RESUMO
Bisphenol A (BPA), diethylhexyl phthalate (DEHP) and pentabrominated diphenyl ether 99 (PBDE 99) are environmental toxicants belonging to the endocrine disrupting compounds (EDCs). They exert adverse effects on the various physiological systems, especially the reproductive system of humans and animals. The aim of this study was to investigate the effects of BPA, DEHP and PBDE 99 on progesterone (P4) synthesis in cultured bovine luteal cells. The bovine luteal cells isolated from the mid-luteal corpora lutea were exposed to different concentrations of BPA (1, 3, 10 and 30 µM), DEHP (1, 3, 10 and 30 µM) and PBDE 99 (0.1, 0.3, 1 and 3 µM) in a serum-free culture media for 48 and 96 hr. At 48 hr, the P4 level in the luteal cells decreased after treatment with all concentrations of BPA; 3, 10 and 30 µM of DEHP; and 3 µM of PBDE 99 compared to the control (p < .05). Treatment of cells with 3-30 µM of BPA, 1-30 µM of DEHP and 1-3 µM of PBDE 99 for 96 hr resulted in reduction in P4 synthesis (p < .05). However, lower concentrations of PBDE 99 (0.1 and 0.3 µM) increased P4 levels at 48 and 96 hr. Synthesis of P4 was lower at 96 hr compared to the 48 hr in the groups treated with BPA (30 µM), DEHP (1-30 µM), PBDE 99 (0.3-3 µM) and control group. Our results showed that BPA, DEHP and PBDE 99 are able to alter luteal steroidogenesis in bovine cells and can disrupt hormonal balance in the ovary. However, it is necessary to evaluate the exact mechanism underlying these effects in future studies.
Assuntos
Disruptores Endócrinos/toxicidade , Células Lúteas/efeitos dos fármacos , Progesterona/metabolismo , Animais , Compostos Benzidrílicos/toxicidade , Bovinos , Células Cultivadas , Dietilexilftalato/toxicidade , Feminino , Éteres Difenil Halogenados/toxicidade , Células Lúteas/metabolismo , Fenóis/toxicidadeRESUMO
Islet cell transplantation is a major treatment strategy for type I diabetes, and has proven to be effective for maintaining glucose homeostasis. However, this treatment requires an extended period of immunosuppression to prevent rejection and recurrent transplantation to maintain function. Thus, to enhance the properties of transplanted islet cells, we examined the effect of the co-culture of luteal cells, which secrete progesterone, on islet cell viability, functionality, and revascularization. It was found that islet viability and functionality were higher in the co-cultured group than in single cultures of islets at 48 and 96 h, in parallel with increased progesterone and vascular endothelial growth factor (VEGF) secretion from luteal cells. In the co-culture groups, VEGF levels at 48 and 96 h and CD31 levels at 48 h were significantly higher than those in the islet groups (p < 0.001 and p < 0.05, respectively), and basic fibroblast growth factor (bFGF) levels were increased at 96 h (p < 0.001). Thus, co-culture with luteal cells may increase islet vascularity by enhancing VEGF and bFGF levels for up to 96 h, which could help to markedly increase the pre-transplantation time to allow for effective immunosuppression therapy. This method may also promote islet cell viability and functionality. Progesterone and angiogenic factors secreted from luteal cells may be responsible for these positive effects.
