Ehlers-Danlos syndrome type IV and recurrent carotid-cavernous fistula: review of the literature, endovascular approach, technique and difficulties.

We report the follow-up of a previously published case (Forlodou et al. Neuroradiology 38:595-597, 1996) of carotido-cavernous fistulas (CCFs) in a patient presenting with type IV Ehlers-Danlos syndrome (EDS 4) that were successfully treated twice by an endovascular approach. Initial treatment with a detachable balloon was in 1994 for a right CCF, and, 8 years later, a left CCF was treated by selective transarterial occlusion of the cavernous sinus with coils. Unfortunately, the patient suffered from a spontaneous post-operative intracranial haemorrhage in the left hemisphere and died. Review of the literature, technical considerations for bilateral CCF and complication are discussed.

[Hypertrophic olivary degeneration. MR imaging findings and temporal evolution]. / Degenerescence olivaire hypertrophique. Aspect IRM et évolution temporelle.

PURPOSE: to describe the magnetic resonance imaging features of hypertrophic olivary degeneration (HOD) subsequent to lesion in the "Guillain-Mollaret triangle". MATERIALS AND METHODS: 15 cases of HOD were diagnosed at MR imaging in 12 patients (4 women and 8 men) with posterior fossa lesion. The time interval from the beginning of the disease to the MR examination was 3 weeks to 8 (1/2) years. Evaluation of the changes in signal intensity over time of the lesions was available in 6 patients. RESULTS: Nine cases of HOD were unilateral and three were bilateral. HOD was associated to a lesion of the contralateral dentate nucleus in 8 cases, to a lesion of the ipsilateral central tegmental tract in 5 cases and to a lesion of the contralateral superior cerebellar peduncle in 2 cases. Hyperintensity and hypertrophy of the olive on proton density and T2-weighted images appeared as early as 3 weeks after the ictus. A curved central hyperintensity (CCH) could be observed 7 months after the initial presentation. Decrease in the signal intensity was observed after 3 (1/2) years and abnormal signal intensity could persist for up to 13 years. Palatal myoclonus at 5 months was associated with HOD in one case. CONCLUSION: HOD is considered a trans-synaptic degeneration subsequent to lesions in the Guillain-Mollaret triangle. Hyperintensity and hypertrophy of the olive are observed, sometimes with palatal myoclonus.

Effects of lycopene-enriched tomato oleoresin on 7,12-dimethyl-benz[a]anthracene-induced rat mammary tumors.

Consumption of carotenoids has frequently been inversely correlated with cancer incidence. In this report we used the 7,12-dimethyl-benz[a]anthracene (DMBA)-induced rat mammary tumor model to compare the effect of lycopene-enriched tomato oleoresin on the initiation and progression of these tumors with that of beta-carotene. Rats were injected i.p. with lycopene-enriched tomato oleoresin or beta-carotene (10 mg/kg, twice per week) for 2 weeks prior to tumor induction by DMBA and for an additional 16 weeks after carcinogen administration. HPLC analysis of carotenoids extracted from several tissues showed that both carotenoids were absorbed into blood, liver, mammary gland, and mammary tumors. The tomato oleoresin-treated rats developed significantly fewer tumors, and the tumor area was smaller than that of the unsupplemented rats. Rats receiving beta-carotene showed no protection against the development of mammary cancer.

El envenenamiento producido por la serpiente neotropical cuaima: (Lachesis muta muta) / The poisoning produced by the cuaima: (Lachesis muta muta)

Los autores exponen un trabajo sobre el envenenamiento ocasionado por las serpientes conocidas vulgarmente como Cuaimas, cuyo habitat se encuentra en el neotrópico con referencia especial en Venezuela, donde se ha comprobado la existencia de la subespecie Lachesis muta muta. Esta serpiente tiene limitada distribución en el país, principalmente en las áreas de selva tropical de los Estados Bolívar, Monagas, Amazonas y Delta Amacuro. La serpiente es muy tímida debido a sus grandes dimensiones y a la enorme cantidad de veneno que poseen. Afortunadamente se describe un número exiguo de accidentes provocados por ella, por ende no rerpresentan un grave problema de salud pública. Su veneno, aunque débil es neurotóxico, proteolítico y hemorrágico, probablemente miotóxico, pero no es fácil que inoculen la totalidad de él. Se expone un caso de envenenamiento accidental en un adulto de 29 años de edad, producido por la mordedura de una Cuaima, tratado con suero antiofídico polivalente (Facultad de Farmacia de la Universidad Central de Venezuela). Que hubo de ser hospitalizado e internado en una Unidad de Terapia Intensiva, por presentar transtornos de coagulación, de difícil remisión

Detection and characterization of antigens from Taenia solium cysticercus in cerebrospinal fluid.

