Venous cerebral infarction due to simultaneous occurrence of dural arteriovenous fistula and developmental venous anomaly.

A case of a left frontal lobe infarction in a 31-year-old male patient is presented. This patient had bilateral frontal dural arteriovenous fistulae (DAVF) and a left frontal developmental venous anomaly (DVA). It is suggested that the simultaneous occurrence of these vascular anomalies was the cause of his infarction.

Polyneuropathy with endoneurial immune complex deposition as the first manifestation of systemic lupus erythematosus.

A 72-year-old male presented with progressive sensorimotor polyneuropathy. Later weight loss, proteinuria and deteriorating renal function were noted. The electrophysiological examinations revealed extensive, symmetrical demyelinating and axonal polyneuropathy. Frozen sections obtained from sural nerve biopsy sample showed the presence of immune complexes and complements in the walls of the epi- and endoneurial blood vessels, and perineurium suggestive of systemic lupus erythematous (SLE). IgG and Clq deposits were also present along the basement membranes of Schwann cells. The electron microscopy confirmed the presence of immune complex deposition. Diagnosis of SLE was proven by positive serology (anti-nuclear antibodies, anti-Sm, anti-RNP, anti-double-stranded DNA) and renal biopsy showing membranous lupus nephritis with extensive immune complex deposition in the tubular basement membranes. Despite combined immunosuppressive treatment for 10 months, the patient died of complications of generalized immune complex vasculitis. The manifestation of SLE in elderly patients, especially in males, is very rare. Moreover, the polyneuropathy is an unusual initial symptom of SLE. Immune complex deposition in Schwann cell basement membrane probably plays an important role in the pathomechanism of sensorimotor polyneuropathy in SLE.

[Quantitative evaluation of the dynamics of tubercular mediastinal adenopathy treated with rifampicin and ethambutol]. / Evaluarea cuantificata a dinamicii adenopatiei mediastinale tuberculoase tratate cu rifampicina si etambutol.

The authors have followed for one year the rhythm of involution of adenopathy in 114 patients aged between 0 and 16 years, with patent primary infection, in which four therapeutic regimens have been randomly applied, in continuous or intermittent administration, with INH-RMP; RMP-EMB; INH-EMB; INH-SM. Quantified data were obtained with the aid of a planimeter, measuring the surface of the adenopathy on trimestrial seriotomographies. The rhythm of involution was evaluated by the variable halving time of the surface of the adenopathy under treatment. The percentage, the data of the physical model, showed that in the first 3--4 months, detection of the curves is more rapid for RMP and the 7/7 formula, but with almost similar results (8--14%) at 12 months. By processing the data in the computer, depending on the mathematical model, it was estimated that the halving time is by 90,4 days shorter for RMP and similar for EMB and SM.