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1.
Folia Morphol (Warsz) ; 79(4): 799-804, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32020582

RESUMO

BACKGROUND: The aim of the study was to establish computed tomography (CT) characteristics, distribution and provide normative data about size of normal inguinal lymph nodes in a paediatric population. MATERIALS AND METHODS: Four hundred eighty-one otherwise healthy children (147 girls, mean age: 8.87, range 0-17 years) underwent pelvic CT in the setting of high-energy trauma were included in the study. Both axial and coronal 1.25-mm reconstructions were evaluated for the presence, location (deep or superficial), number, presence of fat attenuation, and shape of the lymph nodes, short-axis diameter of the biggest lymph node for each of right and left inguinal regions. RESULTS: A total of 7556 lymph nodes were detected in 481 subjects (the mean count of superficial and deep inguinal lymph nodes was 13.35 [range 6-23] and 2.36 [range 0-7] per subject, respectively): 15% (1135/7556) deep located, 85% (6421/7556) superficially located, 86.6% (6547/7556) with fat attenuation, 99.2% (7496/7556) oval in shape, 0.8% (60/7556) spherical. The short-axis diameter of the lymph nodes increased with age. Pearson's correlation coefficient for superficial and deep lymph nodes in boys and girls, respectively: 0.538 (p < 0.001), 0.504 (p < 0.001), 0.452 (p < 0.001) and 0.268 (p < 0.001). The mean maximum short-axis diameters in different age groups and gender varied between 6.33 ± 0.85 mm and 8.68 ± 1.33 mm for superficial, 3.62 ± 1.16 mm and 5.83 ± 1.05 mm for deep inguinal lymph nodes. CONCLUSIONS: Inguinal lymph nodes were multiple, commonly contained fat, and were oval in shape. The data determined about inguinal lymph node size in different paediatric age groups may be applicable as normative data in daily clinical CT evaluation practice.


Assuntos
Linfonodos , Procedimentos de Cirurgia Plástica , Adolescente , Criança , Pré-Escolar , Feminino , Humanos , Lactente , Recém-Nascido , Extremidade Inferior , Linfonodos/diagnóstico por imagem , Masculino , Pelve/diagnóstico por imagem , Tomografia Computadorizada por Raios X
2.
Diagn Interv Imaging ; 98(10): 707-714, 2017 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-28571703

RESUMO

PURPOSE: To prospectively compare the diagnostic capabilities of quantitative susceptibility mapping (QSM) with those of phase images of susceptibility-weighted imaging (SWI) in the detection and differentiation of intracranial calcification and hemorrhage in pediatric patients. METHOD: Sixteen pediatric patients (9 girls, 7 boys) with a mean age of 9.4±6.3 (SD) years (range, 6 days-15 years) were included. Fifty-nine calcifications and 31 hemorrhages were detected. Sensitivities and specificities of the two magnetic resonance (MR) imaging techniques were calculated and compared using McNemar test. RESULTS: QSM had a sensitivity of 84.7% and specificity of 100% for the detection of calcification. SWI phase images had a sensitivity of 49.1% and specificity of 100%. For the detection of hemorrhage, QSM had a sensitivity of 90.3% and a specificity of 98.3% whereas SWI phase images yielded a sensitivity of 64.5% and specificity of 96.6%. Overall, QSM displayed significantly better sensitivity than SWI phase images in identification of calcification and hemorrhage (P<0.05). CONCLUSION: QSM is more reliable than SWI phase images in the identification of intracranial calcification and hemorrhage in pediatric patients using MR imaging.


