PubMed Health⌕ Search

Biomedical subjects

F Paradinas

Publications and source records attributed to F Paradinas.

12 recordsLinked to original sources
PubMed2001

The diagnostic implications of routine ultrasound examination in histologically confirmed early molar pregnancies.

OBJECTIVE: Early ultrasound examination is being used increasingly in the diagnosis of molar pregnancy. The aim of this study was to examine the diagnostic implications of routine ultrasound examination for histologically confirmed molar pregnancies. METHODS: This was a retrospective review of sonographic and histological findings in a series of consecutive cases referred to the National Trophoblastic Disease Surveillance Centre with suspected molar pregnancies. In 194 cases referred to the center over a 6-month period in whom results of a preceding ultrasound examination were documented, review of ultrasound findings and final histological diagnosis was carried out. RESULTS: There were 155 cases with a reviewed histological diagnosis of complete or partial hydatidiform mole. In 131 (67%) cases, the sonographic diagnosis was that of a missed miscarriage/anembryonic pregnancy with no documented suspicion of molar pregnancy, referral being on the basis of histological examination of products of conception. In 63 cases, ultrasound examination suggested molar pregnancy; in 53 (84%) of these, the diagnosis of molar pregnancy was correct. Overall, 37 of 64 (58%) complete moles had sonographic evidence of molar pregnancy compared to 16 of 91 (17%) partial moles. Of 155 histologically confirmed complete or partial hydatidiform moles, only 53 (34%) were suspected as molar sonographically. CONCLUSION: The majority of cases of molar pregnancy now present as missed miscarriage/anembryonic pregnancy sonographically, highlighting the importance of histological examination to diagnose gestational trophoblastic disease.

Abortion, Missed↗
PubMed1999

A molecular cytogenetic approach to studying platinum resistance.

The technique of comparative genomic hybridisation (CGH) has until recently been used to screen for common genomic abnormalities in fresh tumour material; it has identified previously unrecognised regions of amplification associated with poor prognosis subtypes of breast cancer and lymphoma. Our group has applied this technique to resistant cell lines and their sensitive counterparts in order to define chromosomal abnormalities associated with acquired drug resistance. We have demonstrated the applicability of this technique to the study of drug resistance using cell lines with known mechanisms of resistance. The ability to detect novel genomic alterations in cell lines with novel mechanisms of resistance was also demonstrated. We subsequently examined the CGH profiles of seven different cell lines made resistant to three platinum analogues and showed the most consistent abnormalities to involve over-representation of regions 4q and 6q. More recently, we have applied the CGH technique to a series of testicular germ cell tumours (TGCTs) collected as formalin-fixed paraffin-embedded biopsy specimens from patients, both pre- and post-therapy using a platinum-based regimen (POMB/ACE). Previous reports have shown over-representation of X, 7q, 8q and 12p and loss of 13q to occur in 25% of primary TGCTs. Over-representation of 12p was confirmed in the majority of these biopsy samples; deletion of 13q was noted in the initial biopsies of several patients. We also demonstrated alterations of 4p, 4q, 5q and 6q in this series of patients. Newly acquired deletions of 2q and 18q and amplifications of 8q were frequently observed in post-chemotherapy samples from resistant tumours. The CGH studies on these patients with TGCT will not only enable us to correlate our observations on clinical material with those from long-term cell lines, but should also identify sites of key genes involved in clinical platinum resistance.

Antineoplastic Agents↗
PubMed1998

[Neurophysiological study in Alpers syndrome].

INTRODUCTION: Infantil progressive polydystrophy was described by Alpers in a child with psychomotor retardation, crises which were resistant to treatment and diffuse loss of cortical neurons. OBJECTIVE: The aim of this study was to review the neurophysiological aspects of Alpers syndrome and their clinical correlation. MATERIAL AND METHODS: We present three children with subacute encephalopathy, progressive psychomotor retardation, myoclonic epilepsy which was resistant to treatment and crises of apnea, who had degeneration of the cerebral grey matter. Serial EEG, polysomnographs, auditory evoked potentials of the brain stem and visual evoked potentials were done. RESULTS: The electroencephalogram findings showed the presence of complex bursts of acute waves, small many-pointed or slow waves of great amplitude which were irregular and arrhythmical, lasting one to five seconds, separated by periods of inactivity on the tracing which lasted from three to ten seconds. The EEG was distinctive, changing over the course of the illness, and with increasing numbers and duration of the bursts of suppression of cerebral bioelectric activity. Polysomnography showed cerebral bioelectric activity which was markedly unstructured and with little difference between the tracings when asleep and when awake, together with a large number of apneas of obstructive and mixed types. The PEAT showed reduced amplitude and altered morphology in all the waves, and even absence of some of them. The visual evoked potentials were asymmetrical and with delay in the latency of the P100 wave. CONCLUSIONS: Although definite diagnosis of progressive neurone degeneration requires post mortem examination of the brain, clinico-pathological studies, including electrophysiological, radiological and biochemical studies are sufficiently characteristic to suggest the diagnosis during life.

