Splenic Infarction in Acute Cytomegalovirus and Epstein-Barr Virus Concomitant Infection.

In immunocompetent individuals, cytomegalovirus (CMV) infection can range from asymptomatic to infectious mononucleosis syndrome and can cause hemolysis. However, in immunocompromised individuals, the presentation may be complicated with various life-threatening complications. CMV-associated thrombosis is commonly reported in patients who are immunocompromised, especially in transplant recipients and in HIV-positive patients. We present a case of a previously healthy 29-year-old male patient who suffered a splenic infarction. He presented with high temperature, general malaise, and left-sided abdominal pain. He was diagnosed with CMV and Epstein-Barr virus concomitant infection. Serological studies confirmed an acute CMV infection superimposed on a chronic EBV infection.

Sporadic Hemiplegic Migraine.

An uncommon presentation of a migraine headache is hemiplegic migraine, which can clinically imitate other conditions including transient ischemic attacks and stroke with unilateral muscle weakness or hemiplegia. We present a 46-year-old female patient who was admitted with symptoms of a unilateral occipital headache, dysphagia and left-sided motor weakness. Diffusion magnetic resonance imaging (MRI) and brain tomography results were normal. A diagnosis of sporadic hemiplegic migraine was made after extensive workup and managed conservatively with solumedrol. The patient was discharged on prednisone and tetrahydrozoline ophthalmic solution with a drastic improvement in symptoms. On a follow-up visit, there was a complete resolution of symptoms.

Myelinating glia differentiation is regulated by extracellular matrix elasticity.

The mechanical properties of living tissues have a significant impact on cell differentiation, but remain unexplored in the context of myelin formation and repair. In the PNS, the extracellular matrix (ECM) incorporates a basal lamina significantly denser than the loosely organized CNS matrix. Inhibition of non-muscle myosin II (NMII) enhances central but impairs peripheral myelination and NMII has been implicated in cellular responses to changes in the elasticity of the ECM. To directly evaluate whether mechanotransduction plays a role in glial cell differentiation, we cultured Schwann cells (SC) and oligodendrocytes (OL) on matrices of variable elastic modulus, mimicking either their native environment or conditions found in injured tissue. We found that a rigid, lesion-like matrix inhibited branching and differentiation of OL in NMII-dependent manner. By contrast, SC developed normally in both soft and stiffer matrices. Although SC differentiation was not significantly affected by changes in matrix stiffness alone, we found that expression of Krox-20 was potentiated on rigid matrices at high laminin concentration. These findings are relevant to the design of biomaterials to promote healing and regeneration in both CNS and PNS, via transplantation of glial progenitors or the implantation of tissue scaffolds.