide, substance P, methionine-enkephalin, leucine-enkephalin, synenkephalin, neurophysin I-II, and corticotropin releasing factor.

Astrocytoma↗
PubMed1986

The management of ruptured abdominal aortic aneurysms in rural Colorado. With a historical note on Kit Carson's death.

Kit Carson died of a ruptured aneurysm in rural Colorado in 1868. Since that time, techniques for management of aortic aneurysms have been developed and disseminated to rural areas with small hospitals. A survey of six Colorado rural hospitals' experience with ruptured abdominal aortic aneurysms is presented. Fifty-seven ruptured aneurysms had been managed during periods ranging from three to ten years. The average time to the operating room was 3.5 to 4.0 hours after hospital arrival and less than 45 minutes after diagnosis. Of those cases arriving with a systolic blood pressure less than 100 mm Hg, the mortality was 56%. The overall mortality was 53%. Groups are analyzed according to preoperative delay, occurrence of shock, and other risk factors. The results are compared with several series from metropolitan hospitals. Techniques of management that are of potential benefit in low-volume vascular case settings are discussed.

Aorta, Abdominal↗
PubMed1986

Radiotherapy and chemotherapy of malignant brain gliomas.

At present radiation therapy appears to be the only effective adjuvant treatment in malignant supratentorial gliomas (MSG). Six thousand rads given over 6 weeks increase survival significantly, by about 50%, but the addition of a further 1000 rads to the conventional 6000 rad dose may not be beneficial. Radiosensitizers of anoxic cells such as mizonidazole are ineffective. Superfractionation could represent an improvement over conventional radiotherapy. Adjuvant chemotherapy has proved ineffective in the vast majority of trials, with a few exceptions, the most important being the increase of long-term survivors by BCNU. In the author's opinion chemotherapy should be restricted to patients with recurring signs of MSG.

Adolescent↗
PubMed1985

CSF levels of neurotransmitters in Alzheimer-type dementia. Effects of ergoloid mesylate.

The cerebrospinal fluid level of homovanilic acid (HVA), 5 hydroxyindolacetic acid (5HIAA) and 3 methoxy-4-hydroxy phenylglycol (MHPG) was determined twice at 12 to 15-day intervals in 23 patients with Alzheimer-type dementia (ATD). No correlation was found with the degree of dementia as assessed by psychometric testing. In most of the patients, the CSF levels of 5HIAA, MHPG and to a lesser extent HVA were found to be rather stable within a period of 2 weeks. The observation of a decrease in the concentration of HVA but not of 5HIAA or MHPG in 10 out of 12 patients treated with ergoloid mesylate may therefore be of interest in elucidating the mechanism of action of this drug in ATD.

Aged↗
PubMed1984

Sequential CT scanning in radiation myelopathy.

Myelography is usually normal in radiation myelopathy. Occasionally it may show an enlarged spinal cord with block or a spinal cord of reduced size. It is assumed that the enlargement of the spinal cord is transitory, occurs in early stages of radiation myelopathy and is due to oedema, whereas atrophy is seen in later stages of the disease. This assumption however has not been clearly established by sequential radiological examinations. The purpose of this case report is to demonstrate such changes by repeated X-ray investigations.

Adenoma↗