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J Sola

Publications and source records attributed to J Sola.

At least 55 records · Page 3Linked to original sources
PubMed1994

Accidental transmission of Creutzfeldt-Jakob disease by dural cadaveric grafts.

Four patients who received dural grafts of cadaveric origin in the course of posterior fossa procedures subsequently developed Creutzfeldt-Jakob disease (CJD). The interval from dural placement to clinical onset of CJD ranged from 16 months to nine years. Initial clinical presentation consisted of cerebellar symptoms, with dementia and myoclonus developing in later stages of the disease. EEGs showed diffuse slowing that evolved to a periodic activity pattern. CT and MRI were unremarkable in the early stages but pronounced cerebral and cerebellar atrophy with widened sulci and collections of fluid over the convexities were seen in the late stages of disease. The diagnosis was histologically proved by brain biopsy in all four cases. Molecular genetic analysis showed that the four patients were homozygous for methionine at codon 129 of the PrP gene. From this experience, and from six previous descriptions of this occurrence in the literature, it is manifest that awareness of the means of iatrogenic transmission of CJD, and the adoption of preventive measures, constitute the only effective way to stop the spread of CJD among patients who have neurosurgery.

Adolescent↗
PubMed1993

Pediatric Creutzfeldt-Jakob disease: probable transmission by a dural graft.

A 10-year-old boy underwent a posterior fossa craniectomy for removal of a grade 2 cerebellar astrocytoma. Dural closure was achieved by the placement of a dural graft. Eight years later the patient developed dementia and myoclonus. Electroencephalography demonstrated generalized slow activity that evolved into a pattern of periodic triphasic waves. Computed tomography scan and magnetic resonance imaging were unremarkable. Brain biopsy confirmed spongiform encephalopathy of the Creutzfeldt-Jakob type. In the light of previous reports of four similar occurrences, and of our own experience with two further cases of this disease, we believe that the cadaveric dura was the source of transmission of Creutzfeld-Jakob disease in our patient. The authors remark the importance of the awareness of this late complication of dural substitutes, both for the diagnosis of possible future cases and for taking preventive measures to stop the spread of the disease.

Astrocytoma↗
PubMed1993

Histological outcome of chronic hepatitis C treated with a 12-month course of lymphoblastoid alfa interferon.

To assess the effect of long-term alfa interferon therapy (12 months) on liver histology of chronic hepatitis C, we studied 61 treated patients, and compared their outcome with 28 untreated cases followed as controls. A liver biopsy was taken from all patients, before (month 0) and after the completion of the treatment or the control period (month 12). A third liver specimen taken at month 24 was available in 29 treated cases. Liver biopsies were blindly graded following Knodell's method. In 33 out of the 61 treated patients (54.1%), aminotransferase levels became normal shortly after starting therapy and remained within normal values until the end of treatment (sustained response). Nine (27%) sustained responders relapsed after interferon discontinuation, while the remaining 24 (73%) continued with normal aminotransferase values during follow-up (16.8 +/- 9.9 months). All histological parameters, except fibrosis, improved significantly after 12 months of therapy (periportal necrosis, month 0: 2.7 +/- 1.0, month 12: 1.6 +/- 1.1, p < 0.0001; lobular damage, month 0: 2.5 +/- 1.1, month 12: 1.4 +/- 0.9, p < 0.0001; portal inflammation, month 0: 3.6 +/- 0.5, month 12: 3.0 +/- 0.9, p < 0.0001). Histological improvement was especially marked in patients who did not relapse, although those who relapsed and partial responders also improved. Overall histological diagnoses improved in most patients. A sustained response to interferon was predicted by high periportal and lobular scores, and by a low fibrosis score on the pretreatment liver biopsy. At 24 months, histological improvement persisted in patients without posttreatment relapse, while liver inflammation had returned to pretreatment levels in the remaining cases.

Adult↗
PubMed1992

Role of leukotrienes B4 and C4 in liver allograft rejection.

