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Biomedical subjects

J Melamed

Publications and source records attributed to J Melamed.

82 records · Page 5Linked to original sources
PubMedDate not supplied

[Cerebral CT scan alterations in children with ocular lesions caused by congenital toxoplasmosis]

OBJECTIVE: To evaluate the frequency and the types of cerebral CT scan alterations in patients with ocular lesions caused by congenital toxoplasmosis. METHODS: The patients should fit one of the following criteria: reagent IgM serology for toxoplasmosis at birth and mother with positive serology for toxoplasmosis; age less than ten years, with bilateral funduscopic lesions compatible with toxoplasmic retinochoroiditis; or reagent IgG serology for toxoplasmosis and mother with positive serology for toxoplasmosis. All patients were submitted to noncontrast cerebral CT scan. RESULTS: Twenty-two patients participated in this study (44 eyes). Thirteen eyes presented macular lesions (29.5%), eight had peripheral lesions (18.2%) and 22 eyes had concomitant macular and peripheral lesions (50%). Seventeen patients presented radiological alterations (77.3%). Among these, sixteen patients (94.1%) presented brain calcifications, two patients (11.7%) presented ventricular dilation, two patients (11.7%) had hydrocephalus, one had hydranencephaly (5.9%), one presented porencephalic cyst (cerebral hemiatrophy) (5.9%), one had arachnoid cyst (5.9%) and one had mild dilation of ventricles and subarachnoid cistern (5.9%). CONCLUSIONS: Patients diagnosed with congenital toxoplasmosis and ocular lesions should be investigated for concomitant neuroradiologic alterations.

Journal Article↗
PubMedDate not supplied

Efficacy and safety of nedocromil sodium 2% ophthalmic solution b.i.d. in the treatment of ragweed seasonal allergic conjunctivitis.

The efficacy and safety of twice-daily nedocromil sodium 2% ophthalmic solution and vehicle were compared in the treatment of ragweed seasonal allergic conjunctivitis. Two separate multicenter, randomized, double-masked, placebo-controlled studies were subjected to a combined analysis. Following a one-week baseline period during the beginning of the ragweed pollen season, 189 patients with seasonal allergic conjunctivitis received either nedocromil sodium or vehicle b.i.d. for eight weeks. Efficacy was evaluated by patient diary cards and clinical eye examinations. Safety was assessed by reports of adverse events. Compared with vehicle, nedocromil sodium produced significantly greater decreases in summary symptom score (p = 0.005), itch (p = 0.005), tearing (p = 0.004), overall eye condition (p = 0.001), and clinician-evaluated conjunctival edema (p = 0.018), and significantly better (p = 0.001), and patient (p = 0.001) opinions of treatment effectiveness at the peak pollen period. Additionally, the superiority of nedocromil sodium compared to vehicle approached statistical significance in redness reduction (p = 0.087) and clinician-evaluated conjunctival injection (p = 0.087). There were no serious treatment-related adverse events in either treatment group. In summary, nedocromil sodium 2% ophthalmic solution b.i.d. was found to be effective and to have a favorable safety profile in the treatment of seasonal allergic conjunctivitis.

Adolescent↗
PubMedDate not supplied

Spontaneous cerebrospinal fluid rhinorrhea with associated sinusitis and allergic rhinitis.

The entity of spontaneous cerebrospinal fluid rhinorrhea is a rare condition that presents a special challenge to the practicing allergist. Delayed diagnosis can be associated with significant morbidity and mortality. We describe two cases of this condition occurring in association with allergic rhinitis and sinusitis. The presentation and management of these cases is described. A high index of suspicion for this condition should be maintained in all patients who present with profuse and often unilateral rhinorrhea.

Cerebrospinal Fluid Rhinorrhea↗
PubMedDate not supplied

Pigmented melanocytic schwannoma of the uterine cervix.

A 47-year-old woman had a lesion of the uterine cervix that presented clinically as a protruding or aborted leiomyoma. Grossly the tumor occupied a substantial portion of the cervical and endocervical region. Histologically it showed a spindle cell neoplasm arranged in large fascicles that penetrated deeply into the fibromuscular wall of the cervix. The tumor cells had abundant pink cytoplasm that contained considerable brown melanin granules confirmed by Fontana's stain. Cytologically nuclear pleomorphism, hyperchromatism, and giant nuclear forms were observed. Mitoses were also seen. Localized nuclear palisading was present. Electron microscopic examination of paraffin-embedded material revealed numerous premelanosomes and opaque granules that were compatible with mature melanosomes, thus confirming melanogenesis in the tumor. Tumor cells exhibited focal projections, and the connective tissue showed abnormal spacing of collagen. Basal lamina material was noted focally on tumor cell surfaces. Immunocytochemistry showed a positive reaction to S-100 protein and HMB-45 in tumor cell cytoplasm.

