Recurrent isolated oculomotor nerve palsy caused by schwannoma in a pediatric patient

Isolated schwannomas of motor nerves to extraocular muscles are uncommon. In addition, most previous studies on oculomotor nerve schwannoma discuss adult patients, and pediatric cases are rare. We report a 10-year-old girl who developed recurrent oculomotor nerve palsy caused by schwannoma without any vascular malformation. Although the incidence is rare in pediatric patient, the recurrent isolated oculomotor nerve palsy due to schwannoma can develop, and it should be considered in the differential diagnosis of ocular motility disorders in pediatric patients. Careful imaging evaluation is needed to identify schwannoma due to its small size, deep location in the brain, and rarity.

PPARγ induces growth inhibition and apoptosis through upregulation of insulin-like growth factor-binding protein-3 in gastric cancer cells

Peroxisome proliferator activator receptor-gamma (PPARγ) is a ligand-activated transcriptional factor involved in the carcinogenesis of various cancers. Insulin-like growth factor-binding protein-3 (IGFBP-3) is a tumor suppressor gene that has anti-apoptotic activity. The purpose of this study was to investigate the anticancer mechanism of PPARγ with respect to IGFBP-3. PPARγ was overexpressed in SNU-668 gastric cancer cells using an adenovirus gene transfer system. The cells in which PPARγ was overexpressed exhibited growth inhibition, induction of apoptosis, and a significant increase in IGFBP-3 expression. We investigated the underlying molecular mechanisms of PPARγ in SNU-668 cells using an IGFBP-3 promoter/luciferase reporter system. Luciferase activity was increased up to 15-fold in PPARγ transfected cells, suggesting that PPARγ may directly interact with IGFBP-3 promoter to induce its expression. Deletion analysis of the IGFBP-3 promoter showed that luciferase activity was markedly reduced in cells without putative p53-binding sites (-Δ1755, -Δ1795). This suggests that the critical PPARγ-response region is located within the p53-binding region of the IGFBP-3 promoter. We further demonstrated an increase in PPARγ-induced luciferase activity even in cells treated with siRNA to silence p53 expression. Taken together, these data suggest that PPARγ exhibits its anticancer effect by increasing IGFBP-3 expression, and that IGFBP-3 is a significant tumor suppressor.

Antifungal activity of voriconazole on local isolates: An in-vitro study

Objective@#To determine the in-vitro activity of voriconazole and compare it with amphotericin B, fluconazole, itraconazole, ketoconazole, and caspofungin against local yeast and mold clinical isolates Candida albicans, Candida sp., Aspergillus terreus, Aspergillus niger, and Fusarium cylindrocarpone.@*Methods@#Review of the Institute of Ophthalmology microbiology records were done and was the basis for the local isolates included in the study. Mean inhibitory concentration (MIC) was determined using YeastOne Sensititre Microtitre Colorimery method (TREK Diagnostic Systems, England). Two-way ANOVA, Duncan, and Pearson chi-squared tests were used to analyze the data. @*Results@#All isolates tested were sensitive to voriconazole. Eighty percent (80%) of the isolates were sensitive to amphotericin B and 25% showed resistance to itraconazole. Yeast pathogens were all sensitive to amphotericin B and voriconazole. More than 50% of the yeast pathogens were resistant to ketoconazole. Molds or filamentous fungi showed higher susceptibility to voriconazole than amphotericin B and the other antifungals. @*Conclusion@#Voriconazole exhibited good in-vitro activity against the isolates tested. It has the same efficacy on yeast pathogens (Candida albicans and Candida sp.) when compared with amphotericin B. It has superior efficacy on filamentous fungi (Aspergillus and Fusarium). There is a role for voriconazole in the treatment of ocular infections, especially in the setting of poor antifungal drug availability.

