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Biomedical subjects

H Hosseini

Publications and source records attributed to H Hosseini.

At least 19 recordsLinked to original sources
PubMed2006

[Arthroscopic capsular release in the management of refractory adhesive capsulitis. Technique and results].

Idiopathic adhesive capsulitis can severely restrict the comfort and function of the entire extremity, often resulting in prolonged, substantial disability. Some studies have demonstrated long-term residual pain and limitation of motion in most patients after conservative treatment such as physical therapy or corticoid injection. Closed manipulation is associated with severe complications. We report the technique and results of arthroscopic capsular release as an effective and safe alternative for the management of refractory adhesive capsulitis. We operated 23 patients between June 2003 and November 2004 who suffered from a loss of glenohumeral motion in all planes arthroscopically. Ten of the patients were evaluated after a mean follow-up of 6 months. We found significant pain relief a few days after surgery in every patient. Furthermore, we found improvements in the range of motion in all planes. Abduction improved from preoperative 50 degrees to postoperative 120 degrees , flexion from 55 degrees to 120 degrees, external rotation from 10 degrees to 60 degrees and internal rotation from 20 degrees to 65 degrees. The average Constant Score improved from preoperative 32 to postoperative 81 points. Arthroscopic capsular release is an effective and safe technique for the management of refractory adhesive capsulitis, avoiding prolonged disability.

Adult↗
PubMed2006

[The association of cardiac involvement and ischemic stroke in Churg Strauss syndrome].

In Churg and Strauss syndrome (CSS), three patterns of neurological involvement can be found, including mono or polyneuropathy, encephalopathy and stroke. We report two cases of stroke associated with major hypereosinophilia and cardiac involvement, leading to a diagnosis of CSS. Neurological and general outcome were good under treatment with steroids in combination with cyclophosphamide in one case. Churg and Strauss syndrome must be considered when a stroke is associated with a cardiac involvement and hypereosinophilia.

Adrenal Cortex Hormones↗
PubMed2006

[Acute bilateral deafness and facial diplegia as a presentation of occlusion of the basilar artery].

INTRODUCTION: Sudden bilateral deafness and facial weakness are unusual presentations of brain stem stroke. OBSERVATION: We report the case of a patient who presented successively sudden bilateral deafness and facial diplegia in correlation with a brain stem stroke but without any ischemic pontine lesion. DISCUSSION: Unlike our case, all of the earlier publications, have reported the presence of ischemic pontine lesions in patients with bilateral deafness and facial diplegia. Selective vulnerability of inner ear to ischemia has been hypothesized but cannot explain the facial diplegia. CONCLUSION: Our case would suggest extra-neuraxis failure by ischemia of the acoustico-facial nerve.

Acute Disease↗
PubMed2006

Diffusion-weighted MR imaging characteristics of an acute strokelike form of multiple sclerosis.

The characteristics of multiple sclerosis (MS) lesions on diffusion-weighted sequences and apparent diffusion coefficient (ADC) mapping at the very early phase of symptoms have not been clearly described. We report the case of a young woman who presented with a sudden pseudostroke form of MS resulting in hemiplegia and sudden aphasia. MR imaging showed a lesion of the left internal capsule with reduced ADC, which suggests an ischemic stroke. This case shows that very acute MS lesions may have reduced ADC on MR imaging, reflecting cytotoxic and not vasogenic edema.

Acute Disease↗
PubMed2005

[A simplified technique for repair of quadriceps tendon rupture by transpatellar PDS-cord].

Quadriceps tendon ruptures are relatively unusual injuries caused by direct or more frequently indirect trauma. Since complete ruptures lead to loss of active extension of the knee joint, operative treatment is usually indicated. Several techniques are described in the literature. However, relatively little is known about the functional outcome after operative treatment of acute quadriceps tendon ruptures. We present a new operative technique using a 1.3-mm PDS cord passed through a transverse drill hole in the proximal pole of the patella. We operated ten consecutive cases of complete quadriceps tendon ruptures with the technique described between January 2000 and June 2003. Eight of ten patients were evaluated after a mean follow-up time of 38 months by physical examination, IKDC Subjective score, Lysholm and Tegner score as well as an isokinetic test of the quadriceps strength. No complications were noted in this period. The average postoperative scores were 87 (IKDC), 98 (Lysholm), and 4.5 (Tegner). Isokinetic testing showed an average of 25% quadriceps strength deficit. The operative treatment of complete quadriceps tendon ruptures using a PDS cord through a drill hole in the patella is a safe and effective technique permitting functional postoperative treatment.

Adolescent↗
PubMed2005

Hydrocephalus and racemose cysticercosis: surgical alternative by endoscopic third ventriculostomy.

