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Biomedical subjects

J Pimentel

Publications and source records attributed to J Pimentel.

At least 37 records · Page 2Linked to original sources

[Central neurocytomas].

Central neurocytomas are a well-characterized group of neuronal tumors usually arising in the supratentorial ventricular cavities. We describe the anatomical and clinical study of seven of these neoplasms. Patients were in the first four decades of life, and tumors were usually located in one of the lateral ventricles. Surgical resection was subtotal in 6 cases. Light microscopic examination revealed predominantly benign lesions with morphological features similar to the so-called ependymoma of the foramen of Monro, of the oligodendrogliomas, and of the neuroblastomas. Immunohistochemistry and electron microscopy confirmed the diagnosis in each case, showing expression of neuron specific enolase and synaptophysin and containing microtubuli, neurosecretory granules, and presynaptic vesicles. In agreement with the literature, the authors stress the benign behaviour of most of these tumors and the need for systematic immunohistochemical and ultrastructural study. The actual roles of the extent of resection and of postoperative radiotherapy are still a matter of discussion.

Adolescent↗

Raeder's syndrome. A case with an unusual localization.

We describe a patient with a Raeder's paratrigeminal neuralgia consisting of left-sided frontal and orbital pain, Horner syndrome (including anhydrosis of the forehead), and sensory loss in the territory of the first division of the trigeminal nerve. The involvement of the ophthalmic nerve is not consistent with the usual localization of this syndrome to the pericarotid sympathetic plexus. Oculosympathetic and sympathetic fibers supplying the sweat glands of the forehead join the ophthalmic nerve in the cavernous plexus localized in the cavernous sinus. Therefore, this seems to be the most likely site of the lesion when the ophthalmic nerve is involved.

Adult↗

Congenital diaphragmatic hernia and intrathoracic intestinal volvulus.

The main symptom of the congenital diaphragmatic hernia (CDH) is the respiratory distress due to the pulmonary hypoplasia and the persistence of foetal pulmonary circulation. Sometimes the CDH appears outside of the neonatal period with respiratory symptoms, abdominal pain and seldom with intestinal obstruction. A case of CDH presenting with intrathoracic volvulus is reported. This case shows that tendency of delayed repair until the newborn has been recovered, require more attention because the good condition of the patient can be changed not only by the pulmonary hypoplasia and the persistence of the foetal pulmonary circulation but also by the symptoms of the intrathoracic gut complications.

Diaphragm↗

Inflammatory pseudotumor of the choroid plexus. Case report.

The case of an 18-year-old man with a tumor of the left lateral ventricle is reported. The mass was observed to be contiguous with the choroid plexus but could be totally removed. Pathological examination disclosed an inflammatory pseudotumor. The authors review the literature on this lesion and related disorders involving the central nervous system and stress the need for a morphological differential diagnosis. Inflammatory pseudotumor should be considered in any case of intraventricular tumor.

Adolescent↗

[Meningiomas: present and future].

The article describes the most recent advances in the field of the embryology, physiopathology, therapy, and prognosis of meningiomas. It is assumed that the future of our knowledge of these neoplasms will be based upon the present basic and clinical research. The well known arachnoid cell origin of meningiomas is emphasized, the ultrastructure of the arachnoid villi is mentioned and the double embryological origin of the meningeal membranes--neuroectodermal and mesodermal--is stressed. Based upon personal ultrastructural and immunohistochemical studies, the probable pericytic and arachnoid origin of the so-called hemangiopericytic and sarcomatous meningiomas respectively, is reported. The several possible physiopathological mechanisms of the peritumoral oedema are summarized. Concerning the biological behaviour of meningiomas, the relevance of complete surgical resection is stressed, although new imaging or histological technics are also important in the prediction of recurrences. Lastly, regarding the management of these kind of tumors, other therapeutic procedures beyond surgery are also considered.

Humans↗

Cerebral granular cell tumors: report of a case and a note on their nature and expected behavior.

