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Biomedical subjects

J P Plese

Publications and source records attributed to J P Plese.

At least 19 recordsLinked to original sources
PubMed1997

[Infections of cerebrospinal fluid shunts in children. Review of 100 infections in 87 children].

An analysis of 100 infections in 87 children treated with shunts in the period of 1982 to 1995 is reported. The clinical presentation has been more frequently secondary to inflammatory signals. Staphylococcus were the most frequently microorganisms found. Infection by Gram negative agents was more aggressive and directly related with failure of therapy. Treatment included since only systemic antibiotics until withdrawal of shunt with use of systemic and intrathecal antibiotics. The best therapeutic results were obtained with withdrawal of shunt system and replacement by external shunt system associated to systemic antibiotics. In our experience this management must be accepted for treatment of this severe complication.

Bacterial Infections↗
PubMed1997

[Cerebellar astrocytomas in childhood. Experience with 25 cases].

The experience with the surgical treatment of cerebellar astrocytomas in 25 children is reported. The clinical presentation, incidence, CT-scan diagnostic studies, pathology, recurrence and treatment aspects are discussed. The series included children until 10 years old with peak (7 cases) in the 7th year of age. The more frequent opening symptoms were: headache, vomit and gait disturbances. No surgical mortality occurred in the series. The authors conclude that surgical radical resection is the best therapeutics for this type of tumor and that radiotherapy is indicated only for tumors with malignant histology.

Astrocytoma↗
PubMed1996

[Arachnoid cyst and pseudotumor cerebri: case report].

Report on a 12 years old patient with an arachnoid cyst of posterior cranial fossa and pseudotumor cerebri. This patient is a shunt dependent of his cyst-peritoneal shunt. This association and evolution of this pacient suggest a common and specifical pathogenic mechanism of these two pathologies based in a disturbance of the cerebral fluid circulation.

Arachnoid Cysts↗
PubMed1995

Transient mutism following a posterior fossa approach to cerebellar tumors in children: a critical review of the literature.

Transient mutism has been known as a rare complication following a posterior fossa approach to cerebellar tumors and its cause has not been clearly elucidated. The cerebellar mutism is not accompanied by cranial nerve deficits and disorders of consciousness. Since 1985 only 23 cases of mutism following removal of a cerebellar tumor in children have been reported in the literature. Two additional cases have been operated upon in our department. Extensive injury to the vermian and paravermian cerebellar area, involving the hemispheric cortex, cerebellar peduncles, fibers from the dentato-thalamocortical pathway, and dentate and interpositum nuclei may be the most important anatomical substrate of mutism. The mechanism of such transient mutism seems to be a complex of two or more factors (vascular disturbances due to manipulation or retraction of the cerebellar region around the IV ventricle and emotional factors). On the basis of these 25 cases the major features of the cerebellar mutism are discussed.

Ataxia↗
PubMed1995

[Depressed skull fractures in children under 2 years of age. Retrospective study of 43 cases].

Depressed skull fractures (DSF) in infancy and childhood are frequent but only a few articles make an analysis in children with age between 0 and 2 years. This is a retrospective study of 43 patients with DSF and age ranged from 0 to 2 years. Falls and traffic accidents were the most common causes. Most patients were admitted in alert state. 69.8% of the patients were submitted to surgical treatment. The parietal bone was more frequently injured (55.8%). Most of the patients had type 1 DSF (the depressed bone remains connected to the cranial vault). The incidence of associated lesions of nervous system was lower than reported in the literature.

Accidental Falls↗
PubMed1995

[Lipoma of the corpus callosum with extracranial extension through frontal bone defect].

Intracranial lipoma are usually localized in the corpus callosum and rarely extends to the subgaleal region. Only eight cases of lipoma of the corpus callosum with extracranial extension were reported in the literature. Seizures and mental retardation were the most common clinical findings in these patients. Data from the literature show that resection of intracranial lipoma has catastrophic results. The resection must be restricted to the extracranial portion. We report a child with lipoma of the corpus callosum with extracranial extension with no neurologic deficit submitted to resection of the extracranial extension.

