[The convex mirrors in flamenco paintings (II)].
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Biomedical subjects
Publications and source records attributed to J J Barbón García.
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CASE REPORT: A young female patient with systemic lupus erithematosus, inactive for a long period, is described. She develops bilateral serous detachments of the retinal pigment epithelium and neurosensory retina after corticosteroid therapy for a residual nephritis. DISCUSSION: This unusual chorioretinopathy has been reported in association with systemic lupus erithematosus and during corticosteroid therapy in many disorders. This patient, with low activity erithematosus lupus, develops serous retinal detachments after receiving corticosteroid therapy that damage the coriocapillary-pigment epithelium barrier, disordered in lupus patients.
PURPOSE: To determine, by means of immunohistochemistry, tumoral expression of collagenase-3, a matrix metalloproteinase linked to cancer and to basal cell and squamous cell carcinomas of the eyelid. MATERIAL AND METHOD: Retrospective review of 23 basal cell carcinomas and 25 squamous cell carcinomas of the eyelid treated at different hospitals during the last five years. We evaluated collagenase-3 expression and the possible relationship to patient and tumour characteristics which included age, sex, histological type, tumour location and surgical margins status. RESULTS: 65% of the basal cell carcinomas and 88% of the squamous cell carcinomas of the eyelids stained positively for collagenase-3. In both cases, the immunostaining was localized in the cytoplasm of the malignant cells and, occasionally in the surrounding stromal cells. CONCLUSIONS: Statistical analysis showed no significant association between collagenase-3 immunostaining and patients or tumour characteristics but the expression of this protein was more intense in the epithelial tumoral cells located at the invading front which could explain the aggressive behaviour of this kind of tumours.
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CASE REPORT: We present a case of metastatic larynx cancer in the cavernous sinus. It presented itself as a right sixth cranial nerve palsy which progressed into a painful ophthalmoplegia with normal CT and RNM in its early stages. DISCUSSION: We must suspect a cavernous sinus invasion in patients with cranial nerve palsies and with a history of malignancy, despite negative radiologic findings. Tumoral invasion of the skull base has been described in pharyngeal neoplasms but it is exceptional in larynx carcinomas.
CASE REPORT: We report the case of a patient who was surgically treated in his right eye because of an uncontrollable glaucoma and a retinal detachment without retinal break. Ultrasound and computed tomography showed diffuse choroidal thickening. During 6 years of follow-up, he developed a major ocular and orbitary invasion and bone marrow infiltration. He was treated by enucleation and chemotherapy with apparent total remission. DISCUSSION: Reactive lymphoid hyperplasia of the uvea consists of a lymphocytic proliferation that primarily involves the uveal tract. This process is regarded as a low malignant condition, but this case of late diagnosis showed a tendency to orbital and systemic extension.
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CASE REPORT: Male with cranioencephalic trauma who rapidly developed a marked bilateral exophthalmos. A CT was requested, the CT findings suggest a right-side carotid-cavernous sinus fistula (CCSF), which was confirmed by means of a cerebral arteriography. Following treatment with intravascular balloon pump the patient's condition improved quite spectacularly. DISCUSSION: CCSFs are anomalous communications between the cavernous sinus and the carotid artery which may be of a spontaneous nature, a result of trauma or iatrogenia and which have hemodynamic repercussions throughout the drainage area of the cavernous sinus. Sonography, CT or MR are useful whilst a cerebral angiography is required for diagnosis. CCSFs resulting from trauma normally require endovascular therapy with selective embolization techniques.
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PURPOSE/METHOD: We studied a patient whose embolic retinal occlusion originated in a free floating thrombus detached from an atheromatous plaque sited in the aortic arch. RESULTS/CONCLUSIONS: Atheroma in the ascending aorta artery and its arch can be a potential source of emboli in patients suffering of retinal embolism. Atherosclerotic lesions in thoracic aorta may be shedding free floating detachments on to the lumen of the artery with severe risk of peripheral embolism. These lesions can be detected by trans-esophageal echocardiography in thoracic areas of the aorta and may become an option when thrombus sources in cardiac ot carotid artery are not clearly identified.
PURPOSE/METHOD: We observed four patients aged between 41 and 48 with small macular vein occlusions. All of them were evaluated by fluorescence angiography and followed for 3 years. RESULTS/CONCLUSION: The fundus changes were limited to less than 1/4 sector of the macula and, independently of initial visual loss, they progressed to angiography and clinical restitution. Vein occlusions occurred at arteriovenous intersections and had systemic hypertension associated with other significant risk factors. Small venous branch occlusion in young patients has a very good visual pronostic.