Assuntos
Encefalopatias/diagnóstico por imagem , Calcinose/diagnóstico por imagem , Hemorragia/diagnóstico por imagem , Imageamento por Ressonância Magnética/métodos , Adolescente , Criança , Pré-Escolar , Feminino , Humanos , Lactente , Recém-Nascido , Masculino , Estudos Prospectivos , Sensibilidade e Especificidade
3.
Diagn Interv Imaging ; 97(2): 171-6, 2016 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-25936891

RESUMO

PURPOSE: To evaluate diffusion characteristics of tubers and white matter lesions in children with tuberous sclerosis (TS) using diffusion tensor imaging (DTI). MATERIALS AND METHODS: Eighteen children (11 male, 7 female; mean age 9.3years, age range 1-16years) with a definite diagnosis of TS were recruited in this study. Apparent diffusion coefficient (ADC), fractional anisotropy (FA), radial diffusivity (RD), and axial diffusivity (AD) values in 89 tubers and 37 white matter lesions were measured and compared with those of contralateral normal regions. RESULTS: ADC, AD, and RD values were significantly higher and FA values were lower in lesions, than the ones measured in contralateral normal regions for tubers (P<0.001). Similarly RD values were significantly higher and FA values were lower in white matter lesions (P<0.05). ADC and AD measures were detected to increase in white matter lesions, however no statistically significant difference was observed. The increase in the mean values of RD was significantly greater than the increase in the AD values for tubers and white matter lesions (P<0.05). CONCLUSION: DTI can provide valuable information about the cytoarchitectural changes in TS lesions beyond morphologic MRI findings alone.


Assuntos
Encéfalo/diagnóstico por imagem , Imagem de Tensor de Difusão , Esclerose Tuberosa/diagnóstico por imagem , Adolescente , Criança , Pré-Escolar , Feminino , Humanos , Lactente , Masculino
5.
J Neonatal Perinatal Med ; 8(4): 413-6, 2015.
Artigo em Inglês | MEDLINE | ID: mdl-26836824

RESUMO

Neonatal hemochromatosis (NH) is a form of neonatal liver failure caused by maternal-fetal alloimmune injury to hepatocytes. The etiology of neonatal hemochromatosis is not exactly understood. However, according to one theory neonatal hemochromatosis is believed to be an alloimmune disorder causing liver injury in the fetus. In order to diagnose neonatal hemochromatosis there are some criteria that should be taken into account, such as positive family history, high serum ferritin levels, high serum alpha-fetoprotein levels and siderosis demonstrated by histology or with magnetic resonance.We present a case of a monochorionic newborn twin who applied to our hospital with sepsis clinical symptoms like clinics, was diagnosed with NH and immediately treated with antioxidant therapy while the other twin with same clinical symptoms did not respond to therapy and passed away. NH should be considered in the differential diagnosis of cases with sepsis-like clinical symptoms that do not respond to antibiotics; early antioxidant therapy in these cases is lifesaving.


Assuntos
Hemocromatose/diagnóstico , Hemocromatose/tratamento farmacológico , Sepse/diagnóstico , Gêmeos , Antioxidantes/uso terapêutico , Quelantes/uso terapêutico , Diagnóstico Tardio , Diagnóstico Diferencial , Evolução Fatal , Feminino , Humanos , Recém-Nascido
6.
Eur J Microbiol Immunol (Bp) ; 4(1): 83-7, 2014 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-24678409

RESUMO

Interleukin-12 (IL-12) plays an important role in the production of interferon gamma from T cells and natural killer cells and is essential for protection against intra-macrophagic pathogens such as Mycobacterium and Salmonella. Here, we describe a 16-year-old girl with homozygous mutation in exon 12 of the IL12RB1 gene, which causes complete IL-12Rß1 deficiency in association with heterozygous mutation (C677T and A1298C) in the methylenetetrahydrofolate reductase gene. She presented with disseminated Mycobacterium tuberculosis complex infection, retroperitoneal fungal abscess and also thrombosis in the superior mesenteric-portal vein junction. This is the first case report of a primary immunodeficiency associated with a genetically determined venous thrombosis.