Assuntos
Técnicas de Cocultura , Ilhotas Pancreáticas/irrigação sanguínea , Células Lúteas/citologia , Neovascularização Fisiológica , Sobrevivência de Tecidos , Animais , Feminino , Fator 2 de Crescimento de Fibroblastos/metabolismo , Insulina/metabolismo , Camundongos , Molécula-1 de Adesão Celular Endotelial a Plaquetas/metabolismo , Progesterona/metabolismo , Propídio/metabolismo , Ratos Sprague-Dawley , Fator A de Crescimento do Endotélio Vascular/metabolismoRESUMO
OBJECTIVE: The aim of this study was to identify the relationship between complete blood count parameters, mean platelet volume (MPV), and platelet to lymphocyte ratio (PLR) with mortality and hospitalization duration in critically ill patients. PATIENTS AND METHODS: A retrospective analysis was made of patients admitted to our tertiary adult iÌntensive Care Unit (ICU) between January 2015 and January 2016. Hemoglobin (Hb), white blood cell (WBC), lymphocyte and platelet counts were obtained from the complete blood count performed at the time of admission. MPV and PLR levels were calculated from these data. Other data were retrieved from the patient follow-up records. RESULTS: The investigation included a total of 306 patients. The total mortality rate was 40.2%. The initial median PLR level was 206.7 (8.1-1675.0) for non-survivor patients and 194.5 (12.8-1236.6) for survivor patients. The PLR level was higher in the non-survivor group, but there was no statistically significant difference between the groups (p>0.05). The median MPV level was 7.66 (5.17-15.25) for the survivors and 8.09 (4.36-16.19) for the non-survivors, and there was no statistically significant difference between the groups (p=0.237). The median length of stay (LOS) of all patients was 7 (2-61) days. Only the Acute Physiology and Chronic Health Evaluation (APACHE) II score was found to have a positive correlation with LOS (p<0.05). CONCLUSIONS: PLR has no effect on mortality rates regardless of whether the patient has thrombocytopenia or not at the time of admission. MPV levels have no significant relationship with mortality. Neither MPV nor PLR have an effect on LOS. The use of these as a prognostic factor for mortality in critically ill patients is still unclear.
Assuntos
Plaquetas , Estado Terminal , Linfócitos , Volume Plaquetário Médio , Idoso , Idoso de 80 Anos ou mais , Contagem de Células Sanguíneas , Feminino , Humanos , Tempo de Internação , Masculino , Pessoa de Meia-Idade , Prognóstico , Estudos RetrospectivosRESUMO
OBJECTIVE: Increased nitric oxide (NO) production in cirrhotic patients causes splanchnic vasodilation, leading to the development of the hyperdynamic circulatory syndrome. One factor that influences plasma NO concentration is eNOS gene polymorphism; consequently, the aim of this study was to investigate whether the eNOS gene G894T and T-786C polymorphisms play any role in the development of ascites in such patients. PATIENTS AND METHODS: Three groups were created: 70 cirrhotic patients with ascites, 69 cirrhotic participants without ascites (stable cirrhosis), and 60 healthy controls. Polymorphisms were determined using polymerase chain reaction (PCR) and melting curve analysis. The plasma nitrite (NO marker) level was measured by deploying the spectrophotometric Griess reaction. RESULTS: Plasma nitrite levels in the cirrhosis with ascites and stable cirrhosis groups were significantly higher than in the controls (p < 0.0001). The frequency of GG, GT, and TT genotypes for the eNOS G894T polymorphism in the cirrhosis with ascites group was 55.7%, 38.6%, and 5.7% respectively, while in the stable cirrhosis group these figures were 60.9%, 36.2%, and 2.9%. In the controls, the distribution was 63.3%, 33.3%, and 3.3%, respectively. The frequency of TT, TC, and CC genotypes for the eNOS-786C polymorphism in the first group was 52.9%, 34.2%, and 12.9% respectively; in the second group, this was 46.4%, 42%, and 11.6%, and in the controls, 48.3%, 46.7%, and 5%. There were no significant differences in genotype and allele distributions of the eNOS-786C and eNOS G894T polymorphisms among the groups. CONCLUSIONS: Plasma nitrite concentration is enhanced in cirrhotic patients, and there is no relationship between the G894T and eNOS-786C polymorphisms and the development of ascites.
