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1.
Neotrop Entomol ; 49(4): 586-594, 2020 Aug.
Article in English | MEDLINE | ID: mdl-32162246

ABSTRACT

Bombus atratus Franklin is a widely distributed bumblebee of South America. In Colombia, this species is recognized for its ability to adapt to highly disturbed habitats. However, knowledge of its ecology is poorly known, in particular conditions to ensure the long-term conservation of its populations. Identification of pollen resources is an important issue that could be used as a tool to manage and conserve bumblebees. In tropical areas, rainfall patterns could affect floral phenology and therefore the availability of pollen resources. Considering this, the present work aimed to establish the effect of extreme weather conditions (El Niño) in pollen availability, use of pollinic sources, and gyne production in B. atratus colonies. We reared and located 14 B. atratus colonies in a suburban area during a dry season (ENSO "El Niño") and a rainy season (ENSO "La Niña"). We registered time to gyne production and numbers of gynes produced per colony. We extracted pollen samples to establish both its floral origin and its relative abundance. We measured floral offer for each season. The data of pollen use per colony were utilized to perform Bipartite networks. We analyzed the production of gynes and pollen use per season with correlation models and generalized linear models. Colonies of the rainy season produced more gynes and faster. The floral diversity and offer were higher during the rainy season. Successful colonies used specific pollen sources in two seasons, independently of the floral offer. Extreme dry season affected development of B. atratus colonies.


Subject(s)
Appetitive Behavior , Bees/physiology , El Nino-Southern Oscillation , Pollen/chemistry , Animals , Colombia , Female , Flowers/classification , Linear Models , Seasons
2.
ACS Appl Mater Interfaces ; 10(38): 32838-32848, 2018 Sep 26.
Article in English | MEDLINE | ID: mdl-30185027

ABSTRACT

The development of efficient copper deposition processes in high-aspect-ratio silicon structures is still a key technological issue for the microelectronic industry. We describe here a new process for the deposition of copper thin films in three-dimensional (3D) structures induced by the decomposition of a copper amidinate precursor in solution under a moderate H2 pressure. The reduction of a metal precursor under soft conditions (3 bar, 110 °C) affords the preparation of a high-purity, conformal metallic layer. We unveil a novel deposition mechanism driven by colloidal copper nanoparticles (NPs) in solution that behave as a reservoir of metastable metallic NPs that eventually condense as a solid film on all immersed surfaces. The film growth process is characterized by time-resolved analyses of the NPs in the colloidal state (nuclear magnetic resonance NMR and UV-vis spectra) and of the NPs and metallic layer on substrates (transmission electron microscopy TEM, and scanning electron microscopy SEM). Major deposition stages of this process are proposed and the conformal metallization of 3D silicon substrates is successfully achieved. This method is transposable to other metallic layers such as silver or nickel.

3.
Neotrop Entomol ; 47(6): 786-790, 2018 Dec.
Article in English | MEDLINE | ID: mdl-29330667

ABSTRACT

Colombian tropical dry forest is considered the most endangered tropical biome due to anthropic activities. Desierto de la Tatacoa (DsT) is an example of high disturbed tropical dry forest which still maintains a high biodiversity. The objective of the study was to record the diversity and phenology of wild bees in this place by monthly sampling between December 2014 and December 2016 in a 9-km2 area. During the study, there was a prolonged El Niño-Southern Oscillation period. Bees were collected by entomological nets, malaise traps, eugenol scent trapping, and nest traps. Shannon index was calculated to estimate diversity and Simpson index to determine dominance of a species. The effect of environmental conditions (wet and dry season) in richness and abundance was analyzed by paired T tests. A total of 3004 bee specimens were collected, belonging to 80 species from Apidae, Megachilidae, Halictidae, and Colletidae. Apidae was the most diverse. Shannon index value was 2.973 (discarding Apis mellifera Linnaeus 1758 data); thus, DsT can be considered as a zone of high wild bee diversity. Dry and rainy season showed differences in diversity (p < 0.05). Rainy season showed larger blooming periods and higher bee diversity than dry season. In both seasons, social species were dominant (e.g., A. mellifera or Trigona fulviventris Guérin 1844). Although DsT is a highly disturbed ecosystem, this study found it has the second highest number of genera and the fourth highest number of species reported in Colombia.