7.
Eye (Lond) ; 26(8): 1044-51, 2012 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-22627479

RESUMO

PURPOSE: To determine whether metabolite changes at cellular level occur in vitreous and lateral geniculate body (LGB) in patients with glaucoma by magnetic resonance spectroscopy (MRS). METHODS: A total of 29 eyes of 29 patients with glaucoma, no existing ocular pathology and systemic disease (group 1), and 13 eyes of 13 healthy individuals whose routine ophthalmological examinations were normal (group 2) were included in the study. Single-voxel MRS examination was performed by placing region of interest in vitreous and LGB. Glutamate-glutamine (Glx)/creatin (Cr) ratios and lactate peaks in the vitreous, and the Glx/Cr, N-acetyl aspartate (NAA)/Cr, choline (Cho)/Cr ratios in the ipsilateral area of LGB were evaluated. RESULTS: A statistically significant difference was found between the two groups for the Glx/Cr ratio in both the vitreous and LGB (P=0.0001). There was no statistically significant difference between the two groups for the NAA/Cr, and Cho/Cr ratios in the LGB (P=0.108). A lactate peak was established in the vitreous of 11 glaucoma patients. CONCLUSION: Determining increased Glx/Cr ratios in both the vitreous and LGB of glaucoma patients, supports the theory of apoptosis in the etiopathogenesis of glaucoma. The MRS method, which can measure biochemical structures and metabolites of tissues, and also shows on a single spectrum, may be a new and non-invasive method for confirming the diagnosis of glaucoma and the role of apoptosis in the etiopathogenesis of glaucoma.


Assuntos
Creatina/metabolismo , Corpos Geniculados/metabolismo , Glaucoma de Ângulo Aberto/metabolismo , Ácido Glutâmico/metabolismo , Glutamina/metabolismo , Corpo Vítreo/metabolismo , Idoso , Apoptose , Ácido Aspártico/análogos & derivados , Ácido Aspártico/metabolismo , Colina/metabolismo , Feminino , Gonioscopia , Humanos , Pressão Intraocular , Ácido Láctico/metabolismo , Espectroscopia de Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Tonometria Ocular
8.
Eur Rev Med Pharmacol Sci ; 16(1): 126-31, 2012 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-22338559

RESUMO

OBJECTIVE: Our aim was to detect whether there is any change in apparent diffusion coefficients (ADC) levels in different sites of the brain, particularly in areas associated with the vision, in diabetic patients with retinopathy by measuring diffusion-weighted imaging (DWI). MATERIALS AND METHODS: Conventional magnetic resonance imaging (MRI) and DWI of the brain were obtained from 45 diabetic patients (15 patients with proliferative diabetic retinopathy (group 1), 15 patients with nonproliferative diabetic retinopathy (group 2), 15 diabetic patients without retinopathy (group 3) and from 15 age-matched healthy volunteers (group 4). ADC values of visual cortex, cingulate gyrus, orbitofrontal, dorsomedial and dorsolateral frontal, corona radiate, and thalamus were obtained. RESULTS: The ADC values of visual cortex, cingulate gyrus and orbitofrontal cortex significantly increased in groups 1 and 2 compared to groups 3 and 4 (p < 0.001). The ADC values of visual cortex significantly increased in group 1 compared to group 2 (p < 0.001). The duration of disease and value of HbAlc positively correlated with ADC values of the visual and orbitofrontal cortexes, and cingulate gyrus. CONCLUSIONS: We found an increase in ADC values supporting the neuronal loss in some regions, especially in visual center by DWI in the diabetic patients with retinopathy. This result supports the association between diabetic retinopathy and brain injury.


Assuntos
Encéfalo/patologia , Retinopatia Diabética/patologia , Imagem de Difusão por Ressonância Magnética , Idoso , Envelhecimento/fisiologia , Análise de Variância , Diabetes Mellitus/patologia , Feminino , Lobo Frontal/patologia , Giro do Cíngulo/patologia , Humanos , Interpretação de Imagem Assistida por Computador , Imageamento por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Caracteres Sexuais , Córtex Visual/patologia
9.
Eye (Lond) ; 26(2): 278-82, 2012 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-22079968