A case of cerebral granular cell tumor (GCT) is reported. Histologically, the growth was composed of benign astrocytes, granular cells and transitional forms between both elements. Glial fibrillary acidic protein was detected in the glial component and, to a lesser extent, in the granular cells. Alpha-1-antichymotrypsin was demonstrated in the latter component only. Ultrastructural study also supported the evidence that neoplastic astrocytes became granular cells. The survey of the literature and our own results suggest that GCTs in this particular location, even when histologically benign, seem to have a worse prognosis than the low-grade supratentorial astrocytomas.

Astrocytes↗

[Spinal cord tumors. Anatomoclinical study].

The authors review 36 cases of intramedullary spinal tumours, 17 ependymomas, 12 astrocytomas, 6 hemangioblastomas and 1 metastasis of leiomyosarcoma. The tumours were localized in the cervical region in 19 patients, in the thoracic region in 10 in the lumbar region in 4, and in the conus medullaris in 3. All patients presented a clinical picture of myelopathy. No differences were observed between the different hystological types. In 5 patients the tumour was associated with syringomyelia and one of these patients also presented a type I Chiari malformation. All patients were submitted to surgery (using microsurgical techniques in the last seven years). Radiation therapy was also given in 16 cases. Our results demonstrate that microsurgical resection is the only treatment that significantly improves the prognosis of these patients, from both the standpoint of the functional status and survival.

Adult↗

Mesencephalic haematoma: case report with autopsy study.

A 70-year-old hypertensive woman suffered sudden onset of bilateral blepharoptosis. Within a few hours she developed focal signs attributable to a lesion of the mesencephalon, and a stuporous state, from which she did not recover. Neuropathological examination showed a mesencephalic haematoma, but no arteriovenous malformation. A review of reported cases suggests that mesencephalic haematomas have a worse prognosis when they occur in aged hypertensive patients, as compared with younger normotensive patients, in whom they are probably related to arteriovenous malformations.

Aged↗

Spinal cord compression secondary to idiopathic retroperitoneal fibrosis.

Retroperitoneal fibrosis is a rare disorder in which the abnormal fibrotic tissue compresses retroperitoneal organs. In the majority of patients no obvious cause can be found, hence the name idiopathic retroperitoneal fibrosis. The process can also arise from other anatomic areas, suggesting a multifocal origin. We report a case of dorsal epidural compression in a 63-year-old patient harboring idiopathic retroperitoneal fibrosis. A magnetic resonance imaging scan revealed the precise location of the lesion. It is suggested that retroperitoneal fibrosis should be considered in the differential diagnosis of epidural spinal cord compression.

Female↗

[Involvement of the basal ganglia and brain stem in infection by Listeria monocytogenes. Anatomo-clinical study].

A case of a patient with haematogeneous infection by listeria monocytogenes, involving the basal and brainstem is reported. Clinically the disease manifested by fever and brainstem syndrome of acute onset. The microscopic examination revealed foci of suppurative encephalitis in the brainstem and basal ganglia. The possible pathogenic mechanisms are discussed. It is emphasized that the association of a febrile syndrome with brainstem dysfunction should raise the possibility of infection of the nervous system by listeria monocytogenes.

Adult↗

Uveomeningoencephalitis in a human immunodeficiency virus type 2-seropositive patient.

A 35-year-old woman developed longstanding uveitis and later a uveomeningoencephalitis of unknown origin and died of toxoplasmal brain abscesses. The presence of immunological impairment, human immunodeficiency virus type 2 (HIV-2) seropositivity, and multinucleated cells in the brain led us to suspect neurotropic properties for HIV-2 similar to those of HIV-1.

Acquired Immunodeficiency Syndrome↗

Intraventricular schwannoma.

A case of schwannoma occurring in the right lateral ventricle of an 8-year-old boy is described. The child made an excellent recovery. Three years later there is no evidence of recurrence. The precise origin of such an unusual tumor is uncertain, but it probably arises from the sympathetic nerve supply to the choroid plexus.

Cerebral Ventricle Neoplasms↗

A case of acute poisoning by methyl demeton in a female 5 months pregnant.