Assuntos
Ascite/metabolismo , Cirrose Hepática/genética , Óxido Nítrico Sintase Tipo III/genética , Polimorfismo Genético , Ascite/genética , Frequência do Gene , Predisposição Genética para Doença , Genótipo , HumanosRESUMO
PURPOSE: This study was undertaken to evaluate the effects of magnesium sulfate (MgSO4) on the contractile activity of the uterus in a pregnant rat model of preeclampsia induced by N-nitro-arginine methyl ester (L-NAME). MATERIALS AND METHODS: Twenty-eight, 160-220 gram, three to four month old female Sprague-Dawley rats were used in this study. After conception was confirmed by vaginal smears on the first day of pregnancy, the animals were allocated into four groups according to the chemicals fed in their drinking water as control (nothing administered), L-NAME (50 mg/kg L-NAME), MgSO4 (600 mg/kg MgSO4), and MgSO4 + L-NAME group (600 mg/kg MgSO4 + 50 mg/kg L-NAME). The pregnant uterus strips were isolated on the 19th day and the contractile activity of uterus was examined by applying 0, 0.1, 0.2, 0.4, 0.8, and 2.5 mIU/ml oxytocin to each group and responses are recorded accordingly. RESULTS: There were no statistically significant differences regarding fetal parameters and peak amplitudes of the oxytocin stimulated pregnant rat myometrial strips among groups. In L-NAME group at 0 and 0.1 mIU/ml oxytocin, the contraction frequency in a ten-min period was statistically lower than the control group (Z = -2.850, p = 0.004; Z = -2.902, p = 0.004, respectively). In MgSO4 group only at 0 mIU/ml oxytocin, the frequencies of the contractions in ten-min period were statistically lower than the control group (Z = -2.973,p = 0.003). In L-NAME + MgSO4 group at 0, 0.1 and 0.2 mIU/ml oxytocin concentrations the frequencies of the contractions in ten-min period were statistically lower than the control group (Z = - 4.018, p = 0.000; Z = -3.237, p = 0.001; Z = -2.902, p = 0.004, respectively). In L-NAME + MgSO4 given group at each oxytocin concentrations, the frequencies of the contractions in ten-min period were lower but not statistically different than the L-NAME group. CONCLUSION: MgSO4 has no significant effect on the amplitude of spontaneous or oxytocin induced myometrial contractions, but decreased the frequency of spontaneous contractions. At each doses of oxytocin, MgSO4 has no significant effect on the frequency of contraction in a pregnant rat model of preeclampsia induced by L-NAME.
Assuntos
Anticonvulsivantes/farmacologia , Sulfato de Magnésio/farmacologia , Pré-Eclâmpsia/tratamento farmacológico , Contração Uterina/efeitos dos fármacos , Animais , Modelos Animais de Doenças , Feminino , NG-Nitroarginina Metil Éster/farmacologia , Ocitócicos/administração & dosagem , Ocitocina/administração & dosagem , Pré-Eclâmpsia/induzido quimicamente , Gravidez , Ratos , Ratos Sprague-DawleyRESUMO
This study investigated effects of dietary supplementation with vitamin C, vitamin E on performance, biochemical parameters, and oxidative stress induced by copper toxicity in broilers. A total of 240, 1-day-old, broilers were assigned to eight groups with three replicates of 10 chicks each. The groups were fed on the following diets: control (basal diet), vitamin C (250 mg/kg diet), vitamin E (250 mg/kg diet), vitamin C + vitamin E (250 mg/kg + 250 mg/kg diet), and copper (300 mg/kg diet) alone or in combination with the corresponding vitamins. At the 6th week, the body weights of broilers were decreased in copper, copper + vitamin E, and copper + vitamin C + vitamin E groups compared to control. The feed conversion ratio was poor in copper group. Plasma aspartate aminotransferase, alanine aminotransferase, alkaline phosphatase activities, iron, copper concentrations, and erythrocyte malondialdehyde were increased; plasma vitamin A and C concentrations and erythrocyte superoxide dismutase were decreased in copper group compared to control. Glutathione peroxidase, vitamin C, and iron levels were increased; aspartate aminotransferase, alanine aminotransferase, alkaline phosphatase, and copper levels were decreased in copper + vitamin C group, while superoxide dismutase, glutathione peroxidase, and vitamin E concentrations were increased; aspartate aminotransferase, alanine aminotransferase, and alkaline phosphatase were decreased in copper with vitamin E group compared to copper group. The vitamin C concentrations were increased; copper, uric acid, aspartate aminotransferase, alanine aminotransferase, alkaline phosphatase, and malondialdehyde were decreased in copper + vitamin C + vitamin E group compared to copper group. To conclude, copper caused oxidative stress in broilers. The combination of vitamin C and vitamin E addition might alleviate the harmful effects of copper as demonstrated by decreased lipid peroxidation and hepatic enzymes.