RESUMO

PURPOSE: To evaluate the influence of silicone hydrogel contact lenses on the intraocular pressure (IOP) measurement using Goldmann applanation tonometry (GAT), non-contact tonometry (NCT), and Pascal dynamic contour tonometry (DCT). METHODS: We included in the study 40 eyes of 40 patients who did not have any ocular or systemic diseases or contraindications to contact lens use. We measured and recorded the IOP values of each patient using NCT without and with contact lenses (groups 1 and 2, respectively), using DCT without and with contact lenses (groups 3 and 4, respectively), and using GAT without contact lenses (group 5). RESULTS: The mean IOP value of group 1 was 14.55 ± 2.95 mm Hg and 13.92 ± 2.58 mm Hg in group 2. We detected no statistically significant difference between group 1 and group 2 (P=0.053). The mean IOP values for group 3 and group 4 were 16.26 ± 2.33 mm Hg and 15.19 ± 2.40 mm Hg, respectively. We detected a statistically significant difference between groups 3 and 4 (P=0.005). Group 5's mean IOP value was 12.97 ± 2.65 mm Hg. IOP values measured with DCT were statistically significantly higher compared with IOP values measured with NCT and GAT (P<0.0001 and P<0.0001, respectively). Additionally, IOP values measured with NCT were statistically significantly higher compared with IOP values measured with GAT (P<0.0001). CONCLUSION: According to the results of our study, silicone hydrogel soft contact lens use does not significantly affect IOP values measured with NCT, but it affects IOP values measured with DCT.


Assuntos
Lentes de Contato Hidrofílicas , Pressão Intraocular/fisiologia , Tonometria Ocular/métodos , Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Reprodutibilidade dos Testes
10.
Eye (Lond) ; 25(12): 1570-4, 2011 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-21904392

RESUMO

PURPOSE: To measure corneal hysteresis and intraocular pressure (IOP) in patients with dry eye and to compare with normal subjects. METHODS: This cross-sectional study consists of 70 eyes of 40 patients with dry eye (group 1) and 75 eyes of 40 normal subjects (group 2). Eyes were diagnosed as dry eye or normal according to the clinical symptoms, biomicroscopical evaluation, and Schirmer test. Corneal hysteresis (CH), corneal resistance factor (CRF), and cornea-compensated intraocular pressure (IOPcc) were measured by the Ocular Response Analyser (ORA). RESULTS: Mean CH values were 10.56±0.25 mm Hg and 10.34±0.26 mm Hg, mean CRF values were 10.75±0.28 mm Hg and 10.70±0.28 mm Hg, mean CCT values were 542±3.20 µm and 543±3.89 µm in group 1 and group 2, respectively. There was no statistically significant difference between the groups for these three parameters. IOPcc values measured with ORA were 15.73±0.36 mm Hg in group 1 and 16.60±0.33 mm Hg in group 2, and there was no statistically significant difference between the two groups. CONCLUSIONS: Corneal biomechanical parameters such as CH and CRF are not influenced in dry eye. Also statistical difference was not found between the two groups according to CCT and IOPcc values.


Assuntos
Córnea/fisiopatologia , Síndromes do Olho Seco/fisiopatologia , Pressão Intraocular/fisiologia , Adulto , Fenômenos Biomecânicos , Estudos de Casos e Controles , Estudos Transversais , Elasticidade , Feminino , Humanos , Masculino , Pessoa de Meia-Idade
11.
Clin Radiol ; 66(5): 420-5, 2011 May.
Artigo em Inglês | MEDLINE | ID: mdl-21334604