Subject(s)
Bees/classification , Biodiversity , Forests , Animals , Colombia , Seasons , Tropical Climate
4.
Neotrop Entomol ; 45(3): 291-9, 2016 Jun.
Article in English | MEDLINE | ID: mdl-26943232

ABSTRACT

The supply of predatory mites as natural enemies is a key component to guarantee the success of biological pest control programs as alternatives to chemical control in commercial crops. To meet the demand for a supply of biologicals, the mass rearing of natural enemies is an option, and the first step must be to develop a standardized system that maximizes the production of prey. One choice for this first step is to use simulation models that can evaluate scenarios that are difficult or complex to address experimentally. In this work, a model was developed to evaluate the current management conditions for the mass rearing of the pest mite Tetranychus urticae Koch. Our aim was to identify alternative scenarios to maximize mite production through mass rearing that could be evaluated in real systems. We assumed that populations of T. urticae were regulated by the conditions of supply-demand theory and modeled the age structure, temperature effects, and individual phenology of T. urticae. The supply-demand theory of resources was used to regulate populations, which involved structured ages and temperature effects for the different stages in the development of individuals. We used the functional response and the paradigm of metabolic pool models to describe resource acquisition and allocation. We demonstrated that 7- to 14-day-old plants infested with 45 or 62 T. urticae/plant could reach 25,000 individuals/plant, being 50% of these preys at the preferred stages by the predator Phytoseiulus persimilis Athias-Henriot. Our theoretical model requires validation in experimental/real systems of mass rearing to better verify the validity of all of the parameters and predictions before commercial implementation.


Subject(s)
Fabaceae , Pest Control, Biological , Tetranychidae , Animals , Mites , Predatory Behavior
6.
J Laryngol Otol ; 125(4): 423-7, 2011 Apr.
Article in English | MEDLINE | ID: mdl-21269552

ABSTRACT

INTRODUCTION: Nasal dermoid cysts are congenital lesions which are often diagnosed in infancy or childhood. However, a small number present in adulthood, and some extend intracranially. Traditional treatment for the intracranial portion of these cysts includes frontal craniotomy. CASE REPORTS: Two intracranial dermoid cysts were resected via a transnasal endoscopic approach, using 70° nasal endoscopy for complete visualisation and intracranial tumour removal. We describe our technique for the procedure itself and for reconstruction of the skull base defect. DISCUSSION AND CONCLUSION: The endoscopic transnasal skull base approach is an excellent alternative to a traditional frontal craniotomy, to achieve complete resection of intracranial dermoid cysts.


Subject(s)
Dermoid Cyst/surgery , Nose Neoplasms/surgery , Dermoid Cyst/pathology , Endoscopy/methods , Female , Humans , Magnetic Resonance Imaging/methods , Male , Nasal Cavity , Neoplasm Invasiveness , Nose Neoplasms/pathology , Plastic Surgery Procedures/methods , Skull Base/pathology , Skull Base/surgery , Young Adult
7.
Clin Radiol ; 65(6): 431-9, 2010 Jun.
Article in English | MEDLINE | ID: mdl-20451009

ABSTRACT

Progressive multifocal leukoencephalopathy (PML) is a demyelinating disease caused by reactivation of JC virus in immunosuppressed patients. The diagnosis is usually suggested on imaging and confirmed by cerebrospinal fluid polymerase chain reaction (PCR) for JC virus DNA. In this article, we review the imaging manifestations of PML on computed tomography (CT), magnetic resonance imaging (MRI), diffusion-weighted imaging (DWI), diffusion tensor imaging (DTI), MR spectroscopy, single photon-emission computed tomography (SPECT) and positron-emission tomography (PET), and outline the role of imaging in follow-up and prognostication.


Subject(s)
Leukoencephalopathy, Progressive Multifocal/diagnosis , Diffusion Magnetic Resonance Imaging/methods , Diffusion Tensor Imaging/methods , Humans , Immunocompromised Host , Magnetic Resonance Spectroscopy/methods , Positron-Emission Tomography/methods , Prognosis , Tomography, Emission-Computed, Single-Photon/methods , United States
8.
AJNR Am J Neuroradiol ; 31(9): 1564-76, 2010 Oct.
Article in English | MEDLINE | ID: mdl-20299430

ABSTRACT

Since its initial description, there have been significant changes in the epidemiology, pathogenesis, and clinical and imaging manifestations of JCV infection of brain. The most common clinical manifestation is PML. Other recently described CNS manifestations are JCE, JCVGCN, and JCM. Although AIDS is the most common predisposing factor for JCV reactivation, there is increasing incidence of brain manifestations of JCV reactivation in non-HIV settings, including different rheumatologic, hematologic, and oncologic conditions; monoclonal antibody therapy; transplant recipients; primary immunodeficiency syndromes; and even in patients without any recognizable immune deficiency. IRIS may develop secondary to restoration of immunity in HIV-positive patients with PML receiving antiretroviral therapy. This is of profound clinical significance and needs to be diagnosed promptly. Imaging plays a crucial role in the diagnosis of the disease, monitoring of treatment response, identifying disease progression, and predicting prognosis. In this article, current understanding of the epidemiology, pathogenesis, clinical presentations, and all aspects of imaging of JCV infection of the brain have been comprehensively reviewed.


