RESUMO
Vaginitis emphysematosa (VE) is a benign, self-limited condition characterized by a myriad of gas-filled spaces in the subepithelial lining of the vaginal wall, which give it a distinct radiographic appearance. Failure to make the correct diagnosis may lead to an inappropriate course of treatment, including surgery. Although it is considered rare, we have encountered five cases of VE in the course of a year.
Assuntos
Enfisema/complicações , Vaginite/complicações , Adolescente , Adulto , Diagnóstico Diferencial , Enfisema/diagnóstico por imagem , Feminino , Humanos , Pessoa de Meia-Idade , Pelve/diagnóstico por imagem , Urografia , Vaginite/diagnóstico por imagemRESUMO
The effects of perioperative administration of thymopentin (TP-5) on in vivo and in vitro measurements of cell-mediated immunity in elderly patients undergoing major surgery were investigated. A placebo-controlled study was conducted in 25 patients (mean age, 67 years) with congenital or acquired heart disease undergoing surgery with cardiopulmonary bypass. Patients were divided into three groups: Group 1 patients were given 50 mg of TP-5 subcutaneously two hours preoperatively. Group 2 patients were given 50 mg of TP-5 subcutaneously two hours preoperatively and 48 hours postoperatively. Group 3 patients were given placebo at corresponding times. Cell-mediated immunity measurements were the in vivo delayed-type hypersensitivity (DTH) response on day 0 and on day 7 to an antigen skin test battery. The in vitro studies included antigen cocktail-induced lymphocyte proliferation of peripheral blood mononuclear cells. The DTH response on day 7 after surgery was significantly suppressed in group 3 patients compared with the preoperative baseline value, while it remained unaltered in group 1 and 2 patients. There was a considerable difference of DTH measurements (number of positive antigen responses and sum of their mean diameters) between group 2 and 3 patients. Antigen cocktail-induced lymphocyte proliferation, following initial suppression in the majority of patients, was significantly different between the placebo group and patients in group 2 on day 7 after surgery. The data indicate that perioperative administration of TP-5 might be of considerable clinical utility in preventing a defective cellular immune response.
Assuntos
Adjuvantes Imunológicos/farmacocinética , Ponte Cardiopulmonar , Cardiopatias Congênitas/cirurgia , Cardiopatias/cirurgia , Imunidade Celular/efeitos dos fármacos , Ativação Linfocitária/efeitos dos fármacos , Fragmentos de Peptídeos/farmacocinética , Linfócitos T/imunologia , Timopoietinas/farmacocinética , Hormônios do Timo/farmacocinética , Adjuvantes Imunológicos/administração & dosagem , Idoso , Ensaios Clínicos como Assunto , Hipersensibilidade a Drogas/prevenção & controle , Feminino , Cardiopatias Congênitas/imunologia , Cardiopatias/imunologia , Humanos , Técnicas In Vitro , Indometacina/farmacocinética , Injeções Subcutâneas , Interleucina-2/biossíntese , Masculino , Pessoa de Meia-Idade , Fragmentos de Peptídeos/administração & dosagem , Distribuição Aleatória , Testes Cutâneos , Timopentina , Timopoietinas/administração & dosagem , Fatores de TempoRESUMO
Two patients are discussed in whom Caroli diseases was diagnosed with the aid of computed tomography (CT). One patient had the pure form of the disease, characterized primarily by saccular dilatation of the intrahepatic bile ducts and clinically manifesting as recurrent cholangitis. The second patient had a form ccharacterized primarily by hepatic fibrosis and clinically manifesting as portal hypertension. These are the first patients studied with CT to be reported to the authors' knowledge; CT is recommended as the optimal noninvasive method to evaluate such patients.