ABSTRACT
INTRODUCTION: Segmental arterial mediolysis is a rare disorder characterised by disintegration of the medial layer of an arterial wall usually affecting the intra-abdominal splanchnic vessels. REPORT: A case of 50 year old man who presented with sudden-onset left sided flank pain is reported. A computed tomography mesenteric angiogram showed haemorrhage and a stable left upper quadrant haematoma arising from 8 × 8 mm splenic artery aneurysm. DISCUSSION: The patient underwent a successful endovascular coiling procedure to exclude the aneurysm and for complete resolution of his symptoms.
Subject(s)
Aorta/diagnostic imaging , Aortitis/diagnostic imaging , Giant Cell Arteritis/diagnostic imaging , Aged , Aorta/surgery , Aortitis/drug therapy , Aortitis/surgery , Blood Vessel Prosthesis Implantation , Coronary Artery Bypass , Fatal Outcome , Female , Fluorine Radioisotopes , Fluorodeoxyglucose F18 , Giant Cell Arteritis/drug therapy , Humans , Postoperative Complications , Prednisone/therapeutic use , Radiography , Radionuclide Imaging , RadiopharmaceuticalsABSTRACT
Chlorambucil is useful in patients with rheumatoid arthritis (RA) refractory to other agents but there is concern about the risk of haematological malignancy with this agent. A retrospective survey was performed to assess the incidence of all types of malignancy in 39 patients treated with chlorambucil (mean daily dose 4.25 mg, mean duration of treatment 25 months). These patients were compared with 30 patients with RA who received contemporaneously, the purine analogues azathioprine or 6-mercaptopurine (mean dose 100 mg, mean duration of treatment 24 months). Eight patients treated with chlorambucil and one patient receiving purine analogues developed cutaneous malignancy (p = 0.03). In the chlorambucil-treated patients these were mostly multiple and recurrent. Three patients treated with chlorambucil developed myeloid leukaemia or a preleukaemic state, whilst no patient treated with purine analogues developed this complication. The use of chlorambucil in RA is associated with an increased risk of cutaneous as well as haematological oncogenesis.
Subject(s)
Arthritis, Rheumatoid/drug therapy , Carcinogens , Chlorambucil/adverse effects , Acute Disease , Azathioprine/therapeutic use , Chlorambucil/therapeutic use , Humans , Leukemia, Myeloid, Acute/chemically induced , Mercaptopurine/therapeutic use , Pancytopenia/chemically induced , Time FactorsABSTRACT
The 'phospholipid effect' involves agonist induced breakdown of phosphatidyl inositol (PI) or its phosphorylated derivates with increased incorporation of 32P or [myo-2-3H] inositol during resynthesis. In rat pancreas pancreozymin and bethanecol resulted in the standard dose dependent increased incorporation of 32P into PI which was paralleled by increased amylase secretion. By contrast the incorporation of [myo-2-3H] inositol into PI was significantly decreased by pancreozymin whereas bethanecol had no effect. However, pancreozymin caused a 30% decrease in labelled PI irrespective of whether it was prelabelled with 32P or [myo-2-3H] inositol. Thus in rat pancreas, pancreozymin resulted in the standard agonist induced breakdown of pre-labelled PI but inhibited the incorporation [2-3H-myo] inositol during the resynthetic phase.
