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Biomedical subjects

J Sola

Publications and source records attributed to J Sola.

At least 37 records · Page 2Linked to original sources
PubMed1998

Insular carcinoma: an infrequent subtype of thyroid cancer.

BACKGROUND: Insular carcinoma is a little-known thyroid cancer, characterized by the presence of well-defined nidi of small uniform cells with frequent areas of tumor necrosis and microfollicles with thyroglobulin. It was described by Carcangiu in 1984, but its prognosis is not yet clear. STUDY DESIGN: Six of 335 patients undergoing surgery for thyroid carcinoma had the insular type. We studied age, gender, treatment, histology (tumor size, coexistence of another tumor, extrathyroid spread, vascular invasion, multicentricity, and metastatic adenopathies), TNM, and followup (recurrences, mortality, and survival). These results were compared with those published in the literature. RESULTS: Insular carcinoma was more common in women (4 of 6), and mean patient age was 32 years. Three patients had metastatic adenopathies. Four patients presented with other thyroid tumors (2 papillary, 1 follicular, and 1 anaplastic) and 2 were simple. Two patients had vascular invasion, and another 2 were extrathyroid. Only 1 case was multicentric. Three recurrences were detected in 2 patients over 50 years old: 1 lymph node at 60 months, 1 pulmonary at 132 months, and the other a bone recurrence at 8 months. Two patients died at 12 and 140 months. CONCLUSIONS: Insular carcinoma is a special type of thyroid cancer, and the prognosis is poorer than for the classic differentiated thyroid carcinoma.

Adenocarcinoma, Follicular↗
PubMed1998

Use of bile cytology for early diagnosis of complications in orthotopic liver transplantation.

We conducted a daily analysis of bile cellularity in 25 patients undergoing 29 orthotopic liver transplants (OLT) and correlated the cytological parameters with the clinical outcome of each patient. The 16 patients without complications only showed slides with cells during the first 4-5 postoperative days. The four patients with primary non-function (PNF) of the graft had a high cell density up to the time of the retransplant, with a preponderance of polymorphonuclear (PMN) leucocytes (59.2%) and epithelial cells (29.2%). During the episodes of sepsis (n = 3) and rejection (n = 7) we noted the sudden appearance of high cellularity, almost exclusively PMN leucocytes (96.5%), and a preponderance of PMN leucocytes (84.2%) with appreciable percentages of mononuclear cells and macrophages as well as the early appearance of lymphoblasts in the rejection episodes. Our results show that bile cytology can be a useful method for diagnosing graft complications in liver transplantation.

Adult↗
PubMed1998

[Other infections (Streptococcus pneumoniae, Haemophilus influenzae, Pseudomonas aeruginosa, Salmonella spp., Campylobacter spp., Nocardia asteroides, Rhodococcus equi and Bartonella spp.)].

People infected with human immunodeficiency virus (HIV) are at increased risk for bacterial infections due to HIV-associated immunologic defects. Bacterial infections were found to be, both a predictor of progression to AIDS and a substantial cause of mortality in pre-AIDS stages. Most bacterial infections are caused by Streptococcus pneumoniae, Haemophilus influenzae, Salmonella spp. and Pseudomonas aeruginosa. Rhodococcus equi, Nocardia spp., Campylobacter spp. and Bartonella spp. are less common. Data derived from two AIDS Clinical Trials Group studies showed that the most common bacterial infections were sinusitis (8.5 per 100 episodes per person years [py]), bacterial pneumonia (5.0 per 100 py), bronchitis (4.1 per 100 py) and soft tissue infections (3.5 per 100 py). In this review clinical characteristics and treatment recommendations according to data available in the literature for these infections are summarized.

AIDS-Related Opportunistic Infections↗
PubMed1997

Primary malignant rhabdoid tumor of the cerebellum.

Malignant rhabdoid tumor (MRT) is a recently described variety of childhood renal neoplasm. MRT arising primarily in the central nervous system (CNS) is still a rather unfamiliar pathological entity and is frequently misdiagnosed as medulloblastoma or primitive neuroectodermal tumor (PNET). We describe a 7-month-old boy who harbored a CNS-MRT that originated within the IV ventricle and invaded the brain stem and the cerebellar hemispheres. After an initial documented good response to chemotherapy the tumor recurred locally 9 months after operation. We discuss clinical and histopathological features distinguishing between PNET/medulloblastoma and MRTs. Current literature on MRT of the CNS is briefly reviewed.