RESUMO

AIM: To evaluate the ability and the utility of diffusion-weighted (DW) magnetic resonance imaging (MRI) with high and low b values to visualize benign and malignant renal lesions, and to determine which b value (b=100, 600, or 1000s/mm(2)) was most useful in differentiating benign from malignant renal lesions. MATERIALS AND METHODS: Fifty-eight patients with 67 renal lesions and 50 normal contralateral kidneys (as control) were enrolled in the study. DW imaging was performed with b values of 100, 600, and 1000s/mm(2). Results of the histopathological evaluation were compared with the DW MRI results. Apparent diffusion coefficient (ADC) values, and the sensitivity and specificity for differentiating malignant renal lesions from benign renal lesions were calculated for each b value. RESULTS: The mean ADC values of normal renal parenchyma with b=100, 600, and 1000s/mm(2) values were (3.14±0.54)×10(-3), (2.52±0.30)×10(-3), and (2.16±0.43)×10(-3)mm(2)/s, respectively. The mean ADC values of benign renal lesions (n=35) with b=100, 600, and 1000s/mm(2) values were (2.88±0.88)×10(-3), (2.58±0.91)×10(-3), and (2.10±0.93)×10(-3)mm(2)/s, respectively. The mean ADC values of malignant renal lesions (n=32) with b=100, 600, and 1000 values were (2.74±0.58)×10(-3), (2.09±0.63)×10(-3), and (1.66±0.51)×10(-3)mm(2)/s, respectively. Using DW imaging malignant renal lesions could be differentiated from benign renal lesions, and also angiomyolipomas and oncocytomas could be differentiated from renal cell carcinoma. CONCLUSIONS: DW MRI with quantitative ADC measurements can be useful in the differentiation of benign and malignant renal lesions. High b values (b=600 and 1000s/mm(2)) had the best specificity and sensitivity.


Assuntos
Imagem de Difusão por Ressonância Magnética/métodos , Nefropatias/diagnóstico , Adolescente , Adulto , Idoso , Criança , Pré-Escolar , Diagnóstico Diferencial , Feminino , Humanos , Lactente , Nefropatias/patologia , Neoplasias Renais/diagnóstico , Neoplasias Renais/patologia , Masculino , Pessoa de Meia-Idade , Reprodutibilidade dos Testes , Sensibilidade e Especificidade , Adulto Jovem
12.
Ann Ophthalmol (Skokie) ; 41(2): 115-7, 2009.
Artigo em Inglês | MEDLINE | ID: mdl-19845229

RESUMO

We present a case of silent sinus syndrome (SSS) who underwent unilateral surgical endoscopic maxillary meatotomy. Orbital floor reconstruction is delayed after follow up. Enophthalmos recovered 8 months after the surgery and radiologic findings improved. SSS is a clinical entity that should be kept in mind in the differential diagnosis of enophthalmos and can be treated successfully via endoscopic approach.


Assuntos
Enoftalmia/etiologia , Seio Maxilar , Doenças dos Seios Paranasais/complicações , Adulto , Diagnóstico Diferencial , Enoftalmia/diagnóstico , Feminino , Humanos , Oftalmoscopia , Doenças dos Seios Paranasais/diagnóstico , Síndrome , Tomografia Computadorizada por Raios X
15.
Eur J Ophthalmol ; 18(1): 7-12, 2008.
Artigo em Inglês | MEDLINE | ID: mdl-18203078

RESUMO

PURPOSE: To evaluate the effect of horizontal muscle surgery (recession or recession plus resection) on the anterior chamber parameters in patients after strabismus surgery. METHODS: The Scheimpflug of 18 eyes of 12 patients with horizontal deviations were recorded just before surgery and 1 month after surgery. The power of anterior surface of cornea in horizontal and vertical axis, thinnest corneal thickness, anterior chamber depth, anterior chamber volume, and cornea volume were analyzed. The clinical characteristics of patients, the size of the deviations, the surgical doses, and observed responses to surgery were reviewed. RESULTS: There were six male and six female patients with an average age of 11.4 years (range, 4 to 22 years). Mean preoperative deviation was 47.91 PD (range, 20 to 75 PD), eight patients had esotropia with 57.5 PD average deviation (range, 40 to 75 PD), and four patients had exotropia with 28.75 PD average deviation (range, 20 to 35 PD). Of these 18 eyes, 12 eyes had horizontal muscle recession and 6 eyes had recession plus resection surgery. At the end of 1 month, three patients were orthophoric and eight patients had residual deviations varying between 16 and 35 PD. Preoperative and postoperative comparison of the whole study group documented insignificant changes in anterior chamber parameters and in keratometer readings. However, after dividing patients into two groups-recession or recession plus resection group-only one parameter, anterior chamber volume, was significantly reduced in recession plus resection group. CONCLUSIONS: Patients with strabismus who undergo recession plus resection procedure are prone to change in anterior chamber volume. Study with larger groups and long follow-up is necessary for clearer documentation of alterations at anterior chamber parameters.


