Successful treatment with anti-tumor necrosis factor (anti-TNF)-alpha of proteinuria in a patient with familial mediterranean fever (FMF) resistant to colchicine: anti-TNF drugs and FMF.

Familial mediterranean fever (FMF) is an autoinflammatory disease characterized by recurrent attacks of fever, peritonitis, pleuritis, and genetically by autosomal recessive inheritance. The major renal involvement in FMF is the occurrence of amyloidosis that can be prevented by a daily regimen of colchicine. About 5-10% of cases with familial mediterranean fever may be resistant to colchicine. In literature, there is a controversy about the treatment of FMF patients resistant to colchicine. We describe a case with FMF, proteinuria, and bilateral sacroiliitis, which responded to anti-TNF (tumor necrosis factor)-alpha therapy with infliximab and etanercept.

Protective effect of melatonin on experimental spinal cord ischemia.

STUDY DESIGN: Experimental animal model to assess ischemic spinal cord injury following occlusion of the thoraco-abdominal aorta. OBJECTIVES: To measure whether melatonin administered to rabbits before and after occlusion exerts an effect on the repair of ischemia-reperfusion (IR) injury. SETTING: Medical Biology Laboratory, Inonu University, Malatya, Turkey. METHODS: Rabbits were divided into three IR treatment groups and one sham-operated (ShOp) control group. The three treatment groups had their infrarenal aorta temporarily occluded for 25 min, while the ShOp group had laparotomy without aortic occlusion. Melatonin was administered either 10 min before aortic occlusion or 10 min after the clamp was removed. Physiologic saline was administered to the control animals. After treatment, the animals were euthanized and lumbosacral spinal cord tissue was removed for the determination of relevant enzyme activities. RESULTS: Malondialdehyde levels, indicating the extent of lipid peroxidation, were found to be significantly increased in the nonmelatonin treated (IR) group when compared to the ShOp group. Melatonin, whether given to pre- or post occlusion groups, suppressed malondialdehyde levels below that of the ShOp group. Catalase (CAT) and glutathione peroxidase (GSH-Px) enzyme activities were increased in the IR group compared to the ShOp group. Melatonin given preocclusion resulted in a significant decrease in both CAT and GSH-Px enzyme levels. The superoxide dismutase (SOD) enzyme activity was decreased in the ischemia-reperfusion treatment group. However, the melatonin treatment increased SOD enzyme activity to levels approximating that of the ShOp group. CONCLUSION: To our knowledge, this is the first study that shows the effects of melatonin administered both pre- and postischemia on induced oxidative damage to injured spinal cords. Our data also expands on reports that melatonin administration may significantly reduce the incidence of spinal cord injury following temporary aortic occlusion.

Potential salvage therapy for accidental intrathecal vincristine administration: a preliminary experimental study.

BACKGROUND: Accidental intrathecal vincristine (VCR) administration results in severe neurotoxicity, usually fatal in outcome. No specific therapy for initrathecal VCR toxicity has been reported so far. In our recent report, complete in vitro degradation of VCR by hypochlorous acid (HOCl) was demonstrated. METHODS: In this comparative study, we examined the in vivo effectiveness of HOCl in the cerebrospinal fluid of 24 New Zealand rabbits following intracisternal VCR administration. RESULTS: There were no significant clinical or histopathologic abnormalities in the control and HOCl groups; however, multiple necrotic foci on histopathological examination of brain sections in the VCR group were determined. There were significantly lower numbers of necrotic foci in brain sections of rabbits which received HOCl administration than those without therapy. CONCLUSION: Our results indicate that HOCl may reduce VCR neurotoxicity.

An end-plate chondroma mimicking calcified lumbar disc herniation. A case report and review of the literature.

The authors report a case of chondroma arising from a vertebral end-plate and mimicking lumbar disc herniation. This tumor became calcified within 2 weeks. It was completely removed surgically, after which the patient's symptoms were relieved and neurological deficits regressed.

An unusual variant of a growing skull fracture in an adolescent.

A great majority of growing skull fractures occur in infancy and earlychildhood. Since the growth of brain is necessary as a driving force for these lesions to occur, almost all reported cases have been before the first 3 years of life. Although a number of uncommon locations, such as basiooccipital and skull base areas, have been reported, they are commonly located on calvaria. The authors report a growing skull fracture on the orbital roof in a 16-year-old female admitted to hospital with complaints of headache and seizures. She had had an orbital trauma 8 years before. CT scan revealed a hypodense lesion in the right frontal lobe and a diastatic fracture line on the right orbital roof. A right craniotomy was performed. Excision of arachnoid loculations and duraplasty were carried out. This is an unusual condition with respect to the location of the lesion, as well as the age of the patient.

Unusual presentation of a sinonasal carcinoma mimicking an aneurysm rupture.

Although the association of subarachnoid hemorrhage (SAH) and tumoral lesions in adult is well known, hemorrhage from a sinonasal carcinoma extending to the intracranial cavity is exceedingly rare. In this paper, the authors report on a 12-year-old girl who presented with SAH caused by a sinonasal carcinoma located in the anterior skull base area. To our knowledge, this is the first report of a sinonasal carcinoma concomitant with SAH.

An unusual presentation of metastatic adenocarcinoma in the cerebellum associated with intratumoral hemorrhage mimicking a stroke. A case report.

Spontaneous bleeding from a metastatic tumor in the brain is usually associated with melanoma, choriocarcinoma, or hypernephroma. We report a patient with rectum adenocarcinoma which metastasized into the cerebellum and mimicked a stroke, and discuss the clinical features and diagnostic problems of this uncommon condition.