BACKGROUND AND PURPOSE: Hydrocephalus is a frequent and potentially serious complication of neurocysticercosis. Its treatment often requires ventricular shunting. The complication rate is high due to obstruction or material infection, which may justify endoscopic third ventriculostomy (ETV). OBSERVATION: We report a case of obstructive hydrocephalus in a 46-year-old man in the context of racemose cysticercosis, presenting with headaches and transient disorders of consciousness. Imaging showed cystic lesions of the cisterna magna, responsible for hydrocephalus which was treated effectively by ETV. Treatment with albendazole decreased the volume of the cisterna magna cysts. RESULTS: The patient was followed for 6 years after ETV with no recurrence of hydrocephalus despite two more symptomatic episodes of the disease with extension of the cysts into the lumen of the fourth ventricle and into the perispinal subarachnoid spaces, effectively treated by albendazole each time. CONCLUSIONS: Treatment of obstructive hydrocephalus secondary to cerebral racemose cysticercosis by ETV seems to be an effective and safety technique. The role of ETV should be evaluated in this indication.

Endoscopy↗
PubMed2005

[Transient ischaemic attacks due to hypoplasia of the internal carotid artery in a patient with congenital Horner's syndrome].

INTRODUCTION: Hypoplasia of the internal carotid artery (ICA) is a rare developmental anomaly sometime revealed by transient ischaemic attaks (TIA). Association with a Horner's syndrome is very rare. CASE REPORT: We report the case of a 42-year-old woman who presented with a TIA and a cervical murmur. Horner's syndrome with iris hypopigmentation was present shortly after birth. Magnetic resonance imaging showed no dissection but hypoplasia of the ICA. Blood flow in the ICA was antegrade through several branches constituting a rete mirabile across the carotid canal, and via collateral arteries from ipsilateral external carotid artery. CONCLUSION: Horner's syndrome in the setting of TIA evokes a carotid dissection. A skull base CT scan demonstrating carotid canal hypoplasia can rule out an ICA dissection and allows diagnosis of a congenital arterial anomaly.

Adult↗
PubMed2005

[Inflammation and ischaemic stroke: current status and future perspectives].

INTRODUCTION: Inflammation may play an important role in acute ischemic stroke. Experimental and clinical data suggest that post-stroke inflammatory responses are complex cascade phenomena, which may have detrimental or beneficial effects on outcome. This review focuses on the current understanding of inflammation effector pathways in focal cerebral ischemia and on therapeutic perspectives. STATE OF ARTS/PERSPECTIVES: Somatic markers, such as admission body temperature or C-reactive protein, seem to be correlated with outcome, but data are heterogeous and contradictory, perhaps because their kinetics are complex during the first hours of a stroke. The most studied effectors of inflammation are cellular adhesion molecules--CAM (including integrins, selectins and members of the immunoglobulin superfamily), leucocytes, microglia, and blood brain barrier permeability. Evidence from animal data has lead to some clinical trials investigating anti adhesion molecules and hypothermia. However, current results remain disappointing. Recent experimental data also suggest a possible beneficial role of insulin and statins, which may be mediated by their effects on the inflammatory response. CONCLUSION: Inflammation is an important avenue of therapeutic research in acute stroke. A better understanding of the inflammatory pathophysiology may help to a better design of clinical trials.

Acute Disease↗
PubMed2004

[Occlusion of the innominate artery in association with a primary antiphospholipid syndrome: treatment by angioplasty stenting].

INTRODUCTION: Antiphospholipid syndrome may be associated with stroke. CASE REPORT: We report a case of a symptomatic occlusion of the innominate artery in a 37-year-old patient, who developed primary anti-phospholipid syndrome. This association, to our knowledge, has not been reported in the literature. Occlusion of the innominate artery was treated by angioplasty-stenting. Effective oral anticoagulation was given to prevent a new thrombotic event. CONCLUSION: Systematic search for antiphospholipid antibodies is needed as part of the etiology work-up in young stroke victims.

Adult↗
PubMed2003

Neuromyelitis optica after a spinal anaesthesia with bupivacaine.

We report the case of a 53-year old woman who developed a neuromyelitis optica (NMO or Devic's syndrome) after a spinal anaesthesia with bupivacaine. To our knowledge, the use of bupivacaine in human has not been associated to neurological complications like myelitis or NMO. The pathogenesis of this complication will be discussed.

Anesthesia, Spinal↗
PubMed2002

[Paucisymptomatic and reversible myelinolysis after an anaphylactic shock].

Myelinolysis is characterized by a non inflammatory demyelination, affecting the central portion of the pons. Clinical features usually reflect damage to the descending motor tracts and include spastic tetraparesis, pseudobulbar paralysis, and the locked-in syndrome. We describe the case of a 58-year-old man, who developed a pontine and extrapontine myelinolysis, without hyponatremia, after an anaphylactic shock. Follow up demonstrated improvement of the clinical signs after a few days and the normalization of the MRI three months later. Our observation shows that a paucisymptomatic and spontaneously regressive myelinolysis can be the consequence of a state of shock.