Assuntos
Ácido Ascórbico/farmacologia , Galinhas/crescimento & desenvolvimento , Galinhas/metabolismo , Cobre/toxicidade , Suplementos Nutricionais , Estresse Oxidativo/efeitos dos fármacos , Vitamina E/farmacologia , Alanina Transaminase/antagonistas & inibidores , Alanina Transaminase/sangue , Alanina Transaminase/metabolismo , Fosfatase Alcalina/antagonistas & inibidores , Fosfatase Alcalina/metabolismo , Animais , Ácido Ascórbico/administração & dosagem , Aspartato Aminotransferases/antagonistas & inibidores , Aspartato Aminotransferases/sangue , Aspartato Aminotransferases/metabolismo , Cobre/administração & dosagem , Peroxidação de Lipídeos/efeitos dos fármacos , Relação Estrutura-Atividade , Vitamina E/administração & dosagemRESUMO
AIM: To determine the effects of Cu and levamisole on concentrations of Cu and Fe in plasma and liver, and the effects of levamisole on lipid peroxidation induced by Cu intoxication in broiler chickens. METHODS: In a 2×4 factorial study, 80 one-day-old Ross PM3 broiler chicks were fed diets for 21 days containing either 8 mg/kg Cu (Low Cu) or 250 mg/kg Cu (High Cu) and were treated with 0 (L0), 4 (L4), 8 (L8) or 16 (L16) mg/kg bodyweight levamisole per day from Day 7 of the study, on three consecutive days in their drinking water. This treatment was repeated three times, at 3-day intervals. On Day 21, blood samples were collected from each bird for analysis of concentrations of Cu, Fe and malondialdehyde, and activities of aspartate aminotransferase (AST), alanine aminotransferase (ALT), superoxide dismutase, catalase and glutathione peroxidase (GSH-Px). The birds were killed and liver samples collected for analysis of Cu and Fe. RESULTS: Mean concentrations of Cu and Fe in plasma, and Cu in liver, were increased overall in the High Cu groups compared with the Low Cu groups (p<0.001). Compared with the L0 treatment group on the High Cu diet, treatments L4, L8 and L16 decreased concentrations of Cu in plasma, and L8 and L16 increased concentration of Cu in liver (p<0.05). Mean activities of AST and ALT were increased in untreated birds (L0) fed the High compared with Low Cu diets (p<0.01). In birds receiving the High Cu diet, treatments L4 and L8 decreased activities of AST, and L4 and L16 decreased activity of ALT, compared with L0 (p<0.05). The High Cu diet induced an oxidative stress characterised by increased mean concentrations of malondialdehyde and decreased activities of superoxide dismutase, catalase and GSH-Px (p<0.001). Concentration of malondialdehyde, and activities of superoxide dismutase and catalase were not changed following levamisole treatment in birds on the High Cu diet, and activity of GSH-Px was decreased by the L4 and L8 treatments compared with the L0 group. CONCLUSIONS AND CLINICAL RELEVANCE: The results of the study suggest that treatment with levamisole might alleviate the harmful effects of Cu on the liver, as demonstrated by decreased activities of AST and ALT induced by a diet containing 250 mg/kg Cu.