Assuntos
Segmento Anterior do Olho/patologia , Músculos Oculomotores/cirurgia , Estrabismo/cirurgia , Adolescente , Adulto , Pesos e Medidas Corporais , Criança , Pré-Escolar , Feminino , Humanos , Masculino , Fotografação/métodos , Período Pós-Operatório , Cuidados Pré-Operatórios , Técnicas de Sutura
16.
Interv Neuroradiol ; 13(4): 395-8, 2007 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-20566110

RESUMO

SUMMARY: A four-month-old male infant underwent sub-Tenon's steroid irrigation for treatment of orbital capilary hemangioma that was causing exposure keratopathy risk to the left eye from progressive proptosis. The temporal inferior sub-Tenon's space was irrigated with a mixture of triamcinolone acetonide (40 mg/ml) and betamethasone sodium phosphate (6 mg/ml) by a blunt-tipped sub-Tenon's cannula. We describe this procedure as irrigation because reflux of the mixture from the incision was permitted. Two weeks after treatment, a marked reduction of proptosis was noted. One month after treatment, the volume of the intraorbital hemangioma resolved significantly in MRI examination. Steroid treatment can be applied local or systemically to treat orbital capillary hemangioma but side effects must be considered carefully. Sub-Tenon's steroid irrigation may be a benefical, effective, pratical and safe application route in the treatment of orbital capillary hemangiomas.

17.
Interv Neuroradiol ; 12(1): 69-72, 2006 Mar 15.
Artigo em Inglês | MEDLINE | ID: mdl-20569556

RESUMO

SUMMARY: A Song's nasolacrimal duct stent was placed in a patient with epiphora due to primary nasolacrimal duct obstruction and the stent was kept for 32 months. Mitomycin C 0.02% eye drops four times a day were prescribed for four weeks following polyurethane stent placement procedure. No epiphora-related complaints occurred for thirty months after then the epiphora started. Nasolacrimal stent was removed from nasal cavity endoscopially and the tissues within the extruded stent were examined histopathologically. The patient's complaints were relieved following stent removal. Dacryocystogram revealed normal passage and a filling defect within the lacrimal sac. Macroscopic evaluation of the stent revealed a firm mass in the stent mushroom, causing complete obstruction. Pathological examination of the mass revealed chronic inflammation, increased connective tissue and vascular proliferation. Nasolacrimal polyurethane stents can be removed easily by nasal approach. Nasolacrimal passage may be left open temporarily after stent removal. The use of Mitomycin C drop is a novel approach in nasolacrimal stent placement cases. However, when the long-term results of endoscopic and external dacryocystorhinostomy are considered, further research is needed on the biocompatibility of stent material.

