ABSTRACT
OBJECTIVE: This study aims to highlight the clinical features, investigations and treatment outcome of retroperitoneal teratomas (RPT) in children. MATERIALS AND METHODS: A total of eight patients (six males and two females, age range between 6 months-10 years) of RPT admitted in the department of Paediatric Surgery, PGIMS, Rohtak, between 1996-2008, were studied. The patients were investigated with hematology, x-ray, ultrasound, and computerised tomography (CT) of abdomen and serum alpha-fetoprotein levels in pre and postoperative period. All patients underwent complete surgical resection. In one patient, the tumour had malignant component (yolk sac) and was given postoperative chemotherapy. Postoperative follow-up included serum alpha-fetoprotein in addition to clinical examination and radiological assessment to detect recurrences. RESULTS: The tumours were located on both sides in almost equal proportion (four on right, three on left, and one bilateral]. All tumours could be excised completely preserving the kidneys in all patients. But in one patient injury to inferior vena cava (IVC) occurred which was repaired successfully. Majority (7 out of 8) were histological benign, and in one yolk sac tumour was malignant component which needed chemotherapy. All children were on follow-up and one patient with malignancy lost to follow-up after three cycles of chemotherapy. In rest there was no tumour recurrence. CONCLUSION: RPT are rare paediatric neoplasms. As majority are benign, a complete excision preserving the kidneys, is usually curative. Serum alpha-fetoprotein is a reliable method of assessing recurrence. Malignancy in the tumour may warrant further chemotherapy.
Subject(s)
Retroperitoneal Neoplasms/surgery , Teratoma/surgery , Biomarkers, Tumor/analysis , Child , Child, Preschool , Female , Follow-Up Studies , Humans , Infant , Male , Nigeria , Radiography, Abdominal , Retroperitoneal Neoplasms/diagnosis , Retrospective Studies , Teratoma/diagnosis , Tomography, X-Ray Computed , Treatment Outcome , alpha-Fetoproteins/analysisABSTRACT
Antagonists of the N-methyl-D-Aspartate (NMDA) subtype of glutamate receptor (e.g., phencyclidine, ketamine, MK-801) cause a schizophrenia-like psychosis in humans and neurotoxicity in the adult rat brain. We report here that clozapine and structurally related agents (olanzapine, fluperlapine, loxapine, amoxapine) can prevent NMDA antagonist neurotoxicity in the rat with a rank order corresponding to their ability to mimic the antipsychotic properties of clozapine.
Subject(s)
Antipsychotic Agents/pharmacology , Dibenzazepines/pharmacology , Dizocilpine Maleate/antagonists & inhibitors , Pirenzepine/analogs & derivatives , Receptors, N-Methyl-D-Aspartate/antagonists & inhibitors , Animals , Benzodiazepines , Clozapine/pharmacology , Dibenzoxazepines/pharmacology , Dizocilpine Maleate/adverse effects , Female , N-Methylaspartate/antagonists & inhibitors , Nervous System/drug effects , Olanzapine , Pirenzepine/pharmacology , Rats , Rats, Sprague-DawleyABSTRACT
Antagonists of the N-methyl-D-aspartate (NMDA) subtype of glutamate receptor are of considerable interest for various neurotherapeutic purposes, including preventing neuronal degeneration in stroke and CNS trauma, suppressing neuropathic pain and preventing the development of tolerance to opiate analgesics. Unfortunately, NMDA antagonists can cause potentially serious side effects, including acute neurodegenerative changes in corticolimbic regions of the adult rat brain and psychotic reactions in adult humans. We have been investigating the mechanisms underlying the neuropathological changes in rat brain and exploring methods of suppressing or preventing such changes. Here we report that alpha 2 adrenergic agonists can prevent NMDA antagonist neurotoxicity. Therefore, administering alpha 2 adrenergic agonists together with NMDA antagonists may be a valuable strategy for preventing adverse side effects of NMDA antagonists and making these agents safer for various neurotherapeutic purposes.