Child, Preschool↗
PubMed1997

Surveillance policy for stage I ovarian germ cell tumors.

PURPOSE: Surveillance for stage I male germ cell tumors (GCT) is well established as a standard practice; however, such a policy has not been evaluated for women with equivalent tumors. This study was designed to evaluate the management of grade II or higher stage Ia tumors by close surveillance to minimize treatment, while reserving chemotherapy for patients with residual or recurrent disease. PATIENTS AND METHODS: Between 1973 and 1995, 24 patients with malignant stage Ia ovarian GCT were enrolled onto a surveillance program. The group consisted of nine patients with dysgerminoma, nine with pure immature teratoma, and six with endodermal sinus tumor (with or without immature teratoma). Treatment consisted of surgical resection without adjuvant chemotherapy, followed by a surveillance program of clinical, serologic, and radiologic review, and included a second-look procedure for patients enrolled after 1982. RESULTS: All but one patient are alive and in remission after a median follow-up of 6.8 years. The 5-year overall survival is 95%, and the 5-year disease-free survival is 68%. Eight patients have required chemotherapy for recurrent disease or second primary ovarian GCT. This includes three patients with grade II immature teratoma and three patients with dysgerminoma, and a further two women with dysgerminoma who developed contralateral (presumed second primary) dysgerminoma 4.5 and 5.2 years after their first tumor. All but one, who died of a pulmonary embolus, have been successfully salvaged with chemotherapy. CONCLUSION: Our experience emphasizes that patients with true stage Ia ovarian GCT are adequately managed by surgical resection followed by careful clinical, radiologic, and serologic surveillance. These patients do not require adjuvant chemotherapy or radiotherapy, thus avoiding the potential complications of secondary leukemia and infertility.

Antineoplastic Agents↗
PubMed1997

[Neurophysiological aspects of Proteus syndrome].

INTRODUCTION: The Proteus Syndrome was defined in 1983 by Wiedeman. However, the first case mentioned in the literature was that of Joseph Merrick, the Elephant Man, presented by Sir Frederick Treves in 1884. It is a rare pathological condition. Its multiple clinical features include; partial gigantism of hands and/or feet, pigmented nevi, hemihypertrophy of the body, tumors, skeletal anomalies, growth disorders and visceral anomalies. Hereditary transmission has not been clearly defined. Diagnosis and treatment require the participation of experts from several medical and surgical specialties. CLINICAL CASE: We present a case sent to our hospital for the surgical correction of cranio-facial malformations. Epileptic crises post-operatively indicated the need for neurological and neuro-physiological study. This was done by means of conventional electro-encephalography: brainstem, somato-sensorial and visual auditory evoked potentials, together with imaging techniques which showed the structural and functional asymmetry of the central nervous system at both cerebral and brainstem levels. CONCLUSIONS: Few neuro-physiological studies are included in the literature we reviewed for this paper. Therefore we do not know whether the functional anomalies of the central nervous system which we describe should be considered to be part of the syndrome.

Adult↗
PubMed1994

Sarcoidosis presenting as multiple subcutaneous nodules.

We report a young West Indian man who presented with non-specific constitutional symptoms and widespread subcutaneous nodules which were non-diagnostic on histology. The diagnosis of sarcoidosis was made on the basis of progressive bilateral hilar lymphadenopathy, interstitial pulmonary infiltration, a raised serum angiotensin-converting-enzyme level and a granulomatous hepatitis. All symptoms and signs improved dramatically on corticosteroid therapy.

Adult↗
PubMed1989

Successful treatment of patients in whom germ cell tumour masses enlarged on chemotherapy while their serum tumour markers decreased.