Subject(s)
Brain/immunology , Brain/pathology , Leukoencephalopathy, Progressive Multifocal/diagnosis , Leukoencephalopathy, Progressive Multifocal/immunology , Magnetic Resonance Imaging/methods , Magnetic Resonance Spectroscopy/methods , Humans
9.
AJNR Am J Neuroradiol ; 31(9): 1729-31, 2010 Oct.
Article in English | MEDLINE | ID: mdl-20019104

ABSTRACT

SUMMARY: We report DTI and fiber tractography findings in a case of hypertrophic olivary degeneration. A 51-year-old man presented with an abnormal gait and visual difficulties. MR imaging showed enlargement of the right medullary olive and a vascular lesion in the right pontine tegmentum. Fiber tractography showed decreased volume of the right central tegmental tract, supporting a diagnosis of HOD.


Subject(s)
Diffusion Tensor Imaging/methods , Nerve Degeneration/pathology , Olivary Nucleus/pathology , Humans , Hypertrophy/pathology , Male , Middle Aged
10.
AJNR Am J Neuroradiol ; 31(2): 211-8, 2010 Feb.
Article in English | MEDLINE | ID: mdl-19762464

ABSTRACT

Tinnitus affects 10% of the US general population and is a common indication for imaging studies. We describe a sequential compartment-based diagnostic approach, which simplifies the interpretation of imaging studies in patients with tinnitus. The choice of the initial imaging technique depends on the type of tinnitus, associated symptoms, and examination findings. Familiarity with the pathophysiologic mechanisms of tinnitus and the imaging findings is a prerequisite for a tailored diagnostic approach by the radiologist.


Subject(s)
Ear, Middle/diagnostic imaging , Ear, Middle/physiopathology , Tinnitus/diagnostic imaging , Tinnitus/physiopathology , Tomography, X-Ray Computed , Humans
12.
AJNR Am J Neuroradiol ; 30(5): 953-61, 2009 May.
Article in English | MEDLINE | ID: mdl-19193748

ABSTRACT

BACKGROUND AND PURPOSE: MR imaging is widely used for the diagnosis and follow-up of neurosarcoidosis lesions. However, the temporal evolution of imaging abnormalities and the prognostic significance of imaging features is not well understood. We undertook a retrospective study of patients with biopsy-proved or clinically diagnosed neurosarcoidosis for the following reasons: 1) to assess concordance between abnormalities noted on MR imaging with neurologic symptoms at presentation; 2) to correlate changes in imaging findings during follow-up with clinical improvement or worsening; and 3) to identify imaging features that may have prognostic significance. MATERIALS AND METHODS: We reviewed radiologic records from 1999 to 2008 of patients with biopsy-proved or clinically diagnosed neurosarcoidosis and correlated MR imaging findings in these patients with their demographic characteristics, clinical features, and symptomatic responses during follow-up. RESULTS: Thirty-two patients were included in the study. Cranial nerve lesions and leptomeningeal disease identified on MR imaging were symptomatic in 64% patients, dural lesions were associated with symptoms in 28% patients, but nonenhancing white matter lesions did not have correlating symptoms. During follow-up, MR imaging findings generally changed in concordance with the change in clinical symptoms (80% patients). Cranial nerve enhancement (9/11) and spinal lesions (5/8) were most likely to resolve with clinical improvement, whereas dural lesions (6/11), enhancing parenchymal lesions (3/7), and non-enhancing parenchymal lesions (0/4) were less likely to change during therapy. Patients with > or =1 enhancing T2-hypointense lesion (4/7, 57%) were less likely to show clinical improvement than those without such lesions (12/13, 92%). CONCLUSIONS: Although many sarcoid-related MR imaging abnormalities were not associated with correlating symptoms at presentation, there was a high degree of concordance between changes in clinical symptoms and MR imaging abnormalities during follow-up. Enhancing T2-hypointense dural and parenchymal lesions were associated with suboptimal imaging and clinical response to immunosuppressive therapy.