18.
Int J Dermatol ; 42(11): 870-5, 2003 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-14636202

RESUMO

BACKGROUND/AIMS: Vascular endothelial growth factor (VEGF) is a cytokine participating in inflammation with potent endothelial cell effects. It is produced by macrophages, neutrophils and vascular endothelial cells and can alter vessel permeability. Behçet's syndrome is a systemic inflammatory disorder with unknown etiology. Vascular endothelial dysfunction is one of the prominent features of the disease. We previously demonstrated the possible involvement of proinflammatory cytokines [tumor necrosis factor (TNF)-alpha, soluble interleukin-2 receptor (sIL-2R), interleukin (IL)-6 and IL-8], nitric oxide (NO) and adrenomedullin in the etiopathogenesis of Behçet's syndrome. Since VEGF expression is induced by these cytokines and VEGF itself is a potent stimulator of NO production with endothelial cell effects, this study aimed to investigate whether VEGF was affected during the course of Behçet's syndrome. We also assessed the possible involvement of VEGF in ocular Behçet's syndrome or in disease activity. METHODS: This multicenter case-control study included a total of 39 patients with active (n = 22) or inactive (n = 17) Behçet's syndrome (mean age, 38.1 +/- 10.4 years; 21 men and 18 women) satisfying International Study Group criteria, and 15 healthy hospital-based control volunteers (mean age, 39.2 +/- 9.3 years; eight men and seven women) matched for age and gender from a similar ethnic background. Patients were examined by a dermatologist and an ophthalmologist with an interest in Behçet's syndrome. Plasma VEGF concentrations were measured using a newly established enzyme-linked immunosorbent assay. Clinical findings and acute-phase reactant parameters such as erythrocyte sedimentation rate, alpha1-antitrypsin, alpha2-macroglobulin, and neutrophil count were used to classify the disease in Behçet's patients as active or inactive. The Wilcoxon test or the Mann-Whitney U-test was used for statistical analysis as indicated and the results were expressed as mean +/- SD, with range. RESULTS: The mean plasma VEGF level in patients with Behçet's syndrome (291.9 +/- 97.1 pg/mL; range 121-532 pg/mL) was higher than that in control subjects (103.0 +/- 43.6 pg/mL; range 25-187 pg/mL) and the difference was significant (P < 0.001). Patients with active disease had significantly (P < 0.001) higher VEGF levels than patients with inactive disease (347.6 +/- 87.1 vs. 219.9 +/- 51.6 pg/mL). In addition, ocular Behçet's patients (n = 23) had higher VEGF levels (315.7 +/- 92.1 pg/mL) than nonocular patients (n = 16, 257.8 +/- 96.6 pg/mL) and the difference was of borderline significance (P = 0.041). The levels of all acute-phase reactant parameters were significantly higher in the active stage than in the inactive stage (for each, P < 0.01) or in control subjects (for each, P < 0.001). CONCLUSIONS: VEGF may participate in the course of Behçet's syndrome, especially in the active stage, and elevated levels of VEGF may be an additional risk factor for the development of ocular disease, contributing to poor visual outcome.


Assuntos
Síndrome de Behçet/sangue , Fator A de Crescimento do Endotélio Vascular/sangue , alfa 1-Antitripsina/metabolismo , alfa-Macroglobulinas/metabolismo , Adulto , Síndrome de Behçet/fisiopatologia , Sedimentação Sanguínea , Estudos de Casos e Controles , Estudos Transversais , Feminino , Humanos , Contagem de Leucócitos , Masculino , Pessoa de Meia-Idade , Índice de Gravidade de Doença
19.
Eye (Lond) ; 17(3): 350-5, 2003 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-12724698

RESUMO

BACKGROUND: Age-related maculopathy (ARM) or degeneration (ARMD) is the leading cause of irreversible blindness in developed countries. Despite several studies on the morphology of ARMD, the aetiology is unknown and factor(s) contributing to the pathogenesis remain to be characterised. More recent studies have demonstrated that cholesterol esters and lipids are present within Bruch's membrane deposits and drusen, and dietary fat intake is associated with ARMD. The product of Ob gene, leptin, is a recently discovered peptide participating in human metabolism. There is a direct relationship between serum leptin and diet, and lipoprotein metabolism, but the role of leptin in the course of ARMD has not previously been investigated. PURPOSE: This cross-sectional case-control study investigated whether serum leptin level was associated with ARMD as a new possible risk factor and to assess its relationship with disease severity. Methods A total of 32 patients with ARM or ARMD (17 men, 15 women) and 20 age- and sex-matched healthy control subjects without ARMD (11 men, nine women) from a similar ethnic background were enrolled in this multicentre study. Body mass index (BMI) (weight (kg)/height (m(2))) was calculated for each group. The presence of maculopathy was assessed on the basis of colour fundus photographs using an international classification system. Patients were classified as early-ARM (n=16) or late-ARMD (n=16) using clinical examination and grading of photographs. Serum leptin levels were measured by an enzyme-linked immunosorbent assay kit. The Mann-Whitney U test or chi(2) test was used for statistics as indicated, and P&<0.05 was considered to be significant. RESULTS: The age, sex ratio, and BMI between groups were comparable. Patients with maculopathy had significantly (P&<0.001) lower leptin levels (mean+/-SD, 6.01+/-2.55 ng/ml) than control subjects (13.21+/-2.27 ng/ml). In addition, late-ARMD patients had significantly lower leptin levels (3.81+/-0.58 ng/ml) than early-ARM patients (8.21+/-1.68 ng/ml, P&<0.001) or control subjects (P&<0.001). CONCLUSION: Leptin seems to be a possible newly associated factor in the course of ARM and may be involved in the lipid composition of the macular lesions, especially in late-ARMD.


