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Biomedical subjects

C Rugilo

Publications and source records attributed to C Rugilo.

10 recordsLinked to original sources
PubMed2006

Combined protocol of cell therapy for chronic spinal cord injury. Report on the electrical and functional recovery of two patients.

BACKGROUND: This is a preliminary report on successful results obtained during treatment of two patients with chronic spinal cord injury. The therapeutic approach was based on the generation of controlled inflammatory activity at the injury site that induced a microenvironment for the subsequent administration of autologous, BM-driven transdifferentiated neural stem cells (NSC). METHODS: BM mesenchymal stem cells (MSC) were cocultured with the patient's autoimmune T (AT) cells to be transdifferentiated into NSC. Forty-eight hours prior to NSC implant, patients received an i.v. infusion of 5 x 10(8) to 1 x 10(9) AT cells. NSC were infused via a feeding artery of the lesion site. Safety evaluations were performed everyday, from the day of the first infusion until 96 h after the second infusion. After treatment, patients started a Vojta and Bobath neurorehabilitation program. RESULTS: At present two patients have been treated. Patient 1 was a 19-year-old man who presented paraplegia at the eight thoracic vertebra (T8) with his sensitive level corresponding to his sixth thoracic metamere (T6). He received two AT-NSC treatments and neurorehabilitation for 6 months. At present his motor level corresponds to his first sacral metamere (S1) and his sensitive level to the fourth sacral metamere (S4). Patient 2 was a 21-year-old woman who had a lesion that extended from her third to her fifth cervical vertebrae (C3-C5). Prior to her first therapeutic cycle she had severe quadriplegia and her sensitive level corresponded to her second cervical metamere (C2). After 3 months of treatment her motor and sensitive levels reached her first and second thoracic metameres (T1-T2). No adverse events were detected in either patient. DISCUSSION: The preliminary results lead us to think that this minimally invasive approach, which has minor adverse events, is effective for the repair of chronic spinal cord lesions.

Adult↗
PubMed2002

[Hydrosyringomyelia in demyelinating diseases].

Spinal cord cavitation is a frequent finding in optic neuromyelitis (Devic's syndrome) (DS) but it is also, although rarely, observed in patients with multiple sclerosis (MS). The objective of our study was to compare the MRI characteristics of the syringomyelic cavities in 6 patients with DS and 3 patients with MS. All the patients with DS had a relapsing clinical form with normal brain MRI. Spinal MRI revealed unenhanced central cavities which extended more than 3 vertebral bodies and remained unchanged in follow-up studies. Two patients presented multiple cavities.MS patients suffered a relapsing remitting form of the disease, they all had hyperintense T2 enhancing lesions on their spinal MRI. Moreover spinal MRI also revealed non communicating cavities which extended less than 2 vertebral bodies. Follow-up studies in MS patients revealed a reduction of both the spinal lesions and the cavities. It is still debated whether DS represents a distinct clinical entity different from MS. These findings help distinguishing both disorders in cases when spinal cavities are present and also contribute to the therapeutic choice.

Adult↗
PubMed2000

[Mesial temporal sclerosis syndrome in adult patients].

Magnetic resonance imaging (MRI) has become an essential tool in the work-up of epilepsy. Since its appearance it has been possible to identify pathologies, such as hippocampal sclerosis (HS), that had previously only been detected by histopathological assays. The aim of this study was to analyze the clinical manifestations, EEG and the outcome of patients with HS as shown by MRI. We revised the clinical histories of 384 outpatients from the Epilepsy Center, Ramos Mejía Hospital, who had been studied by MRI. Thirty five of them (15.5%) had a diagnosis of HS, based on the structural changes observed on the images. Six patients were excluded because of incomplete clinical data. Therefore, we studied 29 patients including 15 men. The mean age was 32.7 +/- 10.2 years (range: 19-58). All of them had partial seizures. Ten subjects had had febrile convulsions (34.5%) in childhood. Neurological examination was normal in all subjects. Interictal EEG showed focal abnormalities that were coincident in their location with the MRI abnormalities in 16 patients (55.1%). Fourteen patients (48.3%) showed right side hippocampal lesions on MRI, thirteen on the left side (44.9%) and 2 bilateral HS (6.8%). Twenty-seven patients (93.1%) had intractable epilepsy. Anterior temporal lobectomy was performed in 3 subjects with good outcome. The identification of these patients who present certain clinical and MRI characteristics, provides an opportunity to define the mesial temporal sclerosis syndrome. This could benefit patients in their prognosis and for specific treatments.

Adult↗
PubMed1996

[Intracranial pressure monitoring and eclampsia].

