RESUMEN
OBJECTIVE: This paper reports a rare case of cerebrospinal fluid leak due to a Hyrtl's fissure and discusses the non-operative management of the case. Background and case report: Cerebrospinal fluid otorrhoea is a rare phenomenon arising from an abnormal communicating tract between the subarachnoid space and middle ear. Affected patients are at a higher risk of developing meningitis and other neuro-otological complications. There are four common congenital causes of cerebrospinal fluid otorrhoea in the region of a normal labyrinth. This paper describes a case of cerebrospinal fluid in the middle ear resulting from a Hyrtl's fissure, which resolved spontaneously. CONCLUSION: A literature search indicated this to be the first case with such a resolution without the need for any intervention.
Asunto(s)
Otorrea de Líquido Cefalorraquídeo/diagnóstico , Otorrea de Líquido Cefalorraquídeo/terapia , Oído Medio/anomalías , Oído Medio/patología , Remisión Espontánea , Espacio Subaracnoideo/anomalías , Espacio Subaracnoideo/patología , Pruebas de Impedancia Acústica , Audiometría de Tonos Puros , Otorrea de Líquido Cefalorraquídeo/congénito , Niño , Humanos , Masculino , Tomografía Computarizada por Rayos XRESUMEN
Infection with the varicella zoster virus can include pulmonary complications. These may cause such minor symptomatology as to go unrecognized and unimaged. We describe a case of active chickenpox pneumonia that mimicked pulmonary metastases and was detected incidentally by means of computed tomography in a man with a past history of testicular teratoma.
Asunto(s)
Varicela/diagnóstico por imagen , Neoplasias Pulmonares/secundario , Neumonía Viral/diagnóstico por imagen , Teratoma/secundario , Adulto , Diagnóstico Diferencial , Humanos , Pulmón/diagnóstico por imagen , Neoplasias Pulmonares/diagnóstico por imagen , Masculino , Radiografía , Teratoma/diagnóstico por imagen , Teratoma/tratamiento farmacológico , Neoplasias Testiculares/tratamiento farmacológicoAsunto(s)
Adenilil Ciclasas/metabolismo , Agonistas Adrenérgicos beta/farmacología , Ventrículos Cardíacos/enzimología , Animales , Membrana Celular/enzimología , Activación Enzimática/efectos de los fármacos , Técnicas In Vitro , Isoproterenol/análogos & derivados , Isoproterenol/farmacología , Masculino , Miocardio/citología , Miocardio/enzimología , Ratas , Relación Estructura-ActividadAsunto(s)
Adenilil Ciclasas/aislamiento & purificación , Miocardio/enzimología , Sarcolema/enzimología , Adenosina Monofosfato , Adenosina Trifosfatasas/metabolismo , Adenilil Ciclasas/metabolismo , Animales , Colesterol/análisis , Fluoruros/farmacología , Técnicas In Vitro , Isoproterenol/farmacología , Masculino , Proteínas Musculares/análisis , Miocardio/ultraestructura , Fosfatidilinositoles/farmacología , Fosfolípidos/análisis , Monoéster Fosfórico Hidrolasas/metabolismo , Ratas , Fracciones Subcelulares/enzimologíaRESUMEN
1. Isolated rat hearts accumulated 102 pmol/g wet wt/min of isoprenaline when perfused for 5 min with 0-6 muM (+/-)-3H-isoprenaline. 2. The 3-methoxy derivative of isoprenaline ('methoxy isoprenaline') (10 muM) significantly inhibited this uptake by 57%, metanephrine (10 muM) by 29% and normetanephrine (10 muM) by 21%. 3. (+/-)-Isoprenaline (0-6 muM) infused into isolated perfused rat hearts for 5 min activated glycogen phosphorylase 2-4-fold. Normetanephrine (10 muM) or metanephrine (10 muM included in the perfusate significantly potentiated this activation, but 3-0-methyl isoprenaline (10 muM significantly reduced it. However, 3-0-methyl isoprenaline potentiated the ability of 4-8 muM isoprenaline to stimulate phosphorylase. 4. Neither metanephrine (10 muM) nor normetanephrine (10 muM) altered peak inotropic responses to injections of (+/-)-isoprenaline into the solution perfusing isolated rat hearts. 3-0-methyl isoprenaline (10 muM) shifted the isoprenaline dose-response curve to the right, but did not affect the inotropic responses to CaCl2, confirming that 3-0-methyl isoprenaline possess beta-adrenoceptor antagonist activity. 5. Inotropic responses to isoprenaline were significantly prolonged by both 3-0-methyl isoprenaline and normetanephrine (10 muM). 6. These results indicate that blockade of extraneuronal accumulation of catecholamines causes potentiation of both metabolic and mechanical beta-adrenoceptor-mediated responses of the heart to isoprenaline. It is suggested that Uptake2 and the cardiac beta-adrenoceptor are separate entities, and that the beta-adrenoceptor is localized in the sarcolemma. The physiological function of Uptake2 may be to help clear the sympathetic synaptic gap of liberated neurotransmitter.