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Biomedical subjects

A Sami

Publications and source records attributed to A Sami.

At least 19 recordsLinked to original sources

HER-2/neu-gene engineered dendritic cell vaccine stimulates stronger HER-2/neu-specific immune responses compared to DNA vaccination.

HER-2/neu is a candidate for developing breast cancer-targeted immunotherapeutics. Although DNA-based and HER-2/neu transgene-modified dendritic cell (DC)-based vaccines are potent at eliciting HER-2/neu-specific antitumor immunity, there has been no side-by-side study comparing them directly. The present study utilizes an in vivo murine tumor model expressing HER-2/neu antigen to compare the efficacy between adenovirus (AdVneu)-transfected dendritic cells (DC(neu)) and plasmid DNA (pcDNAneu) vaccine. Our data showed that DC(neu) upregulated the expression of immunologically important molecules and inflammatory cytokines and partially converted regulatory T (Tr)-cell suppression through interleukin-6 (IL-6) secretion. Vaccination of DC(neu) induced stronger HER-2/neu-specific humoral and cellular immune responses than DNA vaccination, which downregulated HER-2/neu expression and lysed HER-2/neu-positive tumor cells in vitro, respectively. In two HER-2/neu-expressing tumor models, DC(neu) completely protected mice from tumor cell challenge compared to partial or no protection observed in DNA-immunized mice. In addition, DC(neu) significantly delayed breast cancer development in transgenic mice in comparison to DNA vaccine (P<0.05). Taken together, we have demonstrated that HER-2/neu-gene-modified DC vaccine is more potent than DNA vaccine in both protective and preventive animal tumor models. Therefore, DCs genetically engineered to express tumor antigens such as HER-2/neu represent a new direction in DC vaccine of breast cancer.

Adenoviridae↗

[Intramedullary schwannoma. A case report].

The intramedullary localization of schwannoma is rare, corresponding to 0.3% of all intraspinal tumors. We report a case of intramedullary schwannoma without symptoms suggestive of neurofibromatosis. This patient presented with symptoms of spinal compression. Total removal of the tumor was achieved. The literature is reviewed about of this rare localization of schwannoma.

Adult↗

[Gliosarcomas. A case report].

Gliosarcomas account for 2% of glioblastomas. We report a case of gliosarcoma in a 65-year-old man, which presented as meningioma, and discuss diagnostic, therapeutic and prognostic aspects of this particular entity.

Aged↗

Imprint cytology of needle core-biopsy specimens of breast lesion: is it best of both worlds?

The concept and working of one-stop breast clinic has been evolving over the last 10 years. With more frequent use of core biopsy by the dedicated breast units, one-stop results service cannot be provided. The purpose of this study was to examine the feasibility of the use of imprint cytology of the core-biopsy specimens of breast lesions in a one-stop setting, in order to spare patients pain and suffering of a needle test without anaesthetic while retaining the advantages of availability of greater pathological characteristics of tumours by core biopsy. Forty-one consecutive core-biopsy specimens from symptomatic patients who underwent free hand or ultrasound-guided core biopsies of the suspected breast lesion were rolled on a glass slide to obtain imprint cytology. The cytological reporting was done independent of histological reporting of core biopsy. Overall concordance between imprint cytology and histology was 90%. For imprint cytology overall sensitivity was 91% and specificity was 89%. The positive predictive value was 97% and negative predictive value was 73%. Imprint cytology was found to be a quick, reliable and effective way of diagnosing breast lesions in breast clinic.

Biopsy, Needle↗

[Lumbar intradural hydatid cyst. Case report].

Hydatid disease is a serious public health problem in developing countries. Cerebrospinal localizations account for 1% of all cases of hydatid disease. The spino-radicular form is exceptional. We report a case of a 25-year-old women with cauda equina. Thoraco-lumbar MRI has showed an intradural process extending from L3 to L5, a low-intensity signal on T1 weighted images and a high-intensity signal on T2 weighted images, which were not enhanced after gadolinium injection. There was no vertebral involvement. After L3 L4 and L5 laminotomy and opening of the dura-matter, multiple vesicles were found scattered among the roots, with no adhesion to meninges or nervous structures. Total extirpation was easy. The outcome was marked by recovery of the motor deficit and sphincter disorders. This localization is serious but its prognosis is excellent if the diagnosis is made early enough to prevent cyst rupture and to allow total resection.

Adult↗

[Cerebellar schistomiasis. A case report].

Schistomiasis or bilharziosis remains an endemic parasitic disease in many countries world wide. Urogenital, intestinal and hepatic symptoms are common. The brain is exceptionally involved and very few cases have been described in the literature. We report the case of a 35-Year-old male with a history of hematuria and bladder disorders, who developed signs of intracranial hypertension and a cerebellar syndrome over a period of one Month. Brain MRI disclosed a cerebellar lesion and a pelvic CT scan revealed a bladder tumor. Treatment consisted in a ventriculo-peritoneal shunt and corticosteroid therapy. Cystoscopy was performed for total resection of the bladder lesion. Histopathology confirmed the diagnosis of schistomiasis. Surgery was also performed to approach the cerebellar lesion. Histopathology showed the inflammatory nature of the lesion. The patient was given an antiparasitic treatment. Clinical and radiological radiological manifestations regressed.