Dot-ELISA and standard-ELISA were used to detect T. solium cysticercus antigens in cerebrospinal fluid for the diagnosis of neurocysticercosis. The results indicate that both assays are sensitive, specific and economically adequate for the diagnosis of this disease. Using SDS-PAGE, electroblotting and dot-ELISA we have found that the antigen is a protein with a molecular weight of 66,000 daltons.

Detection of Cysticercus cellulosae antigens in cerebrospinal fluid by dot enzyme-linked immunosorbent assay (Dot-ELISA) and standard ELISA.

The dot enzyme-linked immunoassay and standard enzyme-linked immunoassay were used to detect Cysticercus cellulosae antigens in cerebrospinal fluid of patients suffering with neurocysticercosis. Using the dot enzyme-linked immunoassay, 10 of 17 patients (59%) were positive at a reciprocal titer of 128 (range 128-1,024). In the standard assay, 13 of 17 (77%) were positive (range 128-512). Specificity was 100% in both assays using 48 cerebrospinal fluids from patients with various central nervous system infections. The quantification of antigens in cerebrospinal fluid using standard assay and photometric readings showed a range of 17 to 138 ng/ml. The results indicate that both assays are sensitive, specific, and economical for the diagnosis of neurocysticercosis.

Cimetidine enhances and phenobarbital decreases parathion toxicity.

Parathion toxicity has been attributed to its metabolic product paraoxon which is formed in the mammal liver through the multiple oxidase enzymes. These are induced by barbiturates and inhibited by SKF 525 A and cimetidine. We assessed the effects of these drugs on the acute toxicity of parathion in rats by measuring the rate of survival at 24 h after the administration of the oral LD50 of parathion to four groups of rats: control and pretreated with the aforementioned drugs. Additional rats of these groups were used to measure the capability of liver isolated microsomes to transform p-nitroanisole to p-nitrophenol. In the control and cimetidine groups we also measured the transformation of parathion to paraoxon and p-nitrophenol by the liver microsomes. Phenobarbital increased the survival 100% whereas cimetidine and SKF 525 A dramatically potentiated parathion toxicity. Phenobarbital increased the formation of p-nitrophenol but cimetidine and SKF-525 A produced the opposite effect. Paraoxon and p-nitrophenol from parathion were decreased by cimetidine. Our results strongly suggest that parathion itself is largely responsible of its toxicity and the inhibition of its metabolism is harmful rather than beneficial.

Treatment of neurocysticercosis with flubendazole.

Thirteen patients with neurocysticercosis were studied and treated with flubendazole. Diagnostic procedures included computerized tomography (CT) and enzyme-linked immunosorbent assay. In 12 cases treatment with the drug led to clinical improvement. CT showed that some cysts regressed in size, and in two patients they disappeared. The treatment also lowered the antibody levels. The drug was well tolerated and no allergic reaction or other side effects were observed.

Aplicacion del metodo ELISA para el diagnostico de la cisticercosis. / Use of ELISA method for the diagnosis of cysticercosis

La frecuencia elevada de cisticersosis en paises en desarrollo y sus efectos patologicos y economicos senalan la necesidad de contar con una prueba satisfactoria para diagnosticar esta enfermedad. En el Hospital Central Ignacio Morones Prieto de San Luis Potosi, SLP, Mexico, se realizo un estudio en el que se comparo la sensibilidad del ensayo inmunosorbente enzima conjugada (ELISA) con la del metodo de hermaglutinacion indirecta (HI), para diagnosticar la cisticercosis. Por medio de ambos metodos se analizaron muestras de liquido cefalorraquideo y de suero de 120 pacientes neurologicos que se dividieron en dos grupos control y un grupo de 17 casos de cisticercosis cerebral confirmada. Las muestras de los grupos control resultaron negativas con ambos procedimientos, pero en el grupo de enfermos de cisticercosis con el metodo de HI se obtuvo 29% de resultados falsos negativos, en tanto que con ELISA no se obtuvo ninguno.Se concluye que el metodo ELISA es mas sensible que el de HI puesto que con el no se lograron resultados falsos negativos ni positivos sin embargo, en vista del pequeno numero de casos investigados no es posible llegar a una conclusion definitiva

Effect of flubendazole on Cysticercus cellulosae in pigs.

The effect of flubendazole on Cysticercus cellulosae was tested in 15 pigs. In doses o 8.3 mg/kg body weight or more daily for 10 days the drug was lethal to the cysticerci, causing both macroscopic and microscopic morphological alterations. An in vitro test showed 0% viability of cysticerci in most of the treated pigs, whereas in 90-100% of 11 control pigs they were viable.