Assuntos
Leptina/sangue , Degeneração Macular/sangue , Idoso , Biomarcadores/sangue , Índice de Massa Corporal , Estudos de Casos e Controles , Estudos Transversais , Progressão da Doença , Método Duplo-Cego , Feminino , Humanos , Degeneração Macular/fisiopatologia , Masculino , Pessoa de Meia-Idade , Fatores de Risco , Índice de Gravidade de Doença
20.
Eur J Ophthalmol ; 12(4): 281-6, 2002.
Artigo em Inglês | MEDLINE | ID: mdl-12219997

RESUMO

PURPOSE: Pro-inflammatory cytokines are produced by tissues and play a vital role in the host inflammatory response and uveitis. Nitric oxide (NO) can be produced in large amounts as a response to experimentally-induced uveitis or cytokines. In this study, we measured the levels of pro-inflammatory cytokines such as interleukin (IL)-1beta, IL-6, IL-8, tumor necrosis factor (TNF)-alpha and free-radical in aqueous humor after Nd:YAG laser iridotomy in rabbits, and investigated whether timolol maleate an anti-glaucoma drug, or a NO synthase inhibitor, NG-nitro-L-arginine methyl esther (L-NAME) had an inhibitory effect on these molecules, since L-NAME is a known anti-inflammatory agent in rabbits. METHODS: Bilateral experimental Nd:YAG laser iridotomy (power 7.5 mJ, mode single burst, aiming beam 4) was performed on 18 rabbits under general plus topical anesthesia. Aqueous humor samples were taken by clear corneal paracentesis preoperatively, and 1 and 24 h postoperatively. Six rabbits (12 eyes) were given bilateral topical timolol maleate 0.5% (Timoptic) drop b.i.d. (group 1), six rabbits (12 eyes) received bilateral 0.1 ml subconjuntival injections of L-NAME (150 mg/kg) (group 2), and six rabbits (12 eyes) were treated with topical balanced salt solution (BSS) b.i.d. (control). RESULTS. Preoperative cytokine and NO levels were comparable in the three groups, with no significant differences. In addition, there was no significant difference in baseline cytokine levels between the right and left eyes. In all groups, pre- and postoperative mean IL-1beta levels were below the detection limit of the assay (<5.0 pg/ml). In the control group, postoperative mean IL-6, IL-8 and NO levels were significantly higher after Nd:YAG laser iridotomy than before (for each, p < 0.01). Timolol and L-NAME both inhibited the rise in IL-8 and TNF-alpha levels. Timolol also inhibited the rise in IL-6 but not NO. L-NAME had an inhibitory effect against NO, but not IL-6. CONCLUSIONS: L-NAME has an inhibitory effect on IL-8, TNF-alpha and NO, but not on IL-6. Timolol had inhibitory effects on IL-6, IL-8 and TNF-alpha, but not on NO. These preliminary experimental results might help in assssing the effect of Nd:YAG laser iridotomy in aqueous humor, and to understand the inhibitory effects of timolol and L-NAME against these molecules.


Assuntos
Antagonistas Adrenérgicos beta/farmacologia , Humor Aquoso/efeitos dos fármacos , Citocinas/metabolismo , Inibidores Enzimáticos/farmacologia , Iris/cirurgia , NG-Nitroarginina Metil Éster/farmacologia , Óxido Nítrico/metabolismo , Timolol/farmacologia , Animais , Humor Aquoso/metabolismo , Feminino , Interleucina-1/metabolismo , Interleucina-6/metabolismo , Interleucina-8/metabolismo , Terapia a Laser , Masculino , Coelhos , Fator de Necrose Tumoral alfa/metabolismo
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