Adult↗

[Intramedullary tuberculomas. Five cases].

Tuberculosis of the central nervous system is uncommon. The intramedullary localization is exceptional. We report five cases of intramedullary tuberculosis observed in four women and one man with a mean age of 43 years. Two patients had a prior history of tuberculosis. Spinal cord compression was found clinically in all cases. The spinal MRI visualized the tuberculoma in all patients; two had a double tumor. Complete removal of the tuberculoma was possible in only one patient. Outcome was stationary for four patients.

Adult↗

[Epidermoid cyst of the cerebellopontine angle. A surgical series of 10 cases and review of the literature].

Epidermoid cyst or cholesteastoma is a congenital slow growing lesion. It usually arises in the paramedian cisterns of the posterior fossa. Its incidence varies between 0.2 and 1% of all intracranial tumors. The cerebello-pontine angle (CPA) is the most common localization. Our study reports 10 observations of CPA epidermoid cysts, treated in our department between 1989 and 1999. The age of our patients ranged from 20 to 45 years, with male predominance. The patients were admitted with symptoms of cerebello-pontine angle syndrome or signs of posterior fossa tumor. CT-scan was performed in all cases and MRI was performed in 5 patients. The audiometric explorations only provided an orienting contribution. Treatment was exclusively surgical. The retro-sigmoid approach was used in 6 cases, the sub-occipital in 30% and a subtemporal approach in one case. Total resection of the epidermoid cysts was accomplished in 4 cases, and subtotal resection in 4 cases. Two patients underwent partial resection and underwent a revision procedure. The histological examination showed an epidermoid cyst in all cases. The clinical course was controlled in 6 patients: 4 patients recovered and became symptom free. A persisting neurologic deficit was observed in two cases (hearing loss, dysphonia); 4 patients were lost to follow-up. Epidermoid cyst is a benign tumor. Total resection is the ideal treatment, but we have to be aware, taking into consideration the adherence of the tumor to neurovascular structures, of the risks at attempting total resection.

Adult↗

[Acute subdural hematoma of the posterior fossa in the child. Case report].

Acute subdural hematoma (ASDH) of the posterior fossa is very rare in childhood. It represent 0.52% of all subdural hematomas. We report a case of post-traumatic acute subdural hematoma of the posterior fossa in a 4-year-old child who was drowsy, without a neurologic defect. The CT scan revealed a simple ASDH, with a good recovery after surgical treatment. The literature is reviewed, clinical and therapeutic aspects are discussed.

Bicycling↗

[Suboccipital tuberculosis: a case report].

Suboccipital tuberculosis is an uncommon localization of Pott's disease. The gravity results from the neurological and life threatening risk. We report a case of suboccipital tuberculosis in a 22-year woman who survived. She was given an anti-tuberculosis antibiotic regimen due to pulmonary and pericardal involvement. The patient interrupted her treatment after four months and was admitted six months later for torticolis and spastic tetraplegia without sphincter disorders. Standard x-rays and MRI of the head confirmed suboccipital Pott's disease. Transcranial evacuation was performed and the patient was again given anti-tuberculosis antibiotics. The clinical course was favorable with definitive recovery 45 days later. The patient continued the antibiotic regimen for nine months. An orthopedic supporting device was worn for nine months. The diagnosis of suboccipital tuberculosis can be confirmed on MRI. Appropriate treatment is a subject of debate between exclusive orthopedic or combined orthopedic and surgical treatment. Prognosis depends on the neurological deficit, early diagnosis and prompt treatment.

Adult↗

[Sphenotemporal aneurysmal bone cyst. A new case and review of the literature].

Aneurysmal bone cysts (ABC) are benign tumors of the bones, formed by multiple cysts filled with blood and eroding the bone. They are rarely located at the skull. We report a case of a right temporal ABC in a 5-year-old girl. On admission, the physical examination showed a tough and fixed tumor, with no inflammatory signs nor vascular characteristics. The neurological examination was normal. Imaging studies showed an heterogeneous extracerebral mass, eroding the temporal bone and the greater wing of the sphenoid bone. The treatment consisted in an extensive tumor resection, associated with reconstructive surgery. The outcome was uneventful (follow-up 27 months). We underline the pathogenetic, diagnostic and therapeutic features of this condition.

Bone Cysts, Aneurysmal↗

[Epidermoid cyst in the occipital skull vault. A case report].

