Basal cell adenoma versus pleomorphic adenoma of the parotid gland: CT findings

OBJECTIVE: Basal cell adenoma is a rare benign epithelial tumor of the salivary gland. The objective of this study is to present the CT findings of parotid basal cell adenoma. We also compare CT findings of basal cell adenoma with those of pleomorphic adenoma, the most common parotid tumor, to determine whether any features on CT can help differentiate these two entities. CONCLUSION: Basal cell adenomas of the parotid gland are located chiefly in the superficial lobe. They are generally round, well-circumscribed tumors that show heterogeneous enhancement on CT. The age of the patient and the attenuation on unenhanced and contrast-enhanced CT may help in differentiating basal cell adenoma from pleomorphic adenoma of the parotid gland.     

Biopsy proven acute tubular necrosis associated with vancomycin in a child: case report and literature review

Vancomycin-related nephrotoxicity typically manifests as acute tubulointerstitial nephritis. The drug does appear, however, to increase the nephrotoxicity of concurrently administered aminoglycosides. The extent of direct tubular toxicity attributable to vancomycin, especially in the absence of aminoglycoside treatment, does not appear to have been previously described. We report a case of biopsy-proven acute tubular necrosis secondary to vancomycin toxicity in a 13-year-old boy where there was no likely alternate explanation for toxic or ischemic injury. No hemodialysis was required, and the patient made a full recovery with subsequently regained renal function.     

Novel epoxyfuranoid lignans and antitubercular constituents from the leaves of Beilschmiedia tsangii

Three new epoxyfuranoid lignans, 4alpha,5alpha-epoxybeilschmin A (1), 4alpha,5alpha-epoxybeilschmin B (2), and beilschmin D (3), together with nine known compounds have been isolated from the leaves of Beilschmiedia tsangii. The structures of these new compounds were determined through spectral analyses. Among the isolates, beilschmin A (4) and beilschmin B (5) exhibited potent antitubercular activities (MICs = 2.5 and 7.5 microg/mL, respectively) against Mycobacterium tuberculosis 90 - 221387 in vitro.     

A review of the epidemiologic literature on the role of environmental arsenic exposure and cardiovascular diseases

Cardiovascular disease is the leading cause of mortality worldwide. Arsenic is a ubiquitous metalloid in the crust of the earth. Chronic arsenic poisoning is becoming an emerging epidemic in Asia. Epidemiological studies have shown that chronic arsenic poisoning through ingestion of arsenic-contaminated water is associated with various cardiovascular diseases in dose-response relationships. These cardiovascular disorders include carotid atherosclerosis detected by ultrasonography, impaired microcirculation, prolonged QT interval and increased QT dispersion in electrocardiography, and clinical outcomes such as hypertension, blackfoot disease (a unique peripheral vascular disease endemic in southwestern Taiwan), coronary artery disease and cerebral infarction. Chronic arsenic poisoning is an independent risk factor for cardiovascular disease. The adverse cardiovascular effects of long-term arsenic exposure may be persistent and/or irreversible. Arsenic-induced cardiovascular diseases in human population may result from the interaction among genetic, environment and nutritional factors. The major adverse cardiovascular effect of chronic arsenic poisoning has been established qualitatively and quantitatively in the high arsenic exposure areas, but the low-dose effect of arsenic on cardiovascular diseases remains to be explored. Cardiovascular death is the major cause of mortality worldwide, and a small increased risk may imply a large quantity of excess mortality.     

Quantitative determination of unbound cefoperazone in rat bile using microdialysis and liquid chromatography

Cefoperazone is a third generation cephalosporin antibiotic with a broad spectrum against gram-positive and gram-negative bacteria. It is clinically effective in the treatment of the biliary tract infections. In the present study, we utilized microdialysis sampling technique with shunt linear probe for continuous monitoring levels of cefoperazone from rat biliary ducts. The effects of berberine (a potential P-glycoprotein enhancer) pretreatment were also evaluated. Analysis of cefoperazone in the dialysates was achieved using a reversed phase RP-18 column (250 mm x 4.6 mm i.d.; particle size 5 microm) maintained at ambient temperature. The mobile phase comprised 100 mM monosodium phosphate (pH 5.5)-methanol (70:30, v/v), and the flow rate of the mobile phase was 1 ml/min. The UV detector wavelength was set at 254 nm. The area under the concentration-time curve and elimination half-life of cefoperazone were about 242.3+/-13.4 min mg/ml and 64.1+/-28.2 min, respectively. No significant effect was showed on the pharmacokinetics of cefoperazone with berberine pretreatment. This study represents a successful application of biliary microdialysis sampling technique, which is feasible for pharmacokinetic and biliary drug excretion studies.     

Reductions in healthcare resource utilization in psoriatic arthritis patients receiving etanercept therapy: results from the educate trial

The Experience Diagnosing, Understanding Care, and Treatment with Enbrel (EDUCATE) trial is a phase IV, 24-week, multicenter, open-label study of etanercept 50 mg weekly in the treatment of psoriatic arthritis (PsA) in community dermatology clinics. In this study, patients with active PsA and moderate to severe plaque psoriasis have measurable uses of healthcare resources at baseline, reflecting a burden of illness. Etanercept significantly reduced healthcare resource utilization, absenteeism, and caregiver assistance in PsA patients after 24 weeks of treatment. These results could translate into savings on both direct and indirect costs and improvements in health-related quality of life for patients with PsA.     

Acute Sciatica: An Unusual Presentation of Extramedullary Relapse of Acute Lymphoblastic Leukemia

A 10-year-old boy who had been treated for acute lymphoblastic leukemia presented with persistent numbness of the left big toe and progressive pain of the ipsilateral lower leg. He had received allogeneic bone marrow transplantation 3 months after a testicular relapse. He was in hematologic remission at admission but as progressive swelling of his left leg continued, bone marrow relapse developed. A muscle biopsy revealed leukemic infiltrates in the surrounding muscles of the left sciatic nerve, and swelling of the nerve was found on a magnetic resonance imaging scan. His symptoms/signs subsided soon after reinduction chemotherapy. Unfortunately, he didn't survive because of a fungal sepsis that developed during the neutropenic state. This case represents a rare neurologic complication of what is currently an uncommon presentation for relapse of acute lymphoblastic leukemia, with acute sciatica and without coexisting epidural or leptomeningeal leukemia.