Cerebellar Neoplasms↗
PubMed1997

Papillary thyroid microcarcinoma: clinical study and prognosis.

OBJECTIVE: To study the anatomical and prognostic characteristics of papillary thyroid microcarcinomas (10 mm or less in size). DESIGN: Retrospective review. SETTING: Community hospital, Spain. SUBJECTS: 36 patients with papillary microcarcinomas diagnosed over a period of 20 years from a total of 158 papillary carcinomas with complete follow-up. MAIN OUTCOME MEASURES: Symptoms, treatment, histopathological confirmation and follow-up compared with those of papillary carcinomas more than 10 mm in size. RESULTS: Six of the patients with microcarcinomas presented with adenopathy, the remaining 30 being admitted for treatment of associated thyroid diseases. In 15 cases the tumour was 5 mm or less in size. Thirty were well-differentiated, 2 were follicular, and 2 showed signs of diffuse sclerosis. Three had recurred after total thyroidectomy, but no patient died. When the results were compared with those of the patients with larger tumours, we found differences in histological type (p = 0.001), the incidence of adenopathy (p = 0.03), TNM stage (p = 0.001) and mortality (p = 0.04). CONCLUSIONS: There are clinical, histopathological, and prognostic differences between microcarcinomas (which do well) and larger papillary tumours.

Adolescent↗
PubMed1996

Effects of cold ischemia time on the graft after orthotopic liver transplantation. A bile cytological study.

We conducted a daily analysis of bile cellularity in 16 orthotopic liver transplant patients fitted with a T-tube, and correlated the cytological parameters (number of cells per slide, and percentage of difference cell types) with the duration of cold ischemia time (CIT). Two groups were established: one comprised patients whose CIT was less than 7 hr (CIT averaged 345 min) and the other comprised patients with a CIT of more than 7 hr (CIT averaged 505 min). The control group consisted of 15 patients who had received cholecystectomy for biliary lithiasis and were fitted with a T-tube. All 3 groups showed the highest cell density on the 1st postoperative day (control: 53.3 +/- 15.5 cells/slide; short ischemia: 70 +/0 21.4 cells/slide; long ischemia: 158.8 +/- 53.2 cells/slide), which steadily ischemia group showed a higher cell density than did the control group for the first 2 days, although this was not significant. The long ischemia group showed the highest cell density, although only significantly for the first 2 days when compared with the controls, and basically at the expense of a increase in ductal epithelial cells. Our results show that prolonged cold ischemia causes an increase in bile cell density at the expense of ductal epithelial cells: the longer the preservation time, the greater the increase.

Adolescent↗
PubMed1996

The child with a cephalocele: etiology, neuroimaging, and outcome.

We report a series of 46 children who were treated for one of the diverse forms of cranium bifidum during a period of 22 years. The purpose of the survey was to investigate pathogenetic factors involved in the development of cranial dysraphism and to analyze clinical and pathological factors that influence the patients' outcome. We also investigated the existence of associated intracranial anomalies, in a systematic way, using modern methods of neuroimaging, and related the findings to the patients' final results. The lesions were classified as encephalocele (n = 15), cranial meningocele (n = 3), atretic cephalocele (n = 26), cranium bifidum occultum (n = 1), and exencephaly (n = 1). There was an excess of the atretic form of cephaloceles in our series, a fact that probably reflects geographical variations described for cephaloceles in general. The location of the lesions was occipital in 29 children, parietal in 16, and temporal and frontobasal in one case each. In seven cases there was parental consanguinity. A familial history of malformations of the central nervous system was encountered in eight instances. Associated systemic abnormalities were present in 23 patients, while central nervous system anomalies were found in 36 children. Cephalocele repair was undertaken on 35 occasions. There were no surgical fatalities in the series. The mean follow-up time was of 7 years. Overall mortality for the whole group was of 17/46 or 36%. Twenty of the 29 survivors had no neurological sequelae, but only 18 children exhibited a competitive intelligence level. A good outcome was found to correlate well with: an average head size at birth, a normal initial neurological condition, operability of the lesions, and an absence of disorders of the neuronal migration. Neurological outcome depended also on the occurrence or not of hydrocephalus, while the intelligence level was mainly related to the absence of cerebral tissue within the sac of the malformation.

Abnormalities, Multiple↗
PubMed1996

Unusual osteolytic midline lesion of the skull: benign osteoblastoma of the parietal bone.

