Successful treatment of pure red cell aplasia associated with systemic lupus erythematosus with oral danazol and steroid

We describe a middle-aged Chinese systemic lupus erythematosus (SLE) patient developing steroid refractory and transfusion dependent red cell aplasia. Oral danazol 200 mg twice per day was started together with low-dose prednisolone therapy. There was no further recurrence of anemia 1 month after this combined therapy.     

Deep vein thrombosis: a rare complication of thalidomide therapy in recurrent erythema nodosum leprosum

A case of deep-vein thrombosis is reported in a female patient with multibacillary leprosy who received pulses of dexamethasone and cyclophosphamide for recurrent ENL that had not responded to prednisone and thalidomide.     

Multispiral computed tomographic angiography of renal arteries of live potential renal donors: a review of 118 cases

OBJECTIVES: Review of the angiographic data of 118 live kidney donors was performed to assess the renal vessel anatomy; compare the findings with the perioperative findings using multislice spiral (MS) computed tomographic angiography (CTA) with the use of 50 mL of intravenous contrast; determine the sensitivity of this technique in the workup of live potential renal donors; and finally to discuss and compare the results of the present study with the reported results using single-slice spiral (SS) CTA, magnetic resonance angiography (MRA), and conventional angiography (CA). METHODS: Retrospective analysis of the angiographic data of 118 of prospective live kidney donors was performed. All donors underwent renal angiography on MSCTA scanning using 50 mL of intravenous contrast with 1.25-mm slice thickness followed by maximum intensity projection and virtual rendering techniques postprocessing algorithms. Analysis was made on imaging and intraoperatively for the number of renal arteries as well as their bifurcation pattern, location, vessel caliber, length, and venous anatomy, and these were then compared with each other. RESULTS: MSCTA showed clear delineation of the main renal arteries in all the donors with detailed vessel morphology. The study also revealed a 100% sensitivity in the detection of accessory renal vessels, which had an overall incidence of 26.67%, with the most common distribution in the perihilar region. CONCLUSIONS: The present study showed a 100% sensitivity and specificity in the visualization and detection of main and accessory renal vessels with the use of only 50 mL of intravenous contrast with similar results seen with CA which has so far been considered the "gold standard." The results on MSCTA were also better than those with the use of SSCTA and MRA in the workup of liver renal donors, with the above technique also proving to be more cost effective. The overall incidence of supernumerary vessels was the same as reported in the literature; however, a higher incidence of single aberrant vessels was seen on the right side, contrary to what has been suggested so far and was attributable to improved detection of accessory vessels less then 2 mm in diameter.     

Systemic neutrophil priming by lipid mediators in post-shock mesenteric lymph exists across species

BACKGROUND: Post-hemorrhagic shock mesenteric lymph (PHSML) has been linked with neutrophil (PMN) priming, endothelial cell (EC) activation, and acute lung injury (ALI) in rodent models. We have previously identified the lipid fraction of PHSML as containing the causative agent(s). Due to the lesson learned from the rodent gut bacterial translocation experience, we sought to confirm this phenomenon using a large animal model; hypothesizing that lymph collected from the porcine gut following ischemia/reperfusion (I/R) would cause PMN priming. METHODS: Mesenteric lymph was collected from adult pigs before, during, and for 2 hours after non-lethal hemorrhagic shock (mean arterial pressure = 30 mm Hg x 45 minutes). Whole lymph and the extracted lipid fractions of the lymph were then added to isolated human and porcine PMNs and superoxide production was measured by cytochrome C reduction. RESULTS: Hemorrhagic shock profoundly affected mesenteric lymph flow from baseline (pre-shock) flow rates of 75.63 +/- 8.86 mL/hr to 49.38 +/- 5.76 mL/hr during shock and increasing to 253.38 +/- 27.62 mL/hr after 2 hours of resuscitation. Human PMNs exposed to both whole lymph (PHSML) and its extracted lipids (PHSML Lipid) collected 2 hours after shock exhibited more than a two-fold increase in superoxide release upon activation compared with pre-shock samples: PHSML- 6.27 +/- 0.83 versus 2.56 +/- 0.60 nmolO2(-)/ 3.75 cells/mL/min, respectively (p = 0.007), PHSML Lipid- 4.93 +/- 0.34 versus 2.49 +/- 0.11 nmolO2(-)/ 3.75 cells/mL/min (p < 0.001). Similarly, porcine PMNs exhibited close to a two-fold activation when exposed to the lymph and lipid fraction: PHSML- 4.51 +/- 0.42 versus 1.06 +/- 0.28 nmolO2(-)/ 3.75 cells/mL/min (p = 0.008), PHSML Lipid-4.80 +/- 0.81 versus 1.55 +/- 0.23 nmolO2(-)/ 3.75 cells/mL/min (p = 0.002). CONCLUSION: Mesenteric lymphatics serve as the conduit for inflammatory mediators elaborated by the post-ischemic gut in both small and large animal models. Further, the causal agent(s) exist in the lipid fraction of the lymph and are active on both human and animal PMNs.     

Malattia leventinese presenting with subretinal neovascular membrane and hemorrhage

PURPOSE: To report a case of malattia leventinese involving subretinal hemorrhage. METHODS: Case report. RESULTS: Two weeks after initial presentation, the visual acuity of this 34-year-old man decreased to LE: 20/100. Funduscopic evaluation revealed a subretinal hemorrhage involving the center of the foveal in the left eye that was interpreted as secondary to a neovascular membrane on fluorescein angiography. The patient did well after the removal of the submacular material by pars plana vitrectomy. CONCLUSION: Patients with malattia leventinese may occasionally present with submacular hemorrhage. Prompt diagnosis and intervention may enhance the patient's chance for visual improvement.     

A genome-wide allelotype study of primary and corresponding recurrent glioblastoma multiforme in one patient

Glioblastoma multiforme (GBM) is the most common type of primary malignant brain tumor. Although comprehensive therapeutic measures are available, recurrence is very frequent and the prognosis of GBM remains dismal. To date, little is known about the molecular pathogenesis associated with GBM recurrence. According to Knudson ' s two-hit hypothesis of tumor suppressor gene (TSG) inactivation,1 deletion of a chromosomal region, as revealed by loss of heterozygosity (LOH), is often indicative of the presence of a potential TSG. Allelotype studies involving a comