RESUMO
In this report we present the case of a 16-year-old patient, born in Macedonia, who complained of abdominal and back pain and developed paraparesis. On admission to hospital, he showed a paraplegic syndrome, the level of sensation being T7, together with high-grade paraparesis of the lower extremities and spasticity and urinary incontinence. The protein content of the CSF was raised to 183 mg/dl. CT and MRI of the thoracic spine showed cystic lesions at the level of the 6th and 7th thoracic vertebrae, in the paravertebral area and in the 7th rib on both sides. The antibody titer of Echinococcus in the serum was positive. To treat this problem, corporectomy of the 6th to 8th thoracic vertebrae was performed, the area being bridged by a corticospongoid pelvic bone graft and with instrumental support of the 5th to 9th thoracic vertebrae. Histological examination revealed multilocular Echinococcus lesions. Under long-term treatment with mebendazole, the neurological deficits decreased in the postoperative phase.
Assuntos
Equinococose/complicações , Paraplegia/etiologia , Compressão da Medula Espinal/etiologia , Doenças da Coluna Vertebral/complicações , Vértebras Torácicas , Adolescente , Transplante Ósseo , Equinococose/diagnóstico , Equinococose/cirurgia , Humanos , Laminectomia , Imageamento por Ressonância Magnética , Masculino , Paraplegia/diagnóstico , Paraplegia/cirurgia , Medula Espinal/patologia , Compressão da Medula Espinal/diagnóstico , Compressão da Medula Espinal/cirurgia , Doenças da Coluna Vertebral/diagnóstico , Doenças da Coluna Vertebral/cirurgia , Vértebras Torácicas/patologia , Vértebras Torácicas/cirurgia , Tomografia Computadorizada por Raios XRESUMO
1 Aspiration of duodenal fluid and estimation of recovery by a marker dilution technique was adapted to measure the biliary excretion of two chemically related ureidopenicillins, mezlocillin and azlocillin, in healthy volunteers. 2 The drug was infused intravenously at a constant rate over a period of 6 h during which duodenal fluid was aspirated through the distal opening of a triple-lumen polyvinyl tube. 3 Drug levels in plasma, urine and duodenal fluid were determined by h.p.l.c. 4 Biliary excretion rate was calculated by multiplying the concentration in the duodenal fluid by the dilution factor resulting from the dilution of marker substance infused through the proximal opening of the triple-lumen tube. 5 Since the results obtained by the marker dilution technique are comparable to data obtained by studies in patients with t-tube drainage following biliary surgery, it can be concluded that the method is useful to measure the biliary excretion of drugs in man.