Subject(s)
Brain Diseases/diagnosis , Brain/pathology , Magnetic Resonance Imaging/methods , Sarcoidosis/diagnosis , Adult , Female , Humans , Male , Middle Aged , Reproducibility of Results , Sensitivity and Specificity , Statistics as Topic
13.
AJNR Am J Neuroradiol ; 30(6): 1131-3, 2009 Jun.
Article in English | MEDLINE | ID: mdl-19039043

ABSTRACT

Lupus panniculitis (LP) or lupus erythematosus profundus (LEP) is a lupus-associated dermatologic condition predominantly affecting young to middle-aged women in which the deep dermis and subcutaneous fat are mainly involved. The lesions are usually located on the forehead, cheeks, proximal aspect of the limbs, and buttocks, though cases have occasionally been reported with orbital, breast, and salivary gland involvement. Descriptions of imaging findings of LP are very scarce in the literature. We describe the CT scan imaging features of the case of a patient with head and neck LP.


Subject(s)
Head/diagnostic imaging , Neck/diagnostic imaging , Panniculitis, Lupus Erythematosus/diagnostic imaging , Tomography, X-Ray Computed/methods , Adult , Female , Humans
14.
AJNR Am J Neuroradiol ; 27(10): 2204-9, 2006.
Article in English | MEDLINE | ID: mdl-17110695

ABSTRACT

BACKGROUND AND PURPOSE: Imaging characteristics of temporal bone meningioma have not been previously reported in the literature. CT and MR imaging findings in 13 cases of temporal bone meningioma are reviewed to define specific imaging features. METHODS: A retrospective review of our institutional case archive revealed 13 cases of histologically confirmed temporal bone meningioma. CT and MR imaging studies were reviewed to characterize mass location, vector of spread, bone changes, enhancement characteristics, and intracranial patterns of involvement. Clinical presenting signs and symptoms were correlated with imaging findings. RESULTS: Thirteen temporal bone meningiomas were reviewed in 8 women and 5 men, aged 18-65 years. Meningiomas were stratified into 3 groups on the basis of location and tumor vector of spread. There were 6 tegmen tympani, 5 jugular foramen (JF), and 2 internal auditory canal (IAC) meningiomas. Tegmen tympani and JF meningiomas were characterized by spread to the middle ear cavity. IAC meningiomas, by contrast, spread to the cochlea and vestibule. Hearing loss was the most common clinical presenting feature in all cases of temporal bone meningioma (10/13). The presence of tumor adjacent to the ossicles strongly correlated with conductive hearing loss (7/9). CONCLUSION: Meningioma involving the temporal bone is rare. Three subgroups of meningioma exist in this location: tegmen tympani, JF, and IAC meningioma. Tegmen tympani and JF meningiomas spread to the middle ear cavity. IAC meningiomas spread to intralabyrinthine structures. Conductive hearing loss is commonly seen in these patients and can be surgically correctable.


Subject(s)
Magnetic Resonance Imaging , Meningioma/diagnosis , Skull Neoplasms/diagnosis , Temporal Bone , Tomography, X-Ray Computed , Adolescent , Adult , Female , Humans , Male , Middle Aged , Retrospective Studies
15.
Bone Marrow Transplant ; 36(1): 25-31, 2005 Jul.
Article in English | MEDLINE | ID: mdl-15908977

ABSTRACT

The majority of advanced ovarian cancer patients achieve an objective response following chemotherapy; however, only 20-30% are in remission after 5 years. Intraperitoneal or high-dose chemotherapy (HDC) may prolong disease-free and overall survival (OS) in patients with platinum-sensitive, small volume disease. To better define the subsets of patients who might benefit from HDC, we performed a retrospective analysis on 91 patients in 1st complete remission (CR) treated from 21 centres of the EBMT group. At a median follow-up of 48 months, median time-to-progression (TTP) and OS were 21.2 and 44.4 months, respectively. Tumour grade, stage, residual disease, disease status before HDC, type and year of transplant, source of haemopoietic progenitors and use of haemopoietic growth factors (HGF) after transplant were analysed for TTP and OS. The only significant parameter was the use of HGF: median OS for patients receiving or not receiving HGF was 46.2 vs 17.8 months, respectively (P: 0.035); this difference was maintained after multivariate analysis (P: 0.02). Our analysis does not identify any subgroup of patients in 1st CR who can benefit from HDC; however, median survival of patient with no residual disease has not been reached. The role of HGF after HDC deserves further investigation.