Cell Nucleus↗
PubMedDate not supplied

Pancreatic endocrine tumor with signet ring cell features: a case report with novel ultrastructural observations.

The case of a malignant pancreatic endocrine neoplasm with an unusual signet ring cell appearance is reported. The tumor was resected from a 30-year-old man with a 4.0-cm tumor in the body of the pancreas diagnosed by computerized tomographic (CT) scan. The resected tumor had a unique morphology characterized by numerous mucin-negative, signet ring cells, which were argyrophilic and immunoreactive for cytokeratin (CAM 5.2), chromogranin, synaptophysin, neuron specific enolase, and gastrin. Dense-core neurosecretory-type granules and numerous cytoplasmic lamellar inclusions were identified by electron microscopy. These inclusion bodies consisted of multilayered concentric osmiophilic lamellae (myelin figures), which most likely represent an abnormal accumulation of degenerating organelles. Two years later, the patient developed an abdominal recurrence of the tumor, confirming its malignant behavior. This case expands the spectrum of pancreatic endocrine tumors to include an aggressive signet ring cell tumor with a novel ultrastructural basis.

Abdominal Neoplasms↗
PubMedDate not supplied

BRCA1 germline mutation presenting as an adenocarcinoma of unknown primary.

BACKGROUND: The work-up of adenocarcinoma of unknown primary usually includes history, physical examination, radiographic imaging, tumor markers, and more recently molecular and genetic information. We report here on how the suggestion by family history of a BRCA1 mutation guided the diagnostic and therapeutic approach in a patient with metastatic carcinoma of unknown primary. METHODS: BRCA1 mutation was screened for by polymerase chain reaction (PCR) and single-strand conformational polymorphism analysis. Primers for PCR amplification included selected BRCA1 exons 2, 110, 11L, 13, and 20. The PCR product was cloned into a PCRII vector and sequenced with a Sequenase Version 2.0 Sequencing Kit. RESULTS: Single-strand conformational polymorphism analysis suggested a mutation in the region of exon 20 and sequencing confirmed the presence of a germline mutation 5382insC. CONCLUSIONS: This case illustrates an unusual presentation of adenocarcinoma of unknown primary in a patient with a germline BRCA1 mutation, the use of a suspected germline mutation to guide the work-up and treatment, and finally the value of positron emission tomography scanning in the work-up of an unknown primary.

Adenocarcinoma↗
PubMedDate not supplied

Tobacco smoking, occupation, and p53 nuclear overexpression in early stage bladder cancer.

Epidemiological studies show an increased risk of bladder cancer associated with tobacco smoking and occupational exposures. Certain carcinogens in tobacco and occupational exposures cause DNA damage and may produce specific mutations. TP53 is considered a common target for carcinogenic agents, and mutations of this gene are reported to be the most frequent nuclear abnormalities in human cancer. In order to investigate the relationship between tobacco smoking, occupations, and altered patterns of p53 expression, we have analyzed a group of 109 incident patients with superficial transitional cell carcinoma of the bladder. We assessed p53 nuclear overexpression by the use of anti-p53 antibody PAb1801 and immunohistochemistry, and identified 45 of 109 patients (41%) displaying p53-positive phenotype. We observed a significant association between the number of cigarettes smoked per day and p53 nuclear overexpression (p = 0.02). The odds ratios were 2.3 for those smoking 1-2 packs per day and 8.4 for smoking more than 2 packs per day. Similar estimates were obtained after controlling for age, sex, and race. Elevated odds ratios were also observed for dye-/ink-related (odds ratio = 2.0; 95% CI, 0.4-9.4) and cooking-related occupations (1.8, 0.6-5.0), although those were not statistically significant. These data support the hypothesis that certain carcinogens derived from cigarette smoking and occupations may induce TP53 mutations, which in turn are involved in early steps of bladder carcinogenesis.

Aged↗