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1.
Can J Cardiol ; 10(8): 861-4, 1994 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-7954023

RESUMO

This report describes two cases of cardiotoxicity associated with the use of 5-fluorouracil (5-FU) in the treatment of neoplastic disease, and reviews the literature to date. The manifestations of cardiac toxicity were significant ventricular dysfunction during continuous infusion of 5-FU, accompanied by symptoms resembling cardiac ischemia in one case and irreversible cardiogenic shock in another. Detailed cardiac investigations and pathological findings provide convincing evidence that the development of acute myocarditis is the likely mechanism of 5-FU cardiotoxicity, rather than coronary insufficiency as has commonly been postulated. Although cardiotoxicity as a complication of 5-FU therapy remains rare, recognition of this entity is important as it may lead to serious hemodynamic compromise and may recur with drug rechallenge.


Assuntos
Fluoruracila/efeitos adversos , Miocardite/induzido quimicamente , Doença Aguda , Adenocarcinoma/tratamento farmacológico , Adulto , Carcinoma de Células Escamosas/tratamento farmacológico , Feminino , Fluoruracila/farmacologia , Fluoruracila/uso terapêutico , Humanos , Neoplasias Labiais/tratamento farmacológico , Masculino , Miocardite/fisiopatologia , Neoplasias do Colo do Útero/tratamento farmacológico , Função Ventricular Esquerda/efeitos dos fármacos
2.
J Neurosurg ; 61(1): 174-7, 1984 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-6726394

RESUMO

The authors report a case of chondrosarcoma arising in the cerebellum 16 years after treatment of a cerebellar malignant astrocytoma by subtotal resection and irradiation. It is thought that the chondrosarcoma arising within the intracranial cavity was a probable consequence of previous ionizing radiation.


Assuntos
Neoplasias Cerebelares/patologia , Condrossarcoma/patologia , Neoplasias Induzidas por Radiação/patologia , Adulto , Neoplasias Cerebelares/etiologia , Condrossarcoma/etiologia , Humanos , Masculino
3.
Ann Rheum Dis ; 43(1): 91-4, 1984 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-6198977

RESUMO

A 45-year-old female with selective deficiency of C4 and systemic lupus erythematosus developed puzzling gastrointestinal and systemic symptoms in the last 6 months of her life. Extensive investigation of the gastrointestinal tract did not yield any diagnosis, and the patient died shortly afterwards. Autopsy revealed evidence of a typical Whipple's disease of the jejunum and lymph nodes. This association has not been previously described. The disease is reviewed with emphasis on its being an opportunistic infection in an immunosuppressed host with a complement deficiency and SLE.


Assuntos
Complemento C4/deficiência , Lúpus Eritematoso Sistêmico/complicações , Doença de Whipple/complicações , Feminino , Humanos , Jejuno/patologia , Linfonodos/patologia , Pessoa de Meia-Idade , Doença de Whipple/patologia
4.
Cancer ; 50(11): 2301-6, 1982 Dec 01.
Artigo em Inglês | MEDLINE | ID: mdl-6291739

RESUMO

A prospective randomized trial of 157 patients with malignant astrocytoma (Grade III or IV) was carried out at a single institution. The minimization technique ensured balanced distribution of prognostic factors between the treatment groups. All received oral lomustine (CCNU, 80 mg/m2) six weekly and hydroxyurea (HU, 3.5 gm/m2 over 5 days) three weekly, for one year or until recurrence, with doses adjusted for myelosuppression. Patients were randomized to daily (5000 rad in 25 fractions (fr) in 5 weeks) or Q3h (every 3 hours) Cobalt 60 irradiation (3600-4000 rad in 36-40 fr of 100 rad each, given 4 fr per day at 3-hour intervals over two weeks) Steroid therapy (up to 16 mg day dexamethasone) was permitted. Complications were moderate and equivalent in the two groups. No significant survival or toxicity differences were seen between the two groups. Age, initial performance status, and extent of surgical resection were found to be significant (P less than 0.01) prognostic factors for survival. Median survival of the whole group was 48 weeks with a minimum follow-up of one year. There was no advantage to large radiation fields. The hyperfractionation and daily regimens had similar efficacy and toxicity. Hyperfractionation with chemotherapy offers a useful alternative approach in the management of this disease.


