RESUMO
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.
Assuntos
Anti-Inflamatórios/uso terapêutico , Anticorpos Monoclonais/uso terapêutico , Febre Familiar do Mediterrâneo/tratamento farmacológico , Imunoglobulina G/uso terapêutico , Proteinúria/tratamento farmacológico , Receptores do Fator de Necrose Tumoral/uso terapêutico , Fator de Necrose Tumoral alfa/antagonistas & inibidores , Adulto , Colchicina/uso terapêutico , Etanercepte , Humanos , Infliximab , Masculino , Resultado do TratamentoRESUMO
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.
Assuntos
Antioxidantes/farmacologia , Melatonina/farmacologia , Isquemia do Cordão Espinal/tratamento farmacológico , Animais , Antioxidantes/administração & dosagem , Catalase/análise , Catalase/efeitos dos fármacos , Modelos Animais de Doenças , Glutationa Peroxidase/análise , Glutationa Peroxidase/efeitos dos fármacos , Peroxidação de Lipídeos/efeitos dos fármacos , Masculino , Malondialdeído/análise , Melatonina/administração & dosagem , Coelhos , Traumatismo por Reperfusão/tratamento farmacológico , Medula Espinal/química , Medula Espinal/patologia , Isquemia do Cordão Espinal/patologia , Superóxido Dismutase/análise , Superóxido Dismutase/efeitos dos fármacos , Fatores de TempoRESUMO
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.
Assuntos
Antineoplásicos Fitogênicos/toxicidade , Encéfalo/efeitos dos fármacos , Vincristina/toxicidade , Animais , Encéfalo/patologia , Ácido Hipocloroso/farmacologia , Ácido Hipocloroso/uso terapêutico , Injeções Espinhais , Necrose , Coelhos , Terapia de SalvaçãoRESUMO
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.
Assuntos
Condroma/diagnóstico , Deslocamento do Disco Intervertebral/diagnóstico , Vértebras Lombares , Neoplasias da Coluna Vertebral/diagnóstico , Adulto , Condrócitos/patologia , Condroma/patologia , Condroma/cirurgia , Diagnóstico Diferencial , Humanos , Deslocamento do Disco Intervertebral/patologia , Deslocamento do Disco Intervertebral/cirurgia , Vértebras Lombares/patologia , Vértebras Lombares/cirurgia , Imageamento por Ressonância Magnética , Masculino , Exame Neurológico , Neoplasias da Coluna Vertebral/patologia , Neoplasias da Coluna Vertebral/cirurgia , Tomografia Computadorizada por Raios XRESUMO
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.
Assuntos
Cistos Aracnóideos/diagnóstico , Cistos Aracnóideos/etiologia , Fraturas Orbitárias/complicações , Fraturas Cranianas/complicações , Adolescente , Adulto , Cistos Aracnóideos/fisiopatologia , Criança , Diagnóstico Diferencial , Feminino , Humanos , Imageamento por Ressonância Magnética , Fraturas Orbitárias/fisiopatologia , Tomografia Computadorizada por Raios XRESUMO
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.
Assuntos
Aneurisma Roto/diagnóstico , Carcinoma/diagnóstico , Aneurisma Intracraniano/diagnóstico , Neoplasias Nasais/diagnóstico , Neoplasias dos Seios Paranasais/diagnóstico , Carcinoma/complicações , Criança , Diagnóstico Diferencial , Feminino , Humanos , Imageamento por Ressonância Magnética , Neoplasias Nasais/complicações , Neoplasias dos Seios Paranasais/complicações , Hemorragia Subaracnóidea/complicações , Hemorragia Subaracnóidea/diagnóstico , Tomografia Computadorizada por Raios XRESUMO
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.