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Biomedical subjects

J F Campa

Publications and source records attributed to J F Campa.

14 recordsLinked to original sources
PubMed1988

Lymphorrhage localized to the muscle end-plate in myasthenia gravis.

Lymphocytic infiltration of muscle (lymphorrhage) is occasionally observed in myasthenia gravis. We describe a 56-year-old woman with autoimmune myasthenia gravis, whose muscle biopsy specimen demonstrates acute cellular reaction localized to the end-plate region. This observation raises the possibility of a more direct role of the cellular immune system in the pathogenesis of the disease, and provides a morphologic link between the human and the experimental myasthenia gravis.

Biopsy↗
PubMed1976

Long-term prednisone followed by thymectomy in myasthenia gravis.

The present series of thirty patients has led us to certain conclusions concerning the management and treatment of patients with myasthenia gravis. The use of cholinesterase inhibitors alone is reserved for those patients with purely ocular myasthenia whose deficits can be satisfactorily corrected with those agents. Some of those with ocular involvement may be disabled; and in light of our excellent results with that small group, as well as similar findings presented by Fischer et al., patients with disabling or refractory ocular myasthenia should be considered for treatment with prednisone. All other patients with myasthenia are given a course of oral corticosteroids (prednisone) initially at high doses, with subsequent tapering to maintenance, alternate-day low-dose therapy. Cholinesterase inhibitors are used as needed while the patient is receiving corticosteroids. We now anticipate that patients will exhibit sustained improvement within the first two weeks, reaching maximal improvement at about three months. Exacerbations of myasthenic weakness may occur in the early phases of treatment. Such exacerbations have been commonly mild and occur with a mean onset at 5 days, and have a mean duration of 6 days. Most patients have been able to tolerate an alternate-day schedule of prednisone therapy when maintenance levels were achieved. The effective maintenance dose has been determined as the smallest dose of prednisone which allows the patient to maintain maximal improvement. Following the establishment of maximal improvement, patients have been considered for thymectomy. In our experience, the sternum-splitting procedure has been tolerated extremely well by patients exhibiting marked imporvement or remission while on corticosteroids. In those patients where thymectomy is contraindicated, irradiation of the thymus might be considered. Patients are continued on maintenance steroid therapy following surgery for a period of time that has been arbitrary. Currently, we consider an attempt to discontinue steroids at approximately one year reasonable. Should the patient relapse after discontinuation of the medication, oral corticosteroid treatment is reinitiated. Consideration is given to the possibility of recurrent thymus in patients who repeatedly fail to maintain a remission when steroids have been stopped. Our experience has not permitted us to draw firm conclusions concerning how long a time high-dose daily steroid treatment should be continued in patients who show no favorable response to that therapy. Other modes of treatment, such as courses of parenteral ACTH, methyl prednisolone, dexamethazone, or antimetabolites might be considered if there is no response after 12 weeks of high-dose, daily corticosteroid therapy.

Adolescent↗
PubMed1976

Thyrotoxic neuropathy (Basedow's paraplegia).

Polyneuropathy is a rare but possible manifestation of severe hyperthyroidism. The patient reported here developed a polyneuropathy affecting mostly leg muscles (Basedow's paraplegia) during the course of severe thyrotoxicosis. The polyneuropathy was confirmed with sequential electrophysiological studies of nerves and muscles and by muscle biopsy. The involvement of the proximal leg muscle is also interpreted as a neuropathic or nerve-mediated process rather than a concomitant thyrotoxic myopathy.

Adolescent↗
PubMed1976

Long-term administration of corticosteroids in myasthenia gravis.

Favorable results were obtained in 30 patients with myasthenia gravis treated initially with high daily doses of prednisone and subsequently maintained on lower doses for a protracted period. In 45 incidents of treatment, complete remission occurred in 69 percent, marked improvement in 20 percent, and moderate improvement in 17 percent. Nineteen patients proceeded to thymectomy, with negligible morbidity and sustained improvement. In four patients, it was possible to discontinue prednisone 1 year or more after thymectomy.

Adolescent↗
PubMed1975

Inverse prominence of ependyma and capillaries in the spinal cord of vertebrates: a comparative histochemical study.

Spinal cords of 15 species representing six classes of vertebrates and the protochordate amphioxus were examined with histochemical methods for esterase, ATPase, LDH, PAS, and PAS-phosphorylase. Ependymal and glial cell processes were demonstrated and resembled heavy metal impregnations. Capillaries also were shown. The prominence of glycogen-rich ependymal structures in the spinal cord of nonmammalian vertebrates, and the increase in intramedullary blood vessels in placental mammals, suggest an inverse relationship between the relative development of the ependyma and of the blood supply. The marsupial opossum has sparseness of both ependyma and capillaries, but exhibits an extensive pattern of branched glial processes in both white and gray matter.

Animals↗
PubMed1971

Histochemical and functional correlations in anterior horn neurons of the cat spinal cord.

The histochemical reaction for phosphorylase is completely lost from anterior horn neurons rich in phosphorylase within 72 hours after proximal or distal axonal section. Using this new type of axonal reaction as a marking technique in the anterior horn of the seventh lumbar spinal cord segment of the cat, we demonstrated that (i) alpha motor neurons of slow twitch motor units, like those of fast twitch motor units, are rich in phosphorylase and poor in succinate dehydrogenase, and (ii) interneurons and Renshaw neurons are rich in succinate dehydrogenase and poor in phosphorylase. Gamma motor neurons, because of their small size, are considered to be rich in succinate dehydrogenase and poor in phosphorylase. Thus, anterior horn neurons capable of higher firing frequencies (Renshaw neurons, interneurons, and gamma motor neurons) are richer in mitochondrial oxidative enzyme activity as marked by succinate dehydrogenase. Those firing at lower frequencies (both types of alpha motor neurons) are richer in phosphorylase activity and glycogen content and, thus, apparently better equipped for anaerobic glycolysis.

Animals↗