Biomedical subjects
Publications and source records attributed to A Ariza.
The authors performed laparoscopy on eight patients (six females and two males) with lepromatous leprosy. The findings show that goose flesh hepatomegaly (100% of the cases), and red or gray splenomegaly (75% of the cases) can be considered as laparoscopic hallmarks of lepromatous leprosy.
Case report of a 17-year-old man with acute bridging hepatitis in whom laparoscopy was followed by subcuteneous emphysema, penumomediastinum and pneumopericardium. No previous report has been published on pneumopericardium as a complication of laparoscopy.
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The need to control recurrent biliary strictures implies the practice of repeated major surgical procedures. The hepaticojejunostomy with subcutaneous jejunal access (Chen's procedure) allows the permanent option of a non-operative management of recurrent biliary tract anastomosis complications. Through the subcutaneous jejunal access, the application of a Gianturco metallic prosthesis is permitted and the correction of biliary-intestinal anastomosis strictures with non-operative methods is possible. This report is a review of a series of 20 patients treated with the Chen procedure, of whom 3 patients also had implantation of Gianturco stents via hepaticojejunostomy with subcutaneous access.
A case of multiple myeloma which presented as a solitary intrasellar tumor is reported. The initial radiographic and light microscopic findings were interpreted as being consistent with pituitary adenoma. Subsequently, when systemic disease developed and a bone marrow biopsy demonstrated multiple myeloma, the histopathologic diagnosis of the sellar lesion was established retrospectively.
OBJECTIVE: To determine immunohistochemically the expression of mutant p53 phosphoprotein in hepatocellular carcinoma (HCC) and its possible relationship to several etiologic factors. STUDY DESIGN: The study group consisted of 62 samples of HCC, grades 2, 3 and 4, obtained by fine needle aspiration cytology. The associated risk factors detected in these patients were as follows: ethanol abuse, ethanol abuse plus hepatitis B virus (HBV) or hepatitis C virus (HCV) infection, HBV infection, HCV infection, non-A/ non-B hepatitis, hemochromatosis and obesity. RESULTS: Mutant p53 expression was identified in 22% of HCC and seemed to correlate with tumor grade. Positive immunostaining was frequently associated with a history of alcohol abuse (42%) and also with viral infection (HBV, 21%; HCV, 7%; non-A/non-B hepatitis, 7%). CONCLUSION: Mutant p53 seems to intervene in the progress of HCC through various grades of increasing malignancy. The association we found between alcohol intake and mutant p53 expression may deserve further investigation.
This is a report of a case a larval granulomatosis associated with immunoblastic lymphadenopathy, corroborated by laboratory and histologic studies compatible with that. The etiopathogenesis, clinical picture and diagnosis of both diseases are commented, and the possible relationship between them is stressed.
INTRODUCTION: Peripheral neuropathy is usually one of the initial symptoms of necrotizing vasculitis. Early diagnosis is essential for good prognosis. OBJECTIVE: To determine which parameters are useful for early diagnosis and selection of tissue for biopsy. PATIENTS AND METHODS: We analyzed the clinical, biological, electromyographic and anatomopathological characteristics of 26 patients with necrotizing vasculitis and peripheral neuropathy. RESULTS: Twelve patients had panarteritis nodosa, three Churg Strauss syndrome, two Wegener s syndrome, two disseminated lupus erythematosis, one sarcoidosis and one Walderstrom s macroglobulinemia. Fifteen patients had multineuritis and the remainder distal mixed polyneuropathy which was symmetrical in three cases. In five cases biopsy was normal. Sural nerve biopsy showed the diagnosis to be correct in 20% of the patients. However, when this was done on a neurophysiologically affected nerve, the tissue was seen to be altered in 61%. Biopsy of the gastrocnemius increased the degree of usefulness to 73% when electromyographic anomalies were detected in this muscle. CONCLUSIONS: Neurophysiological study is essential for detection of alterations in patients clinically suspected of having necrotizing vasculitis, even in cases where there is apparently no neuropathy. We recommend biopsy of the gastrocnemius muscle as the first choice in cases where sural nerve neurography is found to be normal. If the sural nerve is not normal, it is the site of choice for biopsy, and muscle biopsy is the site of second choice. When both biopsies are normal, renal biopsy should be considered to establish the diagnosis, as a third alternative.
INTRODUCTION: Chloroquine is a drug that is widely used in rheumatology and occasionally prescribed in dermatology. From a neurotoxicological point of view, chloroquine can have effects on the peripheral nerves, muscles, neuromuscular junctions and the central nervous system. In this study we analyse the clinical, neurophysiological and anatomopathological findings in two patients with chloroquine induced neuromyopathy, which took the form of a polyradiculoneuropathy. CASE REPORTS: Case 1: a 75 year old female with rheumatoid arthritis treated with daily doses of 250 mg of chloroquine for four years. The patient visited because of several months history of predominantly proximal progressive tetraparesis with areflexia. Analytical tests and lumbar puncture were normal. Electromyogram (EMG): proximal myopathic and distal neuropathic patterns. Muscular biopsy: vacuolar myopathy with accumulations of phagolysosomes, lipids, lipofuscin, myelinic curvilinear bodies. Case 2: a 74 year old female with arthropathy treated with daily doses of 250 mg of chloroquine for nine months. The patient presented a progressive proximal paraparesis with generalised areflexia. Analytical tests and lumbar puncture were normal. EMG: mixed sensory motor polyneuropathy, myogenic pattern with high frequency discharges in the iliac psoas and a neurogenic pattern in the distal muscles. Muscular biopsy: vacuolar myopathy suggesting a myopathy due to chloroquine. After stopping treatment with this drug the patients progressed favourably. CONCLUSION: Chloroquine can induce a clinical pattern that suggests a polyradiculoneuropathy. It is important to establish a history of having taken this drug. If this is indeed the case, then an electromyographic study of the most proximal muscles should be performed in order to detect a myogenic pattern and the same exploration should be applied to the distal muscles to reveal a neurogenic pattern. The final diagnosis will be established by muscular biopsy.
We present a 71-year-old man with primary amyloidosis characterized by several outstanding clinical features, namely hip involvement of a pseudotumoral appearance, periarticular osteolytic lesions and a pathological fracture. Kappa light chains in the synovial fluid were observed. The patient survived for 90 months without developing plasma cell dyscrasia, and with preservation of vital functions despite parenchymal involvement of multiple organs.
The results of craniocorpographic recordings in the Babinski-Weil test are discussed, focusing on the star-shaped variant. The variants of star-shaped gait are defined as posterior, centered, advanced, forward, extreme, and lateral. In 22 healthy individuals and 60 patients, star-shaped gait was the most common deviation. Extreme star-shaped gait was the most frequent variant in the healthy subjects and the backward variant was the most frequent in the patient group.