Assuntos
Galinhas , Cobre/toxicidade , Levamisol/farmacologia , Estresse Oxidativo/efeitos dos fármacos , Doenças das Aves Domésticas/induzido quimicamente , Adjuvantes Imunológicos/farmacologia , Ração Animal/análise , Animais , Antioxidantes/metabolismo , Cobre/metabolismo , Overdose de Drogas , Ferro/sangue , Ferro/metabolismo , Fígado/enzimologia , Fígado/metabolismo , Doenças das Aves Domésticas/tratamento farmacológico , Espécies Reativas de OxigênioRESUMO
Oxidative stress may be contributory to the pathophysiology of the abnormalities that underlie the clinical course of sickle cell anemia. We looked for a possible genetic association between the functional polymorphism Ala-9Val in the human Mn-SOD gene and sickle cell anemia. One hundred and twenty-seven patients with sickle cell anemia and 127 healthy controls were recruited into the study. Alanine versus valine polymorphism in the signal peptide of the Mn-SOD gene was evaluated using a primer pair to amplify a 107-bp fragment followed by digestion with the restriction enzyme NgoMIV. In the sickle cell anemia patients, the frequency of Val/Val genotype was approximately 1.4-fold lower and that of Ala/Val was 1.3-fold higher compared to the controls. No significant difference in genotype frequencies was found between patients and controls (χ(2) = 4.561, d.f. = 2, P = 0.101). The Val-9 was the most common allele in patient and healthy subjects. No significant difference in allele frequencies was found between patients and controls (χ(2) = 1.496, d.f. = 1, P = 0.221). We conclude that the Mn-SOD gene polymorphism is not associated with sickle cell anemia.
Assuntos
Substituição de Aminoácidos/genética , Anemia Falciforme/genética , Polimorfismo Genético , Superóxido Dismutase/genética , Adolescente , Adulto , Alanina/genética , Alelos , Anemia Falciforme/enzimologia , Criança , Pré-Escolar , Feminino , Frequência do Gene , Estudos de Associação Genética , Humanos , Masculino , Estresse Oxidativo , Superóxido Dismutase/sangue , Superóxido Dismutase/metabolismo , Valina/genéticaRESUMO
Experiments were designed to investigate the size distribution of queen steroidogenic luteal cells throughout pseudopregnancy. Corpora lutea were obtained from the queens following ovariohysterectomy on days 7, 15 or 25 of pseudopregnancy. Luteal cells were isolated from the ovary by collagenase digestion. Steriodogenic cells were identified by staining of cells for 3beta-HSD activity. Cell diameters were measured using a microscope. Luteal cells having steroidogenic capacity covered a wide spectrum of sizes ranging from 3 to 35 mum in diameter. There was a significant increase in mean cell diameters (p < 0.01) as pseudopregnancy progressed. Mean diameter of 3beta-HSD positive cells increased from 10.41 +/- 0.7 microm, on day 7 of pseudopregnancy, to 19.72 +/- 1.3 microm on day 25 of pseudopregnancy. The ratio of large (>20 microm in diameter) to small (3-20 microm in diameter) luteal cells was 0.08 : 1.0 on day 7 of pseudopregnancy, with the 7.5-10 microm cell size class predominant. By day 25 of pseudopregnancy, the ratio of large-to-small cells was increased to 0.87 : 1.0, and 20-25 microm cell sizes become predominant. In conclusion, this study has demonstrated that the cells of the corpus luteum undergo continuous differentiation during pseudopregnancy in queen. This study also demonstrates that luteal cells dissociated from pseudopregnant queen can be used as a model to study the physiology of corpus luteum in pregnant cats.
Assuntos
Doenças do Gato/patologia , Células Lúteas/patologia , Pseudogravidez/veterinária , 3-Hidroxiesteroide Desidrogenases/análise , Animais , Gatos , Tamanho Celular , Feminino , Células Lúteas/enzimologia , Pseudogravidez/patologia , Fatores de TempoRESUMO
Ganglioneuroma is a rare benign neurogenic tumor originating from the sempathoadrenal nervous system and is considered the benign counterpart of neuroblastoma, lacking the immature neuroblastic cells. A case of pelvic ganglioneuroma is described.