We report a case of an epidermoid cyst of the occipital skull vault in a 28 year-old woman. The symptomatology was an occipital swelling and pain. The diagnosis was evoked on the skull X-ray and computed tomography scan. Total removal of the tumor provided complete recovery.

Adult↗

[Intracranial meningioma in an infant. Report of a case].

We report a case of a benign temporal meningioma in 1 month old infant. The diagnosis was revealed by atypical seizure. The physical exam was normal. We underline the epidemiological, clinical and prognostic aspects of this condition.

Humans↗

[Multiple cerebral hydatic cysts of cardiac origin. A case report].

The hydatic cyst is a pathology observed in developing countries. Multiple cerebral localizations with a cardiac origin are exceptional and are sometimes diagnosed only after onset of complications. We present the case of a 22-year-old male student: the diagnosis of multiple cerebral hydatic cysts caused by rupture of a cardiac hydatic cyst was established after an episode of ischemia of the limbs with cerebral hemorrhage induced by heparin. One year later, the clinical situation consisted in intracranial hypertension, hemiplegia and convulsive seizures. We observed no cardiac symptoms. The brain CT showed 9 hydatic cysts and echocardiography showed a myxomatous cystic tumor. Abdominal CT detected renal and splenic hydatic cysts. The patient underwent total ablation of the cerebral and abdominal cysts and made a full recovery. After surgical removal of the cardiac cyst, the patient has been lost to follow-up. Cerebral hydatidosis of cardiac origin is highly exceptional and, due to nonspecific symptomatology, may go undiagnosed. In general, prognosis is good in case of a cerebral localization but the cardiac localization is associated with high mortality.

Adult↗

Open label gabapentin treatment for pain in multiple sclerosis.

Pain is a frequent and distressing complaint in patients with multiple sclerosis (MS) and may present a difficult therapeutic problem. Conventional therapy is moderately effective and includes, among others, a variety of anticonvulsant medications. Gabapentin (Neurontin) is a new generation antiepileptic drug which appears to be advantageous in treatment of intractable pain of reflex sympathetic dystrophy. This study investigates the benefits of open-label treatment with gabapentin for pain control in 25 patients with MS. Excellent to moderate pain relief was obtained in a substantial number of patients. Throbbing pains and needles, and cramping pains responded best, and dull aching pains responded least to the medication. There was no significant change in distribution and type of pain as a result of this treatment. Mild to moderate side effects were observed. Cautious escalation of the dose of gabapentin is advisable in MS patients. Further clinical trials with larger patient groups are recommended.

Acetates↗

[Hydatid cyst of the spine and spinal cord. Study of 24 cases].

In this retrospective study, we report our experience of severe hydatid disease located to the spine and the adjacent spinal cord observed in 24 cases between 1970 and 1994. In our series the sex ratio was predominant for males, and the mean age was 29 years. Clinically, the patients presented predominantly with a motor deficit. The diagnosis was assessed on radiological and biological investigations and was confirmed preoperatively. Hydatid serology was positive in 7 out of the ten cases explored. On standard X rays, the bone lesions were frequent: lysis in 10 cases, vertebral deformation in 3 cases, costal invasion in 5 cases, and paravertebral collection in 2 cases. These lesions were predominantly located at the thoracic level. Myelography confirmed a complete blockade in 8 out of 11 cases. When possible, the CT scan confirmed the bone lesion in all of the 10 cases explored, with an intrathecal cyst in 7 cases and a paravertebral collection in 8 cases. Magnetic resonance imaging was possible in one case only. Medical antihelminthic treatment was indicated as the sole treatment in one inoperable case. All the other patients were operated on, and the adjunctive specific medical treatment was associated in 5 cases. Using a posterior approach in 20 cases, the operative technique consisted in a complete removal (if possible) of the invaded bone and soft tissue, thus achieving a complete relief of the spinal cord compression. Complementary bone fixation was indicated in 2 cases. During the postoperative follow-up, two patients died from infection and trophic ulceration, 11 patients improved and 8 patients remained unchanged. In 5 cases, a reoperation was indicated and performed from 2 to 4 times. Three patients were lost for follow-up. The severity of this affection is confirmed in the literature. A complete recovery is quite exceptional. The best treatment remains an active nationwide prevention of the disease.

Adolescent↗

[Intradural extramedullary tuberculous abscess. Apropos of a case].

Intradural extramedullary tuberculous spinal abscess is rare and has a poor prognosis if not diagnosed early and treated adequately. We report the case of 13 year-old boy who presented with an 8-month history of paraplegia. MR imaging demonstrated an intradural extramedullary spinal abscess in the mid-thoracic region. At operation, an encapsulated abscess was removed completely. The tuberculous nature was confirmed with microbiological testing. Postoperative antituberculous chemotherapy resulted in complete recovery. MR imaging can prove very helpful in early diagnosis of this condition, which is particular relevant in countries where tuberculosis is endemic.

Abscess↗