Is Conservative Treatment with Antibiotics the Correct Strategy for Management of Right Colonic Diverticulitis?: A Prospective Study

PURPOSE: The goals of this study were to identify whether conservative treatment with antibiotics in right colonic diverticulitis (RCD) patients, our empirical method used until now, is adequate and to determine how the natural history of RCD is affected by conservative treatment. METHODS: This study was designed as a case-control study. Group I was comprised of 12 patients who were managed conservatively, and clinical data were retrospectively collected. In group II, a total of 49 patients, diagnosed by using diagnostic criteria for RCD and managed conservatively, were prospectively included. RESULTS: The period of fasting was 2.7 days, and the hospital stay was 4.6 days in all patients. The intravenous and the oral antibiotic periods were 3.8 days and 9.8 days, respectively. There were no statistically significant differences in treatment results between the two groups except the duration of fasting and the hospitalization, and there were no complications under conservative treatment. Eight patients (13.1%) had recurrent diverticulitis during the follow-up period. The recurrence risk showed no significant difference between the groups. The RCD-free period after management was 60.1 months, and patients with recurrent RCD were treated by conservative treatment or laparoscopic surgery. CONCLUSION: Conservative treatment with antibiotics is the optimal treatment of choice for RCD and shows no increase in complications.

Vision loss following snakebite in a patient with controlled aplastic anemia

Viper venoms act mainly on blood and blood vessels. Reports of ophthalmic manifestations after snakebite include ptosis and ophthalmoplegia. In the current study, we describe a case that developed bilateral retinal and subretinal hemorrhage following snakebite. Bilateral retinal hemorrhage is a rare ocular complication of snake envenomation and has not been reported with fundus photographs in the literature so far.(AU)

Prolactina serica durante un embarazo inducido con gonadotrofinas hipofisarias en una paciente con hipopituitarismo postparto (sindrome de Sheehan). / Serum prolactin during pregnancy induced by pituitary gonadotrophins in a patient with post partum hypopituitarism (Sheehan syndrome)

Con el proposito de investigar si la produccion placentaria de prolactina influye sobre la concentracion serica materna de prolactina, se cuantifico esta hormona en el suero de una mujer con sindrome de Sheehan parcial (produccion deficiente de gonadotropinas y prolactina), cuyo embarazo fue inducido con gonadotropinas hipofisarias. Se demostro la reserva hipofisaria deficiente de prolactina mediante las pruebas de estimulacion hipofisaria con metoclopramida y TRH. El analisis cuantitativo de la prolactina se efectuo por RIA utilizando el metodo de doble anticuerpo. La concentracion serica de prolactina se conservo persistentemente baja durante todo el embarazo y tuvo un incremento minimo (de 1 a 16 ng/ml) al final del embarazo, en comparacion con la concentracion observada durante el embarazo de mujeres normales (20 mas o menos 10 ng/ml media mas o menos 3 DE al final del mismo.) La concentracion de prolactina en el cordon umbilical se encontro en valores normales (252 ng/ml. Los resultados obtenidos demuestran que la prolactina producida en el feto y la placenta no pasa a la madre, y confirman la impresion de que la prolactina serica materna, durante el ambarazo normal, es exclusivamente de origen hipofisario materno

Anastomosis biliodigestiva en el Hospital Santo Tomas (1971 - 1978). / Bilidigestive anastomosis in the Hospital Santo Tomas (1971 -1978)

Se revisaron 37 casos de anastomosis biliodigestivas en el Hospital Santo Tomas desde 1971 hasta 1978. Las indicaciones mas frecuentes para efectuar estos procedimientos fueron las litiasis de vias biliares (11/37) y neoplasias malignas (15/37), en particular el carcinoma de cabeza de pancreas (11/37).La coledocoduodenostomia fue la cirugia biliodigestiva mas frecuente en el tratamiento quirurgico de las litiasis biliares, mientras que la colecistoyeyunostomia fue la mas frecuente en el manejo paliativo de las neoplasias malignas (carcinoma de cabeza de pancreas). La complicacion mas frecuente fue la colangitis ascendente que se registro en cinco ocasiones, asociado a la coledocoduodenostomia en dos casos. Tambien se registraron dos casos de obstruccion de anastomosis biliodigestivas y dos casos de mortalidad postoperatorias no relacionadas con la anastomosis. El promedio de tiempo de seguimiento fue de 17.3 meses (rango de 2 a 108 meses)

Hemobilia traumatica. Presentacion de tres casos. / Traumatic hemobilia. Report of three cases

Se presentaron tres casos de hemobilia traumatica, el tratamiento quirurgico realizado y las consideraciones practicas sobre la ligadura de la arteria hepatica. Se revisa la literatura principalmente la relacionada a la hemobilia traumatica por heridas contusas o penetrantes al higado y se destaca el papel de la angiografia en el diagnostico y orientacion de la tactica operatoria a ser ejecutada en cada caso en particular