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Biomedical subjects

J Sierra

Publications and source records attributed to J Sierra.

At least 235 records · Page 13Linked to original sources
PubMed1985

Effect of large doses of methylprednisolone on supratentorial intracranial tumors. A clinical and CAT scan evaluation.

We studied the action of high doses (500 mg/daily for 7 days) of methylprednisolone sodium succinate in 12 patients with supratentorial intracranial tumors. 10 tumors were malignant (5 gliomas and 5 metastases), and 2 benign (meningiomas). Clinical improvement ranged from moderate to marked after 24-48 h of therapy. In the 5 metastases, mean reduction of peritumoral edema was 27%, and in apparent tumor volume was 18%; in the gliomas, corresponding reductions were 31 and 15%. 1 of the meningioma cases showed a decrease in edema volume of 21%. These results indicate that methylprednisolone, at least for a short period of time, produces a definite decrease in apparent tumor size, in addition to the reduction of peritumoral edema.

Aged↗
PubMed1985

Growth rate of secondary hydatid cysts of the brain. Case report.

Bilateral intracerebral hydatid cysts developed in a 14-year-old patient after an infarct of presumed embolic origin in the left frontotemporoparietal region. The average rate of growth of these cysts was about 5 cm per year. This suggests that the growth rate is far from uniform and indeed, particularly in young patients, may be much faster than originally estimated.

Adolescent↗
PubMed1985

Multiple myeloma with monoclonal IgG and IgD of lambda type exhibiting, under treatment, a shift from mainly IgG to mainly IgD.

A patient with multiple myeloma (MM), who initially presented with a predominant IgG lambda and a minor IgD lambda paraprotein pattern, is described. After chemotherapy, levels of the IgD lambda protein increased and the IgG lambda levels decreased. The following results were obtained when serum IgD was predominant. In the bone marrow, there were three plasma cell populations: a major one containing only delta chains, a minor one containing only gamma chains, and another minor one containing both delta and gamma chains. All these plasma cell populations contained lambda chains. Stimulation of circulating mononuclear cells with pokeweed mitogen (PWM) achieved differentiation of circulating B lymphocytes into plasma cells: 30% with only cytoplasmic delta lambda chains and 10% with only cytoplasmic gamma lambda chains. These IgG-containing plasma cells showed cytoplasmic reactivity with rabbit antiserum raised against monoclonal IgD which was shown to contain specificities recognizing both delta chains and idiotypic determinants present in both serum IgD lambda and IgG lambda. Circulating B lymphocytes were 'monoclonal': almost all expressed surface delta lambda chains, and a small proportion of them expressed both delta gamma and lambda chains. High levels of IgD were detected in the supernatants of all cultures, but high concentrations of IgG were only detected in those from PWM-stimulated cultures with very low levels of IgM and IgA. These findings suggest that plasma cells producing either IgD or IgG were derived from a common B-cell clone. Double paraproteinaemia exhibiting a shift in immunoglobulin production from IgG to IgD has not been previously described.

Antibodies, Monoclonal↗
PubMed1982

[Endocardial cushion defect without ostium primum atrial septal defect associated with tetralogy of Fallot (author's transl)].

A case of endocardial cushion defect without ostium primum atrial septal defect associated with tetralogy of Fallot is presented. The echocardiogram is specially interesting showing two atrioventricular valves recorded simultaneously without an intervening ventricular septum, mitral continuity with the posterior semilunar valve and impossibility of recording the anterior semilunar valve. Findings similar to those of single ventricle with pulmonary stenosis. The anatomopathological findings and their possible embryonic basis are analyzed.

Down Syndrome↗
PubMed1981

[Clinical significance of dissociated cholestasis as a biological syndrome (author's transl)].

The case histories of 1200 patients admitted to our hospital over a 20 month period were reviewed to determine the degree, frequency and cause of dissociated cholestasis as a biological syndrome. Patients were divided into two groups: group I with 80 cases, included all patients whose gamma-GT levels were more than 30 mU/ml and serum-bilirubin less than 1.2 mg/ml, with alkaline phosphatase levels between 90-180 mU/ml. Group II included those with alkaline phosphatase levels higher than 180 mU/ml (57 cases). All over incidence of dissociated cholestasis was 13.82%. Main causes in group I were infectious diseases, mainly pneumonias and urinary infections and congestive cardiac failure. In group II, neoplasias such as Hodgkin's disease and epithelial metastases and obstructions of the biliary tract such as vesicular or choledocal litiasis were the main causes. Transaminase levels underwent variable increases according to the different entities, without there being any difference between the two groups. The physiopathology as well as the anatomopathological aspects which could originate the syndrome are discussed.

Alkaline Phosphatase↗
PubMed1980

[Hypersensitivity vasculitis and granulomatous hepatitis induced by glybenclamide: a case report (author's transl)].

The second case in the medical literature of hypersensitivity vasculitis induced by glybenclamide is reported, and for the first time vasculitic lesions are demonstrated in the histopathological study of liver tissue. The case was a male patient admitted because of a febrile illness and generalized malaise of long duration. He had diabetes mellitus that was being treated with glybenclamide. Physical examination disclosed fever, poor general condition, hepatomegaly, and red nodes in the finger-tips of both hands. Abnormal laboratory parameters included normochromic normocytic anemia, leukocytosis with a high eosinophil count, and markedly elevated erythrocyte sedimentation rate. There was as well slight cytolysis and marked elevation of cholestatic serum enzymes without hyperbilirubinemia. Biopsy of the skin lesions demonstrated anular granulomata, a common lesion in diabetics. The histopathological study of the liver revealed a vasculitic hypersensitivity reaction with conspicuous granulomata located in the vicinity of blood vessels and in the wall of portal arterioles, the endothelium of the latter being disrupted at different levels. Glybenclamide withdrawal resulted in a clinical, biological and histopathological cure of the disease. Unlike the previously reported case, the patient remains alive, and this may partly have been due to early institution of corticosteroid therapy.

Diabetes Mellitus↗
PubMedDate not supplied

Specific cutaneous involvement in Hodgkin's disease.

In Hodgkin's disease (HD) specific cutaneous involvement is rare. When it occurs, retrograde lymphatic spread, direct extension from the underlying lymph nodes, and hematogenous dissemination are the mechanisms usually implicated. Among 349 patients with HD diagnosed and followed-up at our institution from 1969 to 1990, three (0.85 per cent) presented specific cutaneous involvement. In two cases with mixed cellularity subtype, skin lesions displayed histologic features similar to those found in the lymph node. Treatment with combination chemotherapy resulted in rapid disappearance of the lesions in two patients but was ineffective in the third. Previous reports of cutaneous involvement in HD, its differential diagnosis, prognostic significance, and treatment are briefly reviewed.

Adult↗