Brain↗
PubMed1994

Extradural hematomas in children.

The authors studied 58 patients, under 12 years of age, admitted to the Emergency Room of the Sao Paulo University Hospital between September 1987 and November 1991 with the diagnosis of traumatic extradural hematoma. Emphasis was given to the etiology of injury, the time interval from head injury to emergency room evaluation, the clinical features and the outcome after surgical and nonsurgical management. The site of hematoma was defined and correlated with the presence of skull fractures. Computerized tomography is the main diagnostic method, although it is not definitive. Fifteen patients were treated nonsurgically according to rigid clinical and radiological parameters. The overall mortality rate was 3.4%.

Brain Injuries↗
PubMed1994

[Magnetic resonance imaging in spinal dysraphisms].

We studied by magnetic resonance imaging the incidence of associated malformations in a group of 38 patients with diagnosis of spina bifida followed in our outpatient clinic. Twenty-two children were born with spina aperta and 16 with spina bifida occulta. Tethered cord was found in the majority of patients of both groups. Syringomyelia was found in 13 patients. The craniocervical region was studied in 11 patients with the diagnosis of spina bifida aperta; Chiari malformation was found in 8. The results point to the fact that asymptomatic malformations detected by MRI techniques are frequent in patients with spina bifida.

Adolescent↗
PubMed1992

[Traumatic extradural hematoma in childhood and normal early computed tomography: report of 2 cases].

The cases of two children with traumatic extradural hematoma with an early normal CT scan are reported. Consciousness impairment occurred in them respectively 20 and 60 hours after admission, and CT at this occasion evidenced extradural hematoma. Serial neurological examinations are recommended for children with large traumatic cephalohematoma associated or not to skull fracture and in whom an initial early CT was normal, since they can lately develop extradural hematoma.

Brain Injuries↗
PubMed1992

[Conservative treatment of laminar extradural hematomas in children].

We successfully treated by nonsurgical methods 15 children with laminar epidural hematomas (EH), with minimal neurological symptoms and no signs of brain herniation. These EH were discovered 30 minutes to 5 days after head injury. The majority were localized in the parietal region. All children recovered without surgery from 2 to 12 days after hospitalization and all had evidence on CT scan of spontaneous clot reabsorption. We discuss the criteria for patient selection for this kind of treatment on EH in children.

Child↗
PubMed1985

Steroid receptors in meningiomas.

Cytosolic estrogen (ER), progesterone (PR), androgen (AR) and glucocorticoid receptors (GR) were evaluated in 10 meningiomas using a dextran charcoal coated method. We consider as positive specific receptor values greater than or equal to 10 fMol/mg protein. In this study 20% of the meningiomas contained very low titers of specific ER. PR was detectable in 90% of the tumors, at high levels. The mean PR content of PR+ tumors was 60 +/- 38 fMol/mg prot. GR and AR were present in moderate levels, in 70% of the tumors. Competition studies demonstrated steroid specificity for these hormone-binding proteins. Female patients have a higher receptor incidence and titer. In conclusion, it can be hypothesized that the meningioma are a target tissue for steroids and that endocrine therapy may be relevant to unoperable and/or recurrent tumors.

Aged↗
PubMed1984

Steroid receptors in intracranial tumors.

Cytosolic estrogen (ER), progesterone (PR), androgen (AR), and glucocorticoid (GR) receptors were evaluated in 6 meningiomas and 12 gliomas (6 astrocytomas and 6 glioblastomas) using a dextran-coated charcoal method. Thirty-three percent (two) of the meningiomas and 17% (two) of the gliomas contained positive (greater than or equal to 10 fmol/mg protein) but low ER levels. On the other hand, positive PR, GR, and AR levels were detectable in 100% (six) of the meningiomas. PR was present in 50% (six), AR in 42% (five), and GR in 58% (seven) of the gliomas. PR, GR, and AR values were statistically higher in meningiomas than in neuroepithelial tumors.

Adolescent↗