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Biomedical subjects

C Lema

Publications and source records attributed to C Lema.

16 recordsLinked to original sources
PubMed2001

[Inverted metamorphopsia: an alteration in the perception of a special situation of objects].

OBJECTIVES: This study describes the characteristics of six patients who consulted because of episodes of perceptive alteration of extrapersonal space consisting in an inversion of the situation of objects although without changes in shape or size (inverted metamorphopsia). PATIENTS: Six patients (4 males and 2 females) who presented episodes of inverted metamorphopsia were studied: 4 referred right-left inversion (axial plane), 1 upwards-downwards (saggital plane) and 1 inclination of environment (clockwise movement). None had any alteration in the perception of their own bodies during the episodes which lasted from 3 minutes to 1 hour, reporting from 1 to 40 episodes. The most notable antecedents were: traumatism and forced cervical posture (2), arterial hypertension (3), migraine (2), hyperlipemia (2) and protuberantial ischemia (1). RESULTS: Intercritical neurologic exploration was normal. MR study showed leukoaraiosis (4), protuberantial paramedian infarctions (1) and was normal in one case of basilar migraine. Study of vestibular function (performed in 4 cases) did not show alterations. Three patients received antiepileptic drugs (1 carbamazepine and 2 gabapentin) with favorable response. CONCLUSIONS: Inverted metamorphopsia is a paroxistic phenomenon which transduces a dysfunction of the posterior parietal cortex or its afferences (propioceptive, vestibular, retinian). The causes may be multiple (traumatism, migraine, ischemia). Antiepileptic drugs may have a therapeutic role in the cases with multiple episodes.

Adult↗
PubMed2000

Green tea polyphenols induce apoptosis in vitro in peripheral blood T lymphocytes of adult T-cell leukemia patients.

Green tea polyphenols (TEA) are known to exhibit antioxidative activity as well as tumor-suppressing activity. In order to examine the tumor-suppressing activity of TEA against adult T-cell leukemia (ATL), we cultivated peripheral blood T lymphocytes of ATL patients (ATL PBLs), an HTLV-I-infected T-cell line (KODV) and healthy controls (normal PBLs) for 3 days in the presence of TEA and its main constituent, epigallocatechin-3-gallate (EGCg), to measure cell proliferation and apoptosis, and to quantitate mRNAs of HTLV-I pX and beta-actin genes of the cultured cells. Growth of ATL PBLs was significantly inhibited by 9-27 microg/ml of TEA and EGCg, in contrast to minimal growth inhibition of T cells of normal PBLs. Inhibition of KODV was intermediate between ATL PBLs and normal PBLs. The ATL PBLs and KODV treated with 27 microg/ml of either TEA or EGCg induced apoptotic DNA fragmentation, producing terminal deoxynucleotidyl transferase-mediated dUTP-biotin nick end labeling (TUNEL)-positive cells, while the normal PBLs treated with the same concentration of TEA or EGCg produced a negligibly small number of TUNEL-positive cells, in which apoptotic DNA fragmentation was not detectable. Expression of HTLV-I pX mRNA was suppressed more than 90% in ATL PBLs by treatment with 3-27 microg/ml of either TEA or EGCg, while expression of beta-actin mRNA was much less suppressed by treatment with the same concentration of TEA or EGCg. These results indicate that TEA and EGCg inhibit growth of ATL PBLs, as well as HTLV-I-infected T-cells, by suppressing HTLV-I pX gene expression and inducing apoptotic cell death.

Adult↗
PubMed2000

[Malignant prolactinoma with intra- and extracranial metastasis: clinico-radiologic study].

Malignant prolactinomas are very rare pituitary neoplasms which can be identified not from the hystopathologic nor neuroimaging aspects but only retrospectively from the presence of distant metastases. A 32-year-old male patient was diagnosed of a pituitary prolactinoma because of bitemporal hemianopsia on the basis of cranial MRI aspect and raised blood prolactin level. Visual signs improved under bromocriptine treatment but after surgical and X-ray therapies patient developed paralysis of V and XII left cranial nerves and suffered from medulocerebelous angle, vertebrae, spinal epidural space, lung, liver, suprarenal and femoral metastases. Patient died 3 years after the diagnosis time. Prolactin levels raised 2000 ng/ml. This is the first case of malignant prolactinoma described in the spanish literature and the more large one in number of metastatic localizations between the malignant prolactinomas from the literature. These kind of neoplasms can be partially ameliorated under X-ray and bromocriptine treatment but there is not, by the moment, a curative chemotherapy.

Adult↗
PubMed1998

[Long chronic course of hemiparkinson-plus with l-dopa maintained response].

UNLABELLED: OBJECTIVE AND CLINICAL CASE: We describe and present a video film of a patient with a hemiparkinsonian illness associated with hemidystonia and pyramidalism, which responded to continuous L-Dopa treatment for twenty years, with no fluctuation or deterioration at the end of the dose-effect. CT and MR studies were normal. CONCLUSIONS: The characteristics of this case with probable static unilateral dysfunction, basically presynaptic, of the nigrostriate via, make it reasonable to include it in the hemiparkinson-hemiatrophy group.

