RESUMO
Meckel's diverticulum is the most commonly occurring congenital anomaly of the gastrointestinal tract. Diagnosis is usually made by scintigraphy using 99Tc(m) pertechnetate, with low accuracy in adults. We describe a case report and review the literature for difficulties in identifying a recurrent bleeding Meckel's diverticulum. Our patient had a "bladder diverticulum" on scintigraphy, which led to delay in diagnosis. The use of bladder lavage during scintigraphy may assist in distinguishing a Meckel's diverticulum from a bladder diverticulum.
Assuntos
Hemorragia Gastrointestinal/etiologia , Divertículo Ileal/complicações , Divertículo Ileal/diagnóstico por imagem , Pertecnetato Tc 99m de Sódio , Adulto , Humanos , Masculino , Cintilografia , Tomografia Computadorizada por Raios XRESUMO
Adenosquamous carcinoma of the colon is rare. A paraneoplastic syndrome presenting as hypercalcemia may occasionally occur in association with these tumors. Survival for more advanced stages of disease is lower than for patients with adenocarcinoma at a corresponding stage. We report a patient who presented with a primary adenosquamous carcinoma of the rectosigmoid junction and we review the literature regarding the clinical presentation, management, and prognosis of this tumor.
Assuntos
Carcinoma Adenoescamoso/patologia , Colectomia/métodos , Neoplasias do Colo/patologia , Idoso de 80 Anos ou mais , Biópsia , Carcinoma Adenoescamoso/cirurgia , Neoplasias do Colo/cirurgia , Diagnóstico Diferencial , Seguimentos , Humanos , MasculinoRESUMO
RATIONALE: Motivational dysfunctions such as anergia, fatigue, and reduced effort expenditure are common in patients with depression and other disorders. Pro-inflammatory cytokines are implicated in depression, and cytokine administration induces motivational deficits in humans. OBJECTIVES: These studies focused on the effects of the cytokine interleukin-6 (IL-6) on effort-related decision-making. METHODS: Rats were assessed using the concurrent fixed ratio 5-lever pressing/chow feeding choice procedure, which measures the tendency of rats to work for a preferred food (high carbohydrate pellets) in the presence of a concurrently available but less preferred substitute (lab chow). RESULTS: IL-6 (2.0-8.0 µg/kg IP) shifted choice behavior, significantly decreasing lever pressing and increasing chow intake. Further experiments showed that the adenosine A2A antagonist MSX-3 and the stimulant methylphenidate attenuated the effort-related impairments produced by IL-6, increasing lever pressing and decreasing chow intake in IL-6 treated rats. The same doses of IL-6 did not alter food intake or preference in parallel free-feeding choice studies, demonstrating that these low doses were not altering preference for the high carbohydrate pellets or generally suppressing appetite. Also, IL-6 did not affect body temperature. Microdialysis studies showed that 8.0 µg/kg IL-6 significantly decreased extracellular dopamine in nucleus accumbens core. CONCLUSIONS: In summary, IL-6 reduces the tendency to work for food, even at low doses that do not produce fever or loss of appetite. Dopaminergic mechanisms may be involved in these effort-related effects. This research has implications for the involvement of cytokines in motivational dysfunctions such as anergia and fatigue.