Assuntos
Ganglioneuroma/patologia , Ganglioneuroma/cirurgia , Neoplasias Pélvicas/patologia , Neoplasias Pélvicas/cirurgia , Feminino , Seguimentos , Ganglioneuroma/diagnóstico , Humanos , Histerectomia/métodos , Imuno-Histoquímica , Imageamento por Ressonância Magnética , Pessoa de Meia-Idade , Estadiamento de Neoplasias , Ovariectomia/métodos , Neoplasias Pélvicas/diagnóstico , Espaço Retroperitoneal , Medição de Risco , Tomografia Computadorizada por Raios X , Resultado do TratamentoRESUMO
We present a case of a 25-year-old woman with drowsiness, nystagmus, severe ataxia and areflexia, which developed six weeks after admission to an obstetric clinic for hyperemesis gravidarum. She had been treated with intravenous dextrose and electrolyte solutions and antiemetics. Magnetic resonance imaging (MRI) performed on the fifth day of her neurologic symptoms showed increased intensity in both thalami, periaqueductal grey matter, the floor of the fourth ventricle and superior cerebellar vermis in T2 weighted and FLAIR images. Clinical signs and MRI findings were consistent with the diagnosis of Wernicke's encephalopathy. On the third day of thiamine replacement, neurologic signs improved dramatically In addition to our case, we review 29 previously reported cases of Wernicke's encephalopathy associated with hyperemesis gravidarum, and emphasize the importance of thiamine supplementation to women with prolonged vomiting in pregnancy especially if they are given intravenous or parenteral nutrition.
Assuntos
Hiperêmese Gravídica/complicações , Encefalopatia de Wernicke/diagnóstico , Encefalopatia de Wernicke/etiologia , Adulto , Ataxia/etiologia , Diagnóstico Diferencial , Feminino , Humanos , Recém-Nascido , Injeções Intramusculares , Imageamento por Ressonância Magnética , Gravidez , Tiamina/administração & dosagem , Encefalopatia de Wernicke/tratamento farmacológico , Encefalopatia de Wernicke/patologiaRESUMO
We analysed somatosensory evoked potentials (SEPs) in the patients with juvenile myoclonic epilepsy (JME) in order to find out if sodium valproate (VPA) affects SEP latencies and amplitudes. SEPs were studied in 23 patients with JME receiving VPA monotherapy, eight patients with JME not receiving VPA, and a control group consisting of 20 healthy subjects. The N20, P24, and N34 latencies bilaterally were significantly prolonged in the JME group receiving VPA as compared with the control group. In the untreated patients the P24, and N34 latencies bilaterally and the N20-P24 interpeak latency on the right, were significantly prolonged as compared with the control group. In addition, in the patient group without treatment, the N20-P24 amplitudes bilaterally and the P24-N34 amplitudes from left sided median nerve stimulation, were greater as compared with the control group. In the SEP latencies, no significant differences were observed between the patients treated and untreated with VPA. Regarding SEP amplitudes, in the untreated group, while the N20-P24 amplitudes from right sided median nerve stimulation were significantly enhanced, all the other amplitudes also showed increase, even insignificant, as compared with the patients treated by VPA. These findings suggest that the SEPs latencies are prolonged, and the amplitudes are enhanced in JME. The changes of the SEPs latency in JME could be due to abnormal synaptic transmission and not influenced by VPA. On the other hand, the increase of the amplitude tends to be lowered by VPA.