Aged↗
PubMed1998

[From writer's cramp to butcher's spasms: a case of interprofessional dystonia].

INTRODUCTION: Occupational or professional dystonia is a focal motor dystonic disorder which affect motor programs necessaries for the exercise of the patient's profession. Clinical case. A patient with writer's cramp in the childhood presented at the age of 22 years a new dystonia, which we name 'butcher's spasm', giving rise to a laboral incapacity. Neurological exam was normal except for right arm distal (writer's cramp) and proximal dystonias (butcher's cramp), with intentional tremor in the upper extremities. We classified, after complementary exams, the disease as idiopathic. CONCLUSIONS: Idiopathic focal dystonias can progress to segmentary or multifocal dystonias, and, in exceptional cases as ours, can interfere with two different professional activities.

Adult↗
PubMed1996

[Hemiballismus heralding thrombosis of the basilar artery].

We present a patient with top-of-the-basilar syndrome that was preceded by hemiballismus and progressed to coma and tetraplegia. Magnetic resonance imaging showed extensive infarction in the basilar artery territory. Cerebral angiography confirmed basilar artery obstruction. The patient died in spite of anticoagulation therapy.

Aged↗
PubMed1996

[Pseudotumor cerebri secondary to cerebral venous defects not identified by magnetic resonance].

Pseudotumour cerebri is the name of a syndrome characterized by headache and papilloedema, with normal cerebral CT/MR studies and CSF with a high pressure and normal laboratory findings. We describe four patients who fulfilled the diagnostic criteria of this condition (including normal 0.5T MR studies). They all had cerebral angiograms showing minor abnormalities localized to the level of the superior longitudinal sinus. All improved on treatment with anticoagulants and steroids. In view of these findings we consider that in cases of pseudotumour cerebri without a clear aetiological factor, an angio MR study should be done, or if this technique is not available, a cerebral angiogram should be done, to exclude cerebral venous drainage defects.

Adult↗
PubMedDate not supplied

[Coma associated with migraine].

INTRODUCTION: Basilar migraine is a particular form of migraine with an aura in which crises of headache are accompanied by symptoms of dysfunction in the vertebro-basilar territory, including alteration of consciousness in the form of stupor or coma. CLINICAL CASES: We report four patients, three men of 14, 17 and 83 years of age and one woman of 21. All had previous histories of migraine and presented with transitory episodes of coma. During the coma, the woman woke up spontaneously with intense bulimia. In the three men, it was seen, on injecting flumazenil, that the state of consciousness and the EEG returned to normal transiently. Neuroimaging studies (CT and MR) were normal in all patients. CONCLUSIONS: Migraine-coma is an exceptional, emergency condition in which structural, infectious, toxic and metabolic pathology of the Central Nervous System should be ruled out. As well as in patients with basilar migraine, the association of migraine and coma may also be seen in patients with familial hemiplegic migraine and CADASIL and MELAS syndromes. It may be that gabaergic mechanisms are involved in the theoretical dysfunction of the ascending reticular activating system causing alteration of consciousness, since in the three patients in whom flumazenil was injected, there was a response.

Adolescent↗
PubMedDate not supplied

[Isolated hemi-ataxia as a sign of mesencephalic lacunar infarction].

INTRODUCTION: Lesions of the dento-rubro-thalamo-cortical pathway may cause homolateral or contralateral hemiataxia, depending on whether they are found above or below the decussation which occurs at the level of the inferior colliculus. Most mesencephalic infarctions causing hemiataxia also show oculomotor involvement with nuclear or fascicular lesions of the third cranial nerves. This was not seen in the case we report. CLINICAL CASE: We describe the case of a diabetic patient with a permanent right appendicular hemiataxia, without oculomotor involvement, caused by a lacunar infarct shown on MR imaging which was situated in the antero-external part of the left superior mesencephalum. CONCLUSIONS: This case helps to clarify the topography of the thalamic radiations of the mesencephalic calotte, including the decussated superior dento-rubro-thalamic pathway to the red nucleus. Involvement of this, situated in the mesencephalic lateral vascular territory causes contralateral hemiataxia.

Aged↗
PubMedDate not supplied

[Autoscopy and multiple sclerosis].

A female patient with clinically defined multiple sclerosis presented episodes of audiovisual hallucinations in the form of projections of her own body image speaking to her. EEG and EEG-Holter studies were normal. MRI revealed multiple areas of hypersignals in white matter, particularly in both temporal lobes. The episodes remitted with carbamazepine therapy. We postulate that this phenomenon of autoscopy, which is unusual in multiple sclerosis, may be related to a mechanism of ephaptic transmission in the temporal lobe that is inhibited by carbamazepine, or it may be related to seizure.

Adult↗