During the last decade the number of poisonings by pesticides in Portugal has been steadily rising. Out of 140 patients treated in our Intensive Care Unit (I.C.U.), 86 were male and 54 were female, one of whom was 5 months pregnant. Besides all the care and surveillance required by every case of acute poisoning, pregnant females raise particular problems. Four months later, she gave birth to a normal child. Its follow-up has shown a normal morpho-physiological and psycho-motor development.

Adult↗

Tissue injury in marrow transdifferentiation.

Recent findings indicate that adult BM contains cells that can differentiate into mature, nonhematopoietic cells of multiple tissues including cells of the kidney, lung, liver, skin and GI tract and fibers of heart and skeletal muscle. Recently the number of these observations has substantially increased, but there is a lack of information on the mechanistic issues in stem cell plasticity. In three different models for skin, liver and skeletal muscle plasticity, we have shown that following transplantation of the marrow cells from green fluorescent protein (GFP) transgenic mice, high levels of conversion of marrow cells can be identified. Injury to the tissue was the single most important factor for this phenomenon since the incidence of marrow to other tissue conversions significantly increased after tissue injury was implemented. Our studies also demonstrate the effect of radiation on the extent of marrow conversion.

Animals↗

[Acute eosinophilic pneumonia associated with acute respiratory distress syndrome: case report].

The Authors present a case of acute eosinophilic pneumonia (AEP) associated with severe acute respiratory distress syndrome in a previously healthy young adult, medicated with nitrofurantoin. AEP must be included in the differential diagnosis of community adquired pneumonia, as well as a cause of acute respiratory distress syndrome; its diagnosis is suggested by the presence of eosinophilic alveolitis in bronchoalveolar lavage fluid. The early diagnosis of AEP and corticosteroid therapy may be lifesaving.

Acute Disease↗

Lamotrigine as add-on therapy in treatment-resistant epilepsy. Portuguese Lamotrigine as Add-on Therapy in Treatment-resistant Epilepsy Study Group.

The efficacy and safety of lamotrigine as add-on therapy in treatment-resistant epilepsy were evaluated in an open prospective study carried out at five centres in Portugal and involving 61 patients. Daily seizure diaries were kept by patients, and used by the investigators to give a rating of response to therapy. Assessments were recorded after 1, 2, 3, 6, 9, 12, 18 and 24 months. Overall, seizure control was improved in 57% of patients, remained unchanged in 34% and deteriorated in 9%. There were some indications that efficacy was greatest in patients with generalized seizures and in those taking concomitant valproate. Efficacy was maintained throughout the 2-year study. It was possible to reduce the dose of concomitant antiepileptic drug in 56% of patients, and seven patients no longer needed a concomitant antiepileptic drug. Although 75% of patients reported an adverse experience, most of these were mild or moderate in intensity, did not require treatment and were not judged to be serious. A total of 13 patients withdrew from the study (four due to adverse events, four due to lack of efficacy and five for other reasons).

Administration, Oral↗

Supratentorial giant cell ependymoma.

Ependymomas account for 3 to 9% of all neuroepithelial tumors and, although occurring most often within the ventricular system, they may arise from the extraventricular parenchyma as well. Several histologic patterns of these neoplasm are well known, but little attention has been devoted to a variant composed of giant elements. We describe the case of a 13-year-old girl experiencing a 3-month history of partial seizures in whom cranial magnetic resonance imaging showed an extraventricular, right parietotemporal neoplasm, adherent to the overlying dura mater. Histologic, immunohistochemical and ultrastructural findings were consistent with those of a high-grade ependymoma. The tumor was characterized by the presence of a major component of pleomorphic giant cells, as also seen in pleomorphic xantoastrocytoma, subependymal giant cell astrocytoma and glioblastoma multiforme. Similar elements have been described in two filum terminale and one supratentorial, intraventricular ependymoma, respectively. Histologic and evolutional data of those and of our own case suggest that isolated giant cells are not necessarily linked to a bad prognosis in ependymomas.

Adolescent↗