Assuntos
Anticonvulsivantes/uso terapêutico , Potenciais Somatossensoriais Evocados/efeitos dos fármacos , Epilepsia Mioclônica Juvenil/tratamento farmacológico , Epilepsia Mioclônica Juvenil/fisiopatologia , Ácido Valproico/uso terapêutico , Adolescente , Adulto , Estudos de Casos e Controles , Feminino , Humanos , Masculino , Tempo de Reação/efeitos dos fármacos , Valores de ReferênciaRESUMO
OBJECTIVE: The aim of the study was to test the validity of the controversial subdivision of essential tremor (ET) patients into electrophysiological subgroups. METHODS: We evaluated a hundred patients with ET using surface electromyographic (EMG) recordings of antagonists forearm muscles and distinguished three groups: the first group showed synchronous activity of antagonistic muscles, the second showed alternating activity of antagonist muscles; and the third group consisted of patients whose EMG recordings were not compatible with the other two groups. We compared patients with synchronous and alternating activity in terms of sex, age at onset, duration of illness, family history of tremor, symmetry and frequency of tremor, and the scores of a disability scale. RESULTS: The only significant difference between the patients with synchronous and alternating activity was that the patients with synchronous activity were more disabled. CONCLUSION: This result adds to the evidence for distinct electrophysiological subgroups of ET with distinct clinical properties.
Assuntos
Tremor Essencial/classificação , Contração Muscular , Adulto , Idoso , Eletromiografia , Tremor Essencial/fisiopatologia , Feminino , Antebraço/fisiopatologia , Humanos , Masculino , Pessoa de Meia-Idade , Contração Muscular/fisiologiaRESUMO
Reading epilepsy is an uncommon epileptic syndrome preferentially related to the temporoparietal region of the language dominant hemisphere. We report ictal and interictal brain perfusion SPECT images in a 28-year-old woman who was reading epilepsy.
Assuntos
Epilepsia/diagnóstico por imagem , Leitura , Adulto , Encéfalo/diagnóstico por imagem , Dominância Cerebral , Epilepsia/classificação , Epilepsia/fisiopatologia , Epilepsia do Lobo Temporal/classificação , Epilepsia do Lobo Temporal/diagnóstico por imagem , Epilepsia do Lobo Temporal/fisiopatologia , Feminino , Humanos , Idioma , Compostos Radiofarmacêuticos , Tecnécio Tc 99m Exametazima , Tomografia Computadorizada de Emissão de Fóton ÚnicoRESUMO
BACKGROUND: The neuroanatomic and pathologic basis of Tourette's syndrome or related disorders such as obsessive-compulsive disorder and attention deficit-hyperactivity disorder remains unknown. Although a substantial body of neuroimaging and other data implicate basal ganglia and some point out specifically the globus pallidus in the etiopathogenesis of these three related disorders, no clear or pathologically significant isolated lesions restricted to this region have yet been demonstrated, with the exception of obsessive-compulsive disorder. METHODS: A seventeen-year-old male case of Tourette syndrome with comorbid obsessive-compulsive disorder, attention deficit-hyperactivity disorder, stuttering and gait disturbance, who had negative family history is presented. RESULTS: The patient has failed to respond to drug treatment and his MRI scan revealed bilateral and symmetrical globus pallidus lesions with specific "tiger's eye" appearance of unknown etiology. CONCLUSIONS: Well-localized lesions in the globus pallidus support growing data suggesting the involvement of this brain region in Tourette syndrome and related disorders.
