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Biomedical subjects

J L Gil-Salú

Publications and source records attributed to J L Gil-Salú.

17 recordsLinked to original sources
PubMed2004

[Medulloblastoma presenting as an extra-axial tumor in the cerebellopontine angle].

Differences in the imaging characteristic of adult medulloblastomas have been reported, including involvement of lateral cerebellar hemispheres with an extra-axial appearance. We present a case report of this rare circumstance: a 40 year old man presented with a 3 weeks history of headache, morning vomiting and left hearing difficulties. Magnetic resonance imaging revealed a left cerebellopontine angle (CPA) tumor, like a well circumscribed homogeneously enhancing mass. Through a left suboccipital craniectomy the tumor was totally removed. It presented as a cerebellopontine angle tumor, like a meningioma, and not as an intra-axial tumor. Histological analysis revealed that the tumor was composed of densely packed with highly proliferative cells that produce a dense intercellular reticulin fiber network. Inmunohistochemical analysis showed positive expression to synaptophysin, specific neuronal enolase and cromogranin. Histological diagnosis was crucial to define it as a desmoplastic medulloblastoma the present case and to perform postoperative adjuvant therapy. Neurosurgeons should be aware of the possibility that a CPA tumor is of intraaxial origin, because this increase the variability on pathological diagnosis.

Adult↗
PubMed2004

[Survival analysis following the addition of temozolomide to surgery and radiotherapy in patients with glioblastoma multiforme].

OBJECTIVES: To analyze the effect of different therapies -surgery, radiotherapy, and chemotherapy (temozolomide)- on the survival of various groups of patients with glioblastoma multiforme (GBM). METHOD: The overall survival of a total of 85 patients with histopathological diagnosis of GBM was analyzed (descriptive statistics, Kaplan-Meier). Patients were divided into 4 treatment groups: group 1 (n=12), untreated patients (" no treatment" option was chosen by the family); group 2 (n=22), patients undergoing surgery only (retrospective series from the 1980s); group 3 (n=24), patients undergoing surgery + standard radiotherapy (control group, partially effective treatment); group 4 (n=27), patients undergoing surgery + radiotherapy + chemotherapy (temozolomide [TMZ]) (current study group). RESULTS: Mean age (one-way ANOVA) showed no significant difference between the groups. Mean/median survival (weeks) was as follows: group 1, 18/16; group 2, 23/14; group 3, 48/42; group 4, 70/64. The Kaplan-Meier analysis yielded the following 50% survival cutoffs (weeks): group 1, 16.00; group 2, 14.29; group 3, 42.00; group 4, 64.43. This demonstrated a significant difference when radiotherapy (group 3) was added to surgery (group 2) or no treatment (group 1), and a significant difference (p < 0.001) in survival when TMZ (group 4) was added to the so far considered as being the standard treatment (group 3: surgery + radiotherapy). CONCLUSIONS: Surgery alone does not result in a higher survival rate for GBM patients. However, surgery allows to establish a histopathological diagnosis, to improve signs and symptoms which are attributable to intracranial hypertension or tumour topography, and to reduce the number of target cells for adjunctive therapies. Radiotherapy improves survival and TMZ chemotherapy that is given after radiotherapy adds further survival benefit for patients.

Antineoplastic Agents, Alkylating↗
PubMed2004

Intraorbital arteriovenous malformation: case report.

An intraorbital arteriovenous malformation became symptomatic without exophthalmos but with chemosis and bruit of the left eye. The patient underwent only surgical treatment. The orbital rim was removed through a fronto-orbital approach. The chemosis was corrected and postoperative magnetic resonance imaging and angiography confirmed complete removal of the malformation. Histopathological examination disclosed an arteriovenous malformation in the extrabulbar fatty tissue without invasion of the extraocular muscles or optic nerve. The differences between various types of intraorbital malformations are discussed.

Case Reports↗
PubMed2002

[Retropleural paraspinal approach in the treatment of anterolateral thoracic spinal diseases].

The personal experience in the treatment of the spinal and paraspinal thoracic pathology using the paraspinal retropleural approach is presented. A total of 18 patients with neoplastic, traumatic and discal lesions were operated on. Improvement of neurological disturbances and pain was noted in all patients. The surgical technique for spinal cord and root decompression and also for anterior and/or posterior stabilization of the spine is described. The paraspinal retropleural approach is compared with the anterior transthoracic approach. The advantages of the paraspinal retropleural approach are: low rate of complications; allows a very wide decompression of the neurological elements as well as an anterior and/or posterior stabilization of the spine by a single approach; and it can be easily tailored for each lesion. These advantages are enhanced in the management of lesions located in the upper thoracic or thoracocervical levels.