Intracranial pressure (ICP) monitoring has been shown to improve clinical-pharmacological treatment of intracranial hypertension (ICH) in a rising number of situations, assuring effective cerebral perfusion pressure (CPP) and, concomitantly, reducing the risk of brain ischemia. Although its use in entities such as eclampsia have been reported, the continuous use of ICP monitoring is restricted. We report the case of an eclampsic woman in whom ICP was monitored. Recordings allowed CPP to be correctly stabilized, with strict correlation between ICP and tomographic measurements of density. We also review the pathophysiologic mechanisms that have been proposed to cause ICH in eclampsia and emphasize the usefulness of ICP monitoring to manage this complication.

Adult↗
PubMedDate not supplied

[Superficial haemosiderosis of the central nervous system, neuro otological manifestations and images from a magnetic resonance brain scan: a case report].

INTRODUCTION: Superficial haemosiderosis of the central nervous system (SHCNS) is an infrequent clinical entity; it is produced by the formation of clinically silent haemosiderin deposits in the leptomeninges, the subpial tissue, the cranial nerves and spinal cord, secondary to chronic bleeding in the subarachnoid space. Aetiology is idiopathic in half the cases or secondary to a vascular malformation or other structural abnormalities. At least 100 cases have been reported in the literature, most of which were diagnosed post mortem. In these descriptions there is a predominance of cerebellar ataxia, progressive hypoacusis, nystagmus, recurring headaches, pyramidal signs, an absence of caloric responses and xanthochromic cerebrospinal fluid. Magnetic resonance (MR) brain scanning in T2 revealed hypointensity in the brain stem, the cerebellum and the Sylvian fissure, with atrophy of the cerebellum and the brain stem. CASE REPORT: A 64 year old male with bilateral tinnitus and progressive neurosensory hipoacusis, who visited because of loss of balance, urinary incontinence and oscillopsia. The patient s personal history included an episode of unbearable headache at the age of 53. The neurological and neuro otological examination was pathological and the MR brain scan confirmed the diagnosis of SHCNS. CONCLUSIONS: We wish to highlight how extremely rare this entity is, and especially so when there is a predominance of progressive neuro otological manifestations; we also want to emphasize the importance of carrying out specific imaging studies to enable a diagnosis to be made while the patient is still alive.

Brain Diseases↗
PubMedDate not supplied

[Musical memory preserved in an amnesic syndrome].

INTRODUCTION: In amnesic syndromes, it's usually to see dissociation between episodic, semantic and procedural memory. However, a few reports have been found about musical memory's processing and the relation with classic memory systems. AIM: To describe the musical's abilities preserved in a patient with amnesic syndrome and discuss possible neuropsychological and neurobiological bases implicated. CASE REPORT: A 28-years-old woman presenting with amnesic syndrome is reported. Following a carbon monoxide encephalophaty and subsequent hypoxia she remained in coma for 10 days with evidence of bilateral temporal changes, mainly affecting basal ganglia areas. The patient showed anterograde amnesia and semantic memory impairment, with disproportionately spared musical abilities' performance, either music perception (discrimination and recognition of tonal melodies, musical sight-reading) or music production (song and instrumental performance) or musical memory. CONCLUSIONS: This case suggests that the music require elaborate bihemispheric processing and may implicate different forms of information processing. The neural network involved in musical memory can be different that the declarative memory systems (episodic and semantic).

Adult↗
PubMedDate not supplied

[Cerebral vasculitis].

INTRODUCTION: Cerebral vasculitis embraces a wide range of conditions that are characterised by involvement of the vessels of the central nervous system (CNS) due to inflammation of their walls, which in turn leads to occlusion or the formation of aneurysms with the ensuing ischaemic-haemorrhagic disorders this produces. DEVELOPMENT: In cases of cerebral vasculitis perhaps only the vessels of the CNS (isolated angiitis of the CNS) are involved, or they may be just another of the affected territories to be found in primary or secondary systemic angiitis (due to infection, collagen diseases, drugs, tumours). Neurological symptoms and lab tests are usually rather unspecific. The latest neuroimaging techniques are more useful, and the gold standard among them is digital angiography, although its sensitivity and specificity are limited. Brain tissue biopsy allows for confirmation of the diagnosis and is the gold standard for the diagnosis of isolated angiitis of CNS. A large group of conditions (which may be metabolic, demyelinating, vascular, infectious, and other peripheral vascular diseases) have similar clinical and imaging features, which makes it necessary to consider the differential diagnosis. CONCLUSIONS: Involvement of the nervous system casts a shadow over the prognosis in most cases of vasculitis and can be severe, as in isolated vasculitis of large vessels or in Takayasu's disease, or more benign, as in isolated vasculitis of small vessels and in other primary vasculitis. Treatment with corticoids and immunosuppressant agents, as well as anticoagulant and/or antiaggregating therapy, must be considered in each particular case according to the clinical condition and the progression of each patient.

Biopsy↗