Enlargement of tumour masses with a fall or no change in tumour marker levels was noted in eight of 287 patients during chemotherapy for NSGCT at the Charing Cross and Mount Vernon Hospitals between 1977 and 1988. These eight patients had elements of differentiated teratoma in the primary specimen and in five the enlarging masses showed cystic change on CT scan. The increase in tumour mass occurred within 6 months of starting treatment. At surgery, four patients were found to have differentiated teratoma and have been followed for 15 months to 5 years without relapse. Two patients who also had some areas of embryonal carcinoma in the resected specimens had post-operative chemotherapy and are alive disease free at 8 and 24 months respectively. Two patients died: one post-operatively of uncontrolled haemorrhage secondary to aortic rupture and the second of acute myeloid leukaemia following 8 years of intermittent therapy for unresectable differentiated teratoma. The successful outcome in six of these eight patients suggests that enlarging teratomatous masses on chemotherapy can be managed by surgical resection and, when active tumour is present, by the use of post-operative chemotherapy.

Adolescent↗
PubMed1982

Cell-mediated immunity in HBeAg-positive homosexuals with chronic liver disease.

Chronic liver disease developing after infection with the hepatitis B virus may be due to impairment of cell-mediated immunity (CMI). In a study of CMI by the lymphocyte transformation test to two mitogens and hepatitis B surface antigen (HBsAg) the response to the mitogens, phytohemagglutinin (PHA) and purified protein derivative (PPD), was normal in all of 15 male homosexuals with HBsAg-positive chronic liver disease, indicating a normal non-specific cellular immune response. By contrast, only one of the 15 patients showed a response to HBsAg, which may explain the high prevalence of chronic HBsAg carriage in these patients.

Adult↗
PubMedDate not supplied

Extravillus endovascular implantation site trophoblast invasion is abnormal in complete versus partial molar pregnancies.

This study examines endovascular trophoblast invasion in pregnancies complicated by complete hydatidiform mole (CM), partial hydatidiform mole (PM) and non-molar abortions (HA). Two hundred consecutive cases from a supra-regional referral centre for suspected trophoblastic disease were examined histologically with particular regard to the presence or absence of endovascular trophoblast invasion of decidual vessels. There were 57 CM, 75 PM and 68 HA. The prevalence of normal endovascular invasion of decidual vessels was significantly lower in CM compared to all other clinical groups, amongst which there were no significant differences. Endovascular trophoblast was identified in about 80 per cent of HA and PM moles, compared to only around 25 per cent of CM (Z = -4.0, P< 0.0001). The majority of cases of complete mole demonstrated a similar appearance, of implantation site showing florid interstitial extravascular trophoblast invasion with surrounding of decidual vessels but without normal endovascular trophoblast invasion or 'plugging' seen. In many cases, there also appeared to be destruction of decidual vessels with interstitial haemorrhage and extensive fresh blood clot present in the histological sections. These findings may provide some explanation regarding the mechanism of clinical findings in molar pregnancy.

Decidua↗
PubMedDate not supplied

[Behavior disorders during REM sleep. Two clinical cases].

INTRODUCTION: The behavior disorder occurring during REM (Rapid Eye Movement) sleep is a parasomnia characterized by absence of atonia typical of this phase of sleep, although the other characteristics are maintained, namely rapid eye movements and desynchronization of cortical electrical activity. Clinically it is accompanied by abrupt, often violent movements, which may involve a limb or the trunk in relation to dreams typical of this phase of sleep, and which may interrupt sleep. Many pathological processes have been described, including: the Shy-Dragger syndrome, Parkinson's disease, olivopontocerebellar atrophy, multisystemic atrophy, in relation to certain antidepressant drugs, and most frequently the idiopathic form. CLINICAL CASES: We present two cases, one diagnosed as olivopontocerebellar atrophy and another in which there were no pathological findings. Both were referred to our department for the study of possible sleep disorders. In both cases neurophysiological studies, basically polysomnography with monitorization of various muscle groups and video, led to the diagnosis. CONCLUSIONS: We discuss the diagnostic and physiological criteria, and physiopathological explanations of each case, with special reference to N-Methyl-D-Aspartate (NMDA) and non-N-Methyl-D-Aspartate (non-NMDA) receptors. Finally we consider the pharmacological treatment of this disorder.

Adult↗