The authors report the case of a 5-year-old girl who presented with a parietal midline sub-scalp lesion. Skull radiographs demonstrated a lytic lesion surrounded by a sclerotic rim that resembled a dermoid cyst of the cranium. Histopathological analysis proved that the lesion was a benign osteoblastoma. As in other calvarial masses of uncertain nature, after diagnostic workup, we recommend surgical excision both for diagnosis and for treatment.

Child, Preschool↗
PubMed1996

Congenital desmoid tumor of the scalp: a histologically benign lesion with aggressive clinical behavior.

Desmoid tumors are uncommon benign neoplasms of fibroblastic origin, frequently presenting in the abdomen or abdominal wall of adults. This tumor is well known to general surgeons and pathologists, but it has rarely been reported in the neurosurgical literature. We describe a neonate who presented with a right temporal subscalp tumor at birth. In spite of initial apparent total removal, the tumor recurred twice. We discuss the diagnostic pitfalls encountered in assessing this tumor and the difficulties in distinguishing, in the excised specimens, between desmoid and reactive fibrosis. We suggest that desmoid tumor should be considered in the differential diagnosis of scalp and calvarial masses in children. Complete excision is required to prevent recurrences, and sometimes a multidisciplinary team is needed to secure margin-free resection.

Adult↗
PubMed1996

Familial occurrence of atretic cephaloceles.

In this article we report the cases of an 11-year-old girl who presented with an occipital atretic cephalocele and 2 of her siblings who had similar occipital lesions. Neuroimaging studies in these three instances showed a spectrum of posterior fossa cystic malformations. The girl's parents and a further sibling were also investigated by neuroimaging studies that proved to be normal. The familial occurrence of cephaloceles in general, and of atretic cephaloceles in particular, seems to be very rare in the absence of a known syndrome. Current literature on the familial presentation of cephaloceles and of Dandy-Walker complex is briefly reviewed. To the best of our knowledge this is the first description of the familial presentation of atretic cephaloceles not associated with a recognized syndrome.

Adolescent↗
PubMed1996

Encapsulated papillary neoplasm of the thyroid: retrospective clinicopathological study with long term follow up.

OBJECTIVE: To study the clinical course of patients with the encapsulated variant of papillary thyroid carcinoma, in which there is a well-defined fibrous wall completely separating the tumour cells from the adjacent tissue. DESIGN: Retrospective review. SETTING: University hospital, Spain. SUBJECTS: Of a total of 163 patients whose papillary thyroid carcinomas were treated surgically between 1975 and 1985, there were 25 encapsulated tumours. MAIN OUTCOME MEASURES: Clinicopathological features and survival rate compared with those of non-encapsulated papillary thyroid carcinomas. RESULTS: Mean follow up was 9 years (range 7-17), and 42 were excluded because follow up was incomplete. Encapsulated tumours differed from the earlier age of other types in that they presented earlier (mean age 36 years compared with 45), they were significantly less likely to have symptoms of compression (1/25 compared with 24/96, p = 0.024), or nodal metastases (3/25 compared with 43/96, p = 0.002), or to recur (0/25 compared with 33/96, p = 0.002). No patients died in the encapsulated group compared with 11/96 in the other group. CONCLUSIONS: Encapsulated papillary carcinomas have an excellent prognosis, and can be cured by operation.

Adolescent↗
PubMed1994

Comparison between preoperative cytology and intraoperative frozen-section biopsy in the diagnosis of thyroid nodules.

The value of intraoperative frozen-section biopsy of thyroid nodules (solitary or dominant in a multinodular goitre) was examined in patients who underwent fine-needle aspiration cytology (FNAC) for diagnosis before operation. A total of 170 consecutive patients were evaluated and classified according to whether the cytological diagnosis was benign, suspicious or malignant. In the benign group, diagnostic accuracy was 98 per cent for FNAC and 97 per cent for intraoperative biopsy. In those with suspicious cytology, diagnostic accuracy was 12 per cent for FNAC and 96 per cent for intraoperative biopsy. In those with malignant cytology there was 100 per cent accuracy for FNAC and 76 per cent for biopsy. Intraoperative biopsy by frozen section is useful in patients undergoing surgery for a thyroid nodule with a 'suspicious' cytology. It adds no information in patients with a diagnosis of malignancy following cytological assessment and is of limited use in those in whom a benign lesion is diagnosed.

Adolescent↗