Previous studies have shown that eicosanoids may act in vitro as immunoregulatory substances. In this study, the concentrations of leukotriene B4 (LTB4) and leukotriene C4 (LTC4) were measured in a model of allograft rejection. Six orthotopic allotransplants of the liver were performed in dogs without the administration of immunosuppressives. LTB4 levels showed an increase coinciding with the start of rejection, significant differences being present between the basal levels and those measured 24 h post-revascularization (P < 0.05), and every day from the 3rd postoperative day (P < 0.01). LTB4 rose before the parameters generally used in evaluating rejection. LTC4 levels increased significantly (P < 0.001) in the first 24 h, and experienced no further variations. LTB4 may play an important role in the mechanisms which bring about the response to the allograft. This substance could be a specific and early marker for rejection.

Animals↗
PubMed1992

Congenital arachnoid cyst of the lateral ventricles in children.

The authors report a series of three children with symptomatic congenital arachnoid cyst of the lateral ventricles. Presenting symptoms consisted of macrocephally, delay in psychomotor development, and seizures. CT findings were of a well-defined cystic lesion placed in the atrium of the lateral ventricle. One child was treated by direct cyst exposure and cysto-peritoneal shunt. The other two were treated with ventriculo-cysto-peritoneal shunts; in one of these, we used a ventriculoscope both for cyst fenestration and for accurate shunt placement. The origin of intraventricular arachnoid cysts seems to be secondary to the displacement of arachnoid cells by the vascular mesenchyma, through the choroid fissure, during the process of choroid plexus development.

Arachnoid Cysts↗
PubMed1992

Atretic cephalocele: the tip of the iceberg.

Atretic cephalocele appears as an unimportant and benign lesion. This malformation consists of meningeal and vestigial tissues (arachnoid, glial, or central nervous system rests). The authors report the findings in 16 cases (seven parietal and nine occipital) of rudimentary cephaloceles. Twelve patients presented with associated brain abnormalities detected by either computerized tomography (CT) or magnetic resonance imaging (MR). Nine lesions also exhibited an anomalous vascular component demonstrated by CT or MR imaging or at surgery. The existence of this tiny malformation in five cases was the main diagnostic clue to a severe complex of cerebral anomalies, namely cerebro-oculomuscular (Walker-Warburg) syndrome. An occipital location of the atretic cephalocele was associated with the worst prognosis, with only two children developing normally. However, a parietal location carried a better prognosis, which is contrary to the outcome reported in the current literature. The authors classify atretic cephaloceles into two types based on histological examination of the surgical specimens, and suggest that these types represent different stages in the development of this malformation. It is concluded that, in the evaluation of the atretic cephalocele, the neurosurgeon is obliged to proceed to a detailed neuroradiological study of the patient and that the prognosis does not depend on the existence of the cephalocele itself, but rather on associated "occult" brain anomalies.

Encephalocele↗
PubMed1992

Microscopic rice bodies in rheumatoid synovial fluid sediments.

To determine the clinical significance of the microscopic study of the synovial fluid (SF) sediment, 306 sediments were examined from 216 patients with the most frequently occurring acute and chronic arthropathies. The SF was obtained using a fine gauge needle. Microscopic rice bodies were seen in 53 (17.3%) of the samples studied. Forty-five (84.9%) of the samples in which rice bodies were observed were from patients with rheumatoid arthritis (RA) (p < 0.001); 34.9% of the 129 RA samples were found to contain rice bodies. The specificity of finding rice bodies in RA was 95.5%. Most rice bodies were composed of partly or totally hyalinized fibrinous material; in their interior, mononuclear cells were predominantly observed--most of them macrophagic in appearance. With less frequency the rice bodies exhibited central areas of fibrosis. Our results suggest that microscopic rice bodies are fibrinous particles derived from the entrapping of cells in the dense fibrin network present in inflammatory SF.

Arthritis, Rheumatoid↗
PubMed1991

Meningiomas with haemorrhagic onset.

Classically meningiomas present and evolve with a progressive course. Meningiomas manifest themselves mainly in middle and old age when the incidence of strokes is higher. The authors report three instances of meningioma with acute haemorrhagic onset. The clinical picture of our cases consisted of subarachnoid bleeding, subdural hematoma and intracerebral haemorrhage respectively. The diagnostic difficulties encountered when assessing these patients are discussed. The current literature regarding meningioma associated with haemorrhage is reviewed. One of our cases seems to be the first reported case of subarachnoid haemorrhage originating from a meningioma of the petrous bone.

Aged↗