Assuntos
Glioblastoma/radioterapia , Adulto , Idoso , Ensaios Clínicos como Assunto , Feminino , Seguimentos , Glioblastoma/diagnóstico , Glioblastoma/tratamento farmacológico , Humanos , Masculino , Pessoa de Meia-Idade , Dosagem Radioterapêutica , Distribuição Aleatória
5.
Can J Neurol Sci ; 8(2): 181-4, 1981 May.
Artigo em Inglês | MEDLINE | ID: mdl-6457681

RESUMO

The authors report a single case of Huntington's chorea associated with a unilateral focus of ectopic gray matter. The patient's symptoms began at age 45 and included typical involuntary jerking movements of all extremities and face. Mental deterioration may have proceeded the choreiform movements. The family history was positive for Huntington's chorea. Pneumoencephalogram showed atrophy of the caudate nuclei bilaterally early in the disease. The patient improved transiently with haloperidol therapy. The major pathologic features included mild generalized cerebral atrophy with marked atrophy of the caudate nuclei and putamen. Within the white matter of the left frontal lobe, there were irregular nodules of ectopic gray matter with an overall diameter of 2 cm. The rarity of either unilateral ectopia or Huntington's chorea alone, makes it impossible to judge if the two lesions might be linked by a common pathologic mechanism. The significance such a linkage might hold is discussed in light of several currently postulate pathologic mechanisms.


Assuntos
Neoplasias Encefálicas/patologia , Córtex Cerebral/patologia , Coristoma/patologia , Doença de Huntington/patologia , Atrofia , Neoplasias Encefálicas/complicações , Núcleo Caudado/patologia , Coristoma/complicações , Humanos , Doença de Huntington/etiologia , Masculino , Pessoa de Meia-Idade , Putamen/patologia
6.
J Neurosurg ; 53(5): 693-7, 1980 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-7431079

RESUMO

A spontaneous dissecting aneurysm of the left middle cerebral artery with extension into its major branches is reported in a 23-year-old man. The characteristic pathological and angiographic findings are demonstrated, including the rarely documented progression of this lesion. The etiological factors, the early recognition by the neuroradiologist, and the possibility of immediate treatment are briefly discussed in this report.


Assuntos
Dissecção Aórtica/diagnóstico , Aneurisma Intracraniano/diagnóstico , Adulto , Dissecção Aórtica/diagnóstico por imagem , Angiografia Cerebral , Humanos , Aneurisma Intracraniano/diagnóstico por imagem , Masculino
7.
Am J Pathol ; 98(3): 617-38, 1980 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-6244736

RESUMO

Among 300 surgically removed pituitary adenomas, 17 tumors containing immunoreactive 1-39 adrenocorticotropin (ACTH) and/or 19-39 ACTH, beta-lipotropin, and alpha-endorphin but unassociated with clinical signs of Cushing's disease have been detected. These neoplasms were divided into basophilic adenomas with strong periodic acid-Schiff (PAS) and lead-hematoxylin positivity and chromophobic tumors with moderate or no PAS and lead-hematoxylin positivity. The former were densely granulated tumors with a fine structure strikingly similar to that of functioning corticotropic cell adenomas. The latter were sparsely granulated with varying ultrastructural patterns. The marked morphologic diversity suggests that these adenomas, despite their similar immunocytologic characteristics, represent more than one entity. Clinically, the most common finding was a rapidly progressing visual defect. An unusually high incidence of infarction (5 cases) and recurrence (5 cases) was noted, underlining the importance of correct morphologic diagnosis and careful follow-up.