Anaphylaxis↗
PubMed2001

Specific caspase pathways are activated in the two stages of cerebral infarction.

Necrosis and apoptosis have been initially identified as two exclusive pathways for cell death. In acute brain lesions, such as focal ischemia, this binary scheme is challenged by demonstrations of mixed morphological and biochemical characteristics of both apoptosis and necrosis in single cells. The resulting difficulty in defining the nature of cell death that is triggered by severe insults has dramatically impeded the development of therapeutic strategies. We show that in the early stages of cerebral infarction, neurons of the so-called "necrotic" core display a number of morphological, physiological, and biochemical features of early apoptosis, which include cytoplasmic and nuclear condensations and specific caspase activation cascades. Early activation cascades involve the death receptor pathway linked to caspase-8 and the caspase-1 pathway. They are not associated with alterations of mitochondrial respiration or activation of caspase-9. In contrast, pathways that are activated during the secondary expansion of the lesion in the penumbral area include caspase-9. In agreement with its downstream position in both mitochondria-dependent and -independent pathways, activation of caspase-3 displays a biphasic time course. We suggest that apoptosis is the first commitment to death after acute cerebral ischemia and that the final morphological features observed results from abortion of the process because of severe energy depletion in the core. In contrast, energy-dependent caspase activation cascades are observed in the penumbra in which apoptosis can fully develop because of residual blood supply.

Acute Disease↗
PubMed2001

Protection against experimental autoimmune encephalomyelitis by a proteasome modulator.

The capacity of interferon beta to alter the course of multiple sclerosis has promoted a new therapeutic concept, based upon the modulation of the immune response rather than its suppression. As the proteasome plays a crucial role in the control of the inflammatory process and immune cell survival, targeting the proteasome appears as a novel approach for the prevention and treatment of inflammatory autoimmune diseases. We have previously shown that ritonavir, an HIV-1 protease inhibitor used in AIDS therapy, can modulate the proteasome function by inhibiting the chymotrypsin-like activity and enhancing the trypsin-like activity. We have, therefore, explored its therapeutic potential on experimental autoimmune encephalomyelitis (EAE), an experimental model of multiple sclerosis, in Lewis rats and SJL mice. Daily administration of ritonavir during autoimmune antigen stimulation prevented clinical symptoms of EAE in a dose- and time-dependent manner. This protection was accompanied by an inhibition of the mononuclear cell infiltration into the central nervous system usually observed in EAE. Despite a complete absence of clinical symptoms during first EAE induction, ritonavir-treated animals became resistant to further induction of EAE, suggesting an immune mechanism of protection. These results suggest that proteasome modulation using ritonavir or analogues may be of interest for patients with multiple sclerosis.

Animals↗
PubMed2001

Regeneration of a transected peripheral nerve by transplantation of spinal cord encapsulated in a vein.

The objective was to investigate the regeneration of a transected peripheral nerve after transplantation of fragmented embryonic (E14-15) spinal cord cells which were encapsulated within a vein cavity. After 3 months transplantation, axonal regeneration was observed by staining with HE and antibody to neurofilament subtypes in six of 10 rats. In all six animals compound muscle action potentials to electrical stimulation could be recorded and indicated incomplete reinnervation of the fibular and tibial nerve, respectively. A chronic inflammation process around the transplant and a negative result of staining neurofilaments within the vein cavity and the transected nerve were found in animals lacking electrophysiological response to stimulation.

Action Potentials↗
PubMed2000

[Contribution of immunohistochemistry and electron microscopy for the diagnosis of meningeal hemangiopericytomas. 15 case reports].

Meningeal hemangiopericytomas (HPC) are rare CNS tumors with a pour prognosis compared to meningiomas. In order to define diagnosis criteria, we performed an immunohistochemical and ultrastructural study in respectively 15 and 5 meningeal HPC. The following antibodies anti-KL1, EMA, vimentin, CD34, factor VIII, alpha-smooth actin, estrogen and progesteron receptors (RE, RP) were used in paraffin embedded sections whereas anti-NCAM and E-cadherin antibodies were used on frozen sections when available. We can differentiate meningeal HPC from meningioma because of a complete lack of immunostaining with epithelial markers as well as with NCAM antibody or RE and RP receptors. Besides a positivity with CD34 and alpha-smooth actin antibodies was always observed even focally in HPC. On the other hand, solitary fibrous tumor showed a strong and diffuse positivity with anti CD34 and anti-vimentin antibodies. Electron microscopy can be helpful in some instances showing membrane basal-like substance and absence of desmosomes.

Adult↗