Subject(s)
Antineoplastic Combined Chemotherapy Protocols/therapeutic use , Hematopoietic Stem Cell Transplantation/methods , Ovarian Neoplasms/therapy , Adolescent , Adult , Aged , Disease-Free Survival , Female , Hematopoietic Cell Growth Factors/therapeutic use , Hematopoietic Stem Cell Transplantation/mortality , Humans , Middle Aged , Multivariate Analysis , Ovarian Neoplasms/diagnosis , Ovarian Neoplasms/mortality , Prognosis , Remission Induction , Retrospective Studies , Survival Rate , Transplantation, Autologous
16.
Iowa Orthop J ; 21: 49-52, 2001.
Article in English | MEDLINE | ID: mdl-11813951

ABSTRACT

Little information exists about the ability of the Hoffmann sign to predict cervical spinal cord compression. The objective of this study was to determine the correlation between the Hoffmann sign and cervical spinal cord compression in a consecutive series of patients seen by a single spine surgeon. All new patients with complaints related to their cervical spine were included. Hoffmann sign was elicited by flicking the nail of the middle finger. Any flexion of the ipsilateral thumb and/or index finger was considered positive. All imaging studies were reviewed for spinal cord compression. Cord compression was defined as flattening of the AP diameter of the spinal cord coexisting with obliteration of CSF around the cord compared to normal levels. Of 165 patients, 124 patients had imaging of their spinal canal. Review by the spine surgeon found sensitivity of the Hoffmann sign relative to cord compression was 58%, specificity 78%, positive predictive value 62%, negative predictive value 75%. 49 studies were also read by a "blinded" neuroradiologist, the sensitivity was 33%, specificity 59%, positive predictive value, 26%, negative predictive value 67%. Although attractive as a simple method of screening for cervical spinal cord compression, the Hoffmann sign, in the absence of other clinical findings, is not in our experience a reliable test.


Subject(s)
Spinal Cord Compression/diagnosis , Cervical Vertebrae , Female , Humans , Male , Middle Aged , Radiography , Retrospective Studies , Sensitivity and Specificity , Spinal Cord Compression/diagnostic imaging
17.
Facial Plast Surg Clin North Am ; 9(4): 525-49, 2001 Nov.
Article in English | MEDLINE | ID: mdl-17590940

ABSTRACT

The imaging armamentarium for imaging head and neck vascular lesions and the imaging features of each have been reviewed. Imaging is an indispensable part of the diagnosis and treatment planning of these lesions. The architecture and vascularity of these lesions are keys to their correct diagnosis. High-flow lesions (AVMs and hemangiomas) can be distinguished readily from low-flow lesions (venous malformations and lymphatic malformations) with these techniques, without the need for conventional angiography in the majority of cases. More-over, the architecture of the lesions depicted on imaging studies can lead to a reasonably specific diagnosis. MR imaging is the best tool for this assessment, but complementary information from ultrasound or CT can help arrive at the correct diagnosis when the results of MR imaging are equivocal. Ultrasound can correctly characterize the lesion as high flow or low flow but is limited in its ability to determine the full extent of the lesion. The usefulness of CT is more limited. Application of newer CT techniques (multidetector helical CT with image reconstruction) may increase the role of CT in high-flow lesions, but the greater soft tissue contrast sensitivity of MR imaging remains its strong suit. Conventional angiography is usually reserved for pretherapeutic evaluation.


Subject(s)
Arteriovenous Malformations/diagnosis , Head , Neck , Head and Neck Neoplasms/diagnosis , Hemangioma/diagnosis , Hemangioma, Cavernous/diagnosis , Humans , Intracranial Arteriovenous Malformations/diagnostic imaging , Magnetic Resonance Angiography , Magnetic Resonance Imaging , Tomography, X-Ray Computed
19.
Hypertension ; 36(1): 78-82, 2000 Jul.
Article in English | MEDLINE | ID: mdl-10904016