Assuntos
Adenoma/ultraestrutura , Hormônio Adrenocorticotrópico/análise , Neoplasias Hipofisárias/ultraestrutura , Adenoma/análise , Adenoma Basófilo/ultraestrutura , Adenoma Cromófobo/ultraestrutura , Hormônio Adrenocorticotrópico/imunologia , Adulto , Idoso , Endorfinas/análise , Feminino , Histocitoquímica , Humanos , Masculino , Pessoa de Meia-Idade , Hipófise/análise , Hipófise/ultraestrutura , Neoplasias Hipofisárias/análise , beta-Lipotropina/análise
9.
Can Med Assoc J ; 111(6): 545-8, 1974 Sep 21.
Artigo em Inglês | MEDLINE | ID: mdl-4413961

RESUMO

Four days after the onset of a severe headache a 22-year-old woman who had been taking oral contraceptives for less than three weeks had a convulsion, followed by right hemiparesis. Other focal neurologic signs and evidence of raised intracranial pressure appeared, and she became comatose on the seventh day. A left craniotomy revealed extensive cerebral venous thrombosis. She died the next day. On postmortem examination extensive thrombosis of the superior sagittal sinus and draining cerebral veins, and multiple areas of cerebral hemorrhage and hemorrhagic infarction were seen. Some of the superficial cerebral veins showed focal necrosis of their walls, and the lateral lacunae of the superior sagittal sinus contained proliferating endothelial cells. The adrenal veins were also thrombosed. The significance of these findings is discussed. The literature on cerebrovascular complications of oral contraception, particularly cerebral venous thrombosis, is reviewed.


Assuntos
Anticoncepcionais Orais Sintéticos/efeitos adversos , Cavidades Cranianas , Embolia e Trombose Intracraniana/induzido quimicamente , Mestranol/efeitos adversos , Noretindrona/efeitos adversos , Glândulas Suprarrenais/irrigação sanguínea , Adulto , Autopsia , Encéfalo/patologia , Angiografia Cerebral , Hemorragia Cerebral/induzido quimicamente , Hemorragia Cerebral/patologia , Coma/induzido quimicamente , Cavidades Cranianas/patologia , Craniotomia , Diagnóstico Diferencial , Combinação de Medicamentos , Feminino , Cefaleia/induzido quimicamente , Hemiplegia/induzido quimicamente , Humanos , Embolia e Trombose Intracraniana/patologia , Convulsões/induzido quimicamente , Tromboflebite/patologia
10.
J Clin Invest ; 49(9): 1694-708, 1970 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-5270914

RESUMO

Serum levels, urinary excretion, and clearances of several proteins of different molecular weights were studied in 18 patients with mono- and myelomonocytic leukemia. Nine patients had normal renal function (group A) and nine had impaired renal function with azotemia (group B). The majority of patients in both groups had increased concentration of immunoglobulins, particularly IgG, IgA, and IgM; IgD level was normal. Serum transferrin and alpha(2)-macroglobulin were frequently reduced while the level of ceruloplasmin was often increased, especially in patients with azotemia. The activity of lysozyme in the serum was high in all patients, but was considerably higher in group B. Proteinuria was found in most patients but was more prominent in group B. Almost invariably albumin constituted less than 25% of the total protein excreted. Qualitative analysis of various urinary proteins by immunochemical techniques and clearance studies suggested the presence of glomerular as well as tubular dysfunction. Determination of urinary lysozyme frequently showed no direct correlation between the serum level of the enzyme and its concentration in the urine or its clearance by the kidney. In addition to glomerular filtration, impaired tubular reabsorption may account for the high level of lysozyme in the urine. It is postulated that the very high level of lysozyme in the glomerular filtrate and possibly hypergammaglobulinemia may play a role in the induction of tubular damage. Renal impairment has been correlated with histological changes in the kidneys. From a comparative study of various leukemias, it seems that the combined glomerular-tubular dysfunction is a manifestation unique to mono- and myelomonocytic leukemia.


Assuntos
Proteínas Sanguíneas , Glomérulos Renais/fisiopatologia , Túbulos Renais/fisiopatologia , Leucemia Mieloide/fisiopatologia , Muramidase/análise , Proteinúria/complicações , Adulto , Agamaglobulinemia/complicações , Idoso , Albuminúria/complicações , Análise Química do Sangue , Ceruloplasmina/análise , Ceruloplasmina/urina , Feminino , Humanos , Hipergamaglobulinemia/complicações , Hipergamaglobulinemia/fisiopatologia , Imunoglobulinas/análise , Leucemia Mieloide/sangue , Leucemia Mieloide/complicações , Leucemia Mieloide/urina , Masculino , Pessoa de Meia-Idade , Muramidase/sangue , Muramidase/urina , Nitrogênio/sangue , Transferrina/análise , Transferrina/urina , Uremia/complicações
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