Assuntos
Lateralidade Funcional/fisiologia , Globo Pálido/patologia , Síndrome de Tourette/patologia , Adolescente , Transtorno do Deficit de Atenção com Hiperatividade/complicações , Transtorno do Deficit de Atenção com Hiperatividade/diagnóstico , Humanos , Imageamento por Ressonância Magnética , Masculino , Transtorno Obsessivo-Compulsivo/complicações , Transtorno Obsessivo-Compulsivo/diagnóstico , Gagueira/complicações , Gagueira/diagnóstico , Síndrome de Tourette/complicações , Recusa do Paciente ao TratamentoRESUMO
Six patients admitted to the Department of Pediatric Neurology at Hacettepe University Children's Hospital between 1992 and 1997 with a clinical diagnosis of Rasmussen encephalitis received surgical treatment for their intractable epilepsy. MRI, SPECT and WADA tests were performed in patients with an epileptic focus demonstrated on routine or long-term video EEG monitoring. Viral studies using the PCR methodology were performed in cases with histopathological evidence of Rasmussen encephalitis. The ages of these patients ranged between 7 and 16 years, and the mean age at onset of seizures was 7.1+/-2.2 years. In four patients seizures presented as epilepsia partialis continua and were refractory to anticonvulsive drug therapy. In three cases intravenous immunoglobulin therapy yielded temporary and partial improvement in seizure control. The mean presurgical follow-up duration was 2.04+1.74 years, and early surgical intervention for epilepsy was performed in one case. The surgical approach selected for the treatment of epilepsy was resective surgery with electrocorticography. The mean postoperative follow-up duration was 32.3+17.2 months. Seizures were fully controlled in one patient, in whom surgery was performed 3 months after the seizures first started. Early surgical intervention may provide histopathological evidence for diagnosis as well as effective seizure control.
Assuntos
Encefalite/complicações , Epilepsia/complicações , Criança , Pré-Escolar , Doença Crônica , Eletroencefalografia , Encefalite/diagnóstico , Encefalite/patologia , Encefalite/cirurgia , Epilepsia/diagnóstico , Epilepsia/cirurgia , Epilepsia/terapia , Feminino , Humanos , Imunoglobulinas Intravenosas/uso terapêutico , Imageamento por Ressonância Magnética , MasculinoRESUMO
We present a 34-year-old woman with right hemidystonia. She had a cavernous angioma (CA) of left thalamo-mesencephalic junction, revealed by magnetic resonance imaging (MRI). Her symptoms were moderately alleviated by biperiden 20 mg daily. We identified 11 patients reported in the literature to have movement disorders due to a cavernous angioma. None of them presented with hemidystonia. Some clinical properties of patients with CA associated with a movement disorder were evaluated.
Assuntos
Neoplasias Encefálicas/complicações , Hemangioma Cavernoso/complicações , Transtornos dos Movimentos/etiologia , Adulto , Antiparkinsonianos/uso terapêutico , Biperideno/uso terapêutico , Neoplasias Encefálicas/diagnóstico , Neoplasias Encefálicas/tratamento farmacológico , Feminino , Hemangioma Cavernoso/diagnóstico , Hemangioma Cavernoso/tratamento farmacológico , Humanos , Imageamento por Ressonância Magnética , Tomografia Computadorizada por Raios XRESUMO
We report a case of one-and-a-half syndrome occurring as the first manifestation of central nervous system (CNS) involvement in systemic lupus erythematosus (SLE). The lesion in the pons was documented with magnetic resonance imaging (MRI). The patient responded quite satisfactorily to high-dose i.v. methyl-prednisolone therapy.
Assuntos
Encefalopatias/etiologia , Lúpus Eritematoso Sistêmico/complicações , Transtornos da Motilidade Ocular/etiologia , Ponte/patologia , Idoso , Encefalopatias/diagnóstico , Encefalopatias/tratamento farmacológico , Feminino , Glucocorticoides/administração & dosagem , Glucocorticoides/uso terapêutico , Humanos , Infusões Intravenosas , Lúpus Eritematoso Sistêmico/tratamento farmacológico , Imageamento por Ressonância Magnética , Metilprednisolona/administração & dosagem , Metilprednisolona/uso terapêutico , Transtornos da Motilidade Ocular/tratamento farmacológico , Oftalmoplegia/tratamento farmacológico , Oftalmoplegia/etiologia , Ponte/efeitos dos fármacos , SíndromeRESUMO
We report the case of a young man suffering from the rare combination of livedo reticularis and recurrent ischemic cerebrovascular disease (Sneddon's syndrome). He also had a circulating anticardiolipin antibody. in the absence of systemic lupus erythematosus, we suggest the likelihood of a primary antiphospholipid syndrome.