[Extrahepatic cholestasis in a patient with Kaposi sarcoma associated with the acquired immunodeficiency syndrome].
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Biomedical subjects
Publications and source records attributed to J Sola.
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The authors report a series of three children with symptomatic congenital arachnoid cyst of the lateral ventricles. Presenting symptoms consisted of macrocephally, delay in psychomotor development, and seizures. CT findings were of a well-defined cystic lesion placed in the atrium of the lateral ventricle. One child was treated by direct cyst exposure and cysto-peritoneal shunt. The other two were treated with ventriculo-cysto-peritoneal shunts; in one of these, we used a ventriculoscope both for cyst fenestration and for accurate shunt placement. The origin of intraventricular arachnoid cysts seems to be secondary to the displacement of arachnoid cells by the vascular mesenchyma, through the choroid fissure, during the process of choroid plexus development.
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Atretic cephalocele appears as an unimportant and benign lesion. This malformation consists of meningeal and vestigial tissues (arachnoid, glial, or central nervous system rests). The authors report the findings in 16 cases (seven parietal and nine occipital) of rudimentary cephaloceles. Twelve patients presented with associated brain abnormalities detected by either computerized tomography (CT) or magnetic resonance imaging (MR). Nine lesions also exhibited an anomalous vascular component demonstrated by CT or MR imaging or at surgery. The existence of this tiny malformation in five cases was the main diagnostic clue to a severe complex of cerebral anomalies, namely cerebro-oculomuscular (Walker-Warburg) syndrome. An occipital location of the atretic cephalocele was associated with the worst prognosis, with only two children developing normally. However, a parietal location carried a better prognosis, which is contrary to the outcome reported in the current literature. The authors classify atretic cephaloceles into two types based on histological examination of the surgical specimens, and suggest that these types represent different stages in the development of this malformation. It is concluded that, in the evaluation of the atretic cephalocele, the neurosurgeon is obliged to proceed to a detailed neuroradiological study of the patient and that the prognosis does not depend on the existence of the cephalocele itself, but rather on associated "occult" brain anomalies.
To determine the clinical significance of the microscopic study of the synovial fluid (SF) sediment, 306 sediments were examined from 216 patients with the most frequently occurring acute and chronic arthropathies. The SF was obtained using a fine gauge needle. Microscopic rice bodies were seen in 53 (17.3%) of the samples studied. Forty-five (84.9%) of the samples in which rice bodies were observed were from patients with rheumatoid arthritis (RA) (p < 0.001); 34.9% of the 129 RA samples were found to contain rice bodies. The specificity of finding rice bodies in RA was 95.5%. Most rice bodies were composed of partly or totally hyalinized fibrinous material; in their interior, mononuclear cells were predominantly observed--most of them macrophagic in appearance. With less frequency the rice bodies exhibited central areas of fibrosis. Our results suggest that microscopic rice bodies are fibrinous particles derived from the entrapping of cells in the dense fibrin network present in inflammatory SF.
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Classically meningiomas present and evolve with a progressive course. Meningiomas manifest themselves mainly in middle and old age when the incidence of strokes is higher. The authors report three instances of meningioma with acute haemorrhagic onset. The clinical picture of our cases consisted of subarachnoid bleeding, subdural hematoma and intracerebral haemorrhage respectively. The diagnostic difficulties encountered when assessing these patients are discussed. The current literature regarding meningioma associated with haemorrhage is reviewed. One of our cases seems to be the first reported case of subarachnoid haemorrhage originating from a meningioma of the petrous bone.
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We studied liver changes in the hepatic biopsies of five patients with hyperthyroidism. A characteristic histopathologic picture consisting of mild to moderate intrahepatocytic cholestasis, lobular inflammatory infiltrate with some eosinophils, and Kupffer cell hyperplasia was found in all cases. We discuss the specificity, clinicopathological correlations and the possible pathophysiology of these lesions.
We report a case of primary lymphoma on a previously resected stomach in a 62-year-old man. The patient was treated 22 years earlier with a partial gastrectomy and Billroth II reconstruction for a benign gastric ulcer. The rarity of this entity and its possible relationship with pseudolymphoma or lymphoid nodular hyperplasia is discussed, and the literature is reviewed.
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Cathepsin D, like most lysosomal enzymes, undergoes multiple proteolytic cleavages during its lifetime. Although the significance of the earliest cleavages of cathepsin D is apparent (loss of the NH2-terminal signal peptide and activation peptide), functions of the two later cleavages are not understood and do not occur in all species. To examine these later events, a cDNA coding for human cathepsin D, which is normally processed to a two-chain form, was isolated and then expressed in mammalian cells from species which do not process the enzyme to the two-chain form. Analysis of the expressed human cathepsin D demonstrated proteolytic processing identical with that seen in normal human fibroblasts. Since processing to the two-chain form of the enzyme occurs in the lysosome, these studies revealed that the human cathepsin D was correctly sorted. The data also indicated that the sorting mechanism was conserved between diverse species and that late proteolytic processing in a variety of species was not determined by the presence or absence of the processing enzymes in the cell.
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Increased levels of eicosanoids in lesions of psoriasis suggest activation of arachidonic acid metabolism in different cell types play a physiopathologic role. The contribution of each cell type present in psoriasis has been the subject of some controversy, which has led us to study the metabolism of arachidonic acid in human epidermal cells suspensions. 12-HETE was found to be the main product, followed by PGE2 and PGF2 alpha; no 5-lypoxygenase products were found. Thus epidermal cell contribution to LTB4 levels present in plaques of psoriasis appears to be irrelevant. Conversely, increased levels of 12-HETE probably do result from arachidonic acid metabolism by epidermal cells.
Gonorrheal urethritis was induced in three males by intraurethral instillation of predominantly pilus+ protein II- gonococci. Virtually all gonococci reisolated from the infected men exhibited protein II+ phenotype. The reisolated gonococci expressed five distinct outer membrane protein II species. Protein IIc+ organisms predominated in urines of all three subjects, but variants expressing this particular protein II were rarely spawned in vitro by input organisms. Protein IIc+ gonococci appeared early in one man's infection; they were joined later by variants that displayed eight other protein II phenotypes, including protein II-. These results show that input protein II- gonococci are supplanted by protein IIc+ variants during incipient gonorrheal urethritis. As infection progresses, a broader variety of protein II+ variants appears.
The authors report a case of a ventricular oligodendroglioma associated with a cortical arteriovenous malformation. The patient presented with subarachnoid hemorrhage. Computed tomographic scan showed an intraventricular hyperdense lesion, mimicking a hematoma. Angiography revealed a superficial arteriovenous malformation in the right parietal lobe, unrelated to ventricular cavities. Both lesions were treated during the same operation. The diagnostic difficulties and the significance of this uncommon association are discussed.