Adolescent↗
PubMed2001

[Prognosis value of p53 gene and cellular proliferation factors in malignant supratentorial gliomas].

OBJECT: The aim of this study was to investigate prognosis value of p53 oncosuppresor gene and labeling index by MIB-1 and PCNA monoclonal antibodies in malignant gliomas. METHODS AND RESULTS: We operated 60 patient with malignant glioma between July 1994 and August 1998. Forty-five cases had the histopathological diagnosis of Glioblastoma Multiforme and fifteen cases of anaplastic astrocytoma or olygoastrocytoma. Initially we compare MIB-1/PCNA labeling index in eighteen cases. Patients < 40 years old, short period of symptoms preoperatively, only one cerebral lobe localization, total surgical exeresis, Karnofsky index > 70 postoperatively, low labeling index (MIB < 8.6%), forward radiotherapy treatment and surgical re-operation, were identified like favourable outcome factors in the uninvariable analysis. However to the multivariable analysis, only had outcome significance: patients < 40 years old, low labeling index, Karnofsky index > 70 postoperatively and surgical reoperation. CONCLUSIONS: On the basis of the results of current analysis, moreover classical factors associated with better outcome, low labeling index to Glioblastoma Multiforme have been noted in patients with longer survival, and must be included to conventional histopathological studies.

Adult↗
PubMed1998

Giant solitary synovial chondromatosis of the temporomandibular joint with intracranial extension.

Synovial chondromatosis are rare entities but are well-described lesions in the literature that can affect many joint areas of the body. A case of tumoral synovial chondromatosis involving the temporomandibular joint with intracranial extension through mandibular fossa is reported. As long as there was significant infratemporal and extradural invasion of the middle and posterior fossa, a transtemporal and infratemporal approach was performed and total removal of the lesions was achieved. A brief review of skull base synovial chondromatosis is presented.

Case Reports↗
PubMed1998

[Neuro-radiological findings in probable moyamoya disease].

INTRODUCTION: Unilateral moyamoya disease presents as unilateral stenosis or obstruction of the supraclinoid internal carotid artery, which causes cerebral hypoperfusion resulting in seizures or transitorial ischemic accidents (TIA). CLINICAL CASE: Atypical moyamoya disease was diagnosed as the cause of intraventricular hemorrhage in a 41 year-old-woman. The cerebral angiography, CT, MR and brain SPECT are reported. CONCLUSION: We discuss the clinic course and diagnostic techniques in this unilateral, atypical moyamoya disease and which steps are necessary toward an acceptable method for diagnosis and pursuit.

Brain↗
PubMed1992

Changes in mechanical responsiveness of the rat aorta after cervical spinal cord stimulation.

The effect of cervical spinal cord stimulation on the mechanical vascular responsiveness of rat aortic artery rings was studied "in vitro". Arteries with and without endothelium from sham and stimulated male Wistar rats were placed in an organ bath studying the contractile response induced by noradrenaline, prostaglandin F2 alpha and serotonin. For spinal cord stimulation two electrodes were placed in the cervical epidural space using microsurgical technique. The parameters of stimulation were: monophasic waveform current, pulse width of 0.1 ms, frequency of 120 cps, and intensity one third of the threshold which produced motor responses (between 0.3 and 0.5 v). The total period of stimulation was 120 minutes. The potency of each vaso-active agent was calculated in the organ bath for each experimental group. There were differences only when arteries with endothelium from sham (7.2587 +/- 0.2308) and stimulated (8.0720 +/- 0.3723) rats were tested with noradrenaline (p less than 0.01). Our results suggest that cervical spinal cord stimulation induces changes in the vascular wall that might explain the effects of spinal cord stimulation on vasomotor control.

Animals↗
PubMed1991

Intrathecal antiepileptic drugs in experimental epilepsy.