ABSTRACT

The pathophysiological factors of neurogenic or sympathetically mediated essential hypertension are unknown. Neurons close to the surface of the ventrolateral medulla (specifically, in the retro-olivary sulcus [ROS]) are integrally involved in the control of blood pressure by means of efferent connections to presympathetic neurons in the spinal cord. It is hypothesized that vascular contact with the ROS is pathogenically involved in neurogenically mediated hypertension. We evaluated that theory in 20 subjects with uncomplicated stage 1 to stage 2 essential hypertension (EHTN) (18 of whom completed the study). The baseline supine plasma norepinephrine level served as an index of central sympathetic outflow. The response of blood pressure to clonidine was used as a surrogate marker for neurogenically mediated hypertension. We also examined the relationship between those markers and evidence of anatomic abnormalities in the area of the ROS that was provided by magnetic resonance imaging. A vessel contacted the left ROS in 5 of the 18 subjects. Those 5 subjects had higher plasma norepinephrine concentrations than did the 13 subjects without this vascular contact (358+/-46 versus 76+/-43 pg/mL, P<0.001). These 5 subjects also exhibited a significant depressor response to clonidine that tended to be greater than that seen in the 13 subjects without vascular contact (-20.6+/-3.2 versus -13.6+/-9 mm Hg). Both race and baseline mean blood pressure had only an independent effect on the depressor response to clonidine. The findings are consistent with the theory that vascular contact with the left ROS may contribute to neurogenically mediated "essential" hypertension in some patients.


Subject(s)
Hypertension/etiology , Medulla Oblongata/physiology , Sympathetic Nervous System/physiology , Adult , Clonidine/pharmacology , Female , Humans , Hypertension/physiopathology , Magnetic Resonance Imaging , Male , Middle Aged , Norepinephrine/blood
20.
Mol Genet Metab ; 69(4): 312-22, 2000 Apr.
Article in English | MEDLINE | ID: mdl-10870849

ABSTRACT

X-linked adrenoleukodystrophy (X-ALD) is a progressive demyelinating disorder whose neurological signs and symptoms can manifest in childhood as cerebral ALD or in adulthood in the form of a progressive myelopathy (AMN). The consistent metabolic abnormality in all forms of X-ALD is an inherited defect in the peroxisomal beta-oxidation of very long chain (VLC) fatty acids (>C(22:0)) which may in turn lead to a neuroinflammatory process associated with demyelination of the cerebral white matter. The current treatment for X-ALD with Lorenzo's oil aims to lower the excessive quantities of VLC fatty acids that accumulate in the patients' plasma and tissues, but does not directly address the inflammatory process in X-ALD. We have previously demonstrated that lovastatin and other 3-HMG-CoA reductase inhibitors are capable of normalizing VLC fatty acid levels in primary skin fibroblasts derived from X-ALD patients. Lovastatin can block the induction of inducible nitric oxide synthase and proinflammatory cytokines in astrocytes, microglia, and macrophages in vitro. In a preliminary report, we demonstrated that lovastatin therapy can normalize VLC fatty acids in the plasma of patients with X-ALD. Here we report our clinical and biochemical observations on 12 patients with X-ALD who were treated with lovastatin for up to 12 months. Our results show that the high plasma levels of hexacosanoic acid (C(26:0)) showed a decline from pretreatment values within 1 to 3 months of starting therapy with 40 mg of lovastatin per day and stabilized at various levels during a period of observation up to 12 months. The percentage decline from pretreatment values varied and did not correlate with the type of ALD gene mutation (point mutation versus gene deletion). In 6 patients, in whom red cell membrane fatty acid composition was studied, a mean correction of 50% of the excess C(26:0) was observed after 6 months of therapy suggesting sustained benefit. In a few patients who discontinued lovastatin therapy plasma C(26:0) levels reverted to pretreatment values suggesting a cause and effect relationship between these events. Two patients dropped out of the study claiming no clinical benefit, 1 was withdrawn due to adverse effects, and an adult patient with cerebral involvement died during the study. A 10-year-old boy with severe cerebral involvement showed worsening of his neurological status. All patients with AMN remained neurologically stable or showed modest subjective improvement. All patients who did not have Addison's disease at the time of enrollment maintained normal adrenal function throughout the study. The implications of our findings for developing an effective therapy for X-ALD are discussed.


Subject(s)
Adrenoleukodystrophy/drug therapy , Hydroxymethylglutaryl-CoA Reductase Inhibitors/therapeutic use , Lovastatin/therapeutic use , Adult , Aged , Aspartate Aminotransferases/blood , Aspartate Aminotransferases/drug effects , Child , Creatine Kinase/blood , Creatine Kinase/drug effects , Fatty Acids/blood , Female , Follow-Up Studies , Humans , Hydroxymethylglutaryl-CoA Reductase Inhibitors/adverse effects , Lovastatin/adverse effects , Male , Middle Aged , Platelet Count/drug effects , Treatment Outcome
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