The effect of intrathecal administration of antiepileptic drugs on electroshock-induced convulsions (maximal electroshock seizure, MES test) was investigated in an experimental study in rats. Drugs tested were phenobarbital sodium (50-800 micrograms), sodium valproate (50-6,400 micrograms) and midazolam (50-250 micrograms), delivered into the cerebrospinal fluid via a catheter placed in the upper cervical intrathecal space. Control animals were tested with saline. The animals were tested in the MES test 30 min after drug administration. Phenobarbital sodium showed a dose-related protective effect on the tonic phase of the convulsion, with a 50% effect at a dose of 200 micrograms. Sodium valproate showed a less protective effect, even when reaching doses that produced neurological symptoms. Midazolam protected at a high dose but produced a severe decrease in motor activity. The results indicate the feasibility to treat experimental convulsions by means of intrathecal injection of antiepileptic drugs.

Animals↗
PubMed1990

Study of nerve regeneration in centrocentral anastomosis.

Nerve regeneration was studied in a model of centrocentral anastomosis (CCA) performed on the sciatic nerve of the rat. Experimental CCA was made by suturing the proximal end of the peroneal branch on the proximal end of the sural branch, placing between them a peroneal nerve graft (Group I, 20 rats) or a silicone chamber (Group II, 12 rats). Nerve grafts had a length of 5 mm and silicone chambers 7 mm. In six silicone chambers an 1 mm nerve graft was placed in the centre of the tube. In group I animals anterograde degeneration was studied by cutting the graft 60 days after surgery. In group II, nerve regeneration was studied 2, 4 and 8 weeks after surgery. Results indicate that in CCA: 1) regenerated axons coming from one nerve end grow into the graft but do not cross the contralateral suture line; 2) regeneration is poorer in silicone chambers than in nerve grafts; and 3) in silicone chambers regeneration is related to time. The reduction in the regenerative capability in CCA seems to be related to the alteration of nerve sprouts aiming for the peripheral targets.

Anastomosis, Surgical↗
PubMedDate not supplied

[Calcification of the thoracic yellow ligament as a cause of myelopathy].

INTRODUCTION: Ossified yellow ligaments are a rare cause of thoracic myelopathy, which has been reported mainly in Japanese patients. The lower thoracic spine is the most common site affected and symptomatic patients usually begin to develop spactic paraparesis in combination with reduced depth sensation. CLINICAL CASE: A 45 year old female that since 8 months presented progressive gait disturbance with paresthesias to both lower extremities. Neurologic examination revealed a spactic gait with exaggeration of lower extremities reflexes, positive bilateral Babinski sign and reduced depth sensation. The MRI revealed concentric narrowing of the spinal canal between D(8) to D(11) with spinal cord compression due to enlarged calcified yellow ligaments and hypertrophy of articular processes. A D(9)-D(10) laminectomy was performed, with removed of calcified yellow ligaments, and foraminotomy in affected levels. The postoperative follow up during 30 months has been uneventful. CONCLUSION: Calcified yellow ligaments are a poorly understood cause of thoracic myelopathy which should be treated as early as possible in symptomatic patients.

Diagnosis, Differential↗
PubMedDate not supplied

[The treatment of intradural arteriovenous fistulas in the spine: two case reports].

INTRODUCTION: Spinal dural arteriovenous fistulas (AVFs) frequently cause progressive myelopathy. Although endovascular approaches to spinal cord vascular malformations become an important adjunct or primary treatment of theses disorders, surgery can be safely performing in some categories. CASE REPORTS: Two males patients presented with progressively myelopathy two months and three years before, were diagnosed by typical MRI findings and spinal selective arteriograms of dorsal AVFs with single feeder of Spetzler's modified classification of spinal cord vascular lesions. After an attempt of embolization following diagnostic angiography in first case, surgical approach for clipping the afferent single feeder was done for both. CONCLUSIONS: Early recognition by selective diagnostic spinal angiography in patients with slowly progressive and fluctuating myelopathy, allow us surgery as recommended treatment in AVFs, so can effect a better outcome and often reverse presenting neurologic deficits.

Angiography↗
PubMedDate not supplied

[Microsurgical catheterization of the intrathecal space in the rat for chronic infusion of drugs].

An original technique for placement of intrathecal catheters suitable for drug administration is described. For implantation a microsurgical laminectomy is carried out, opening the dura mater and placing the catheter under surgical microscope control. Only a few instrumentation is mandatory. The mean time for this surgery was between 15 and 20 minutes. A 10% of the animals operated on developed neurological deficits and must be dropped. The mortality rate was a 5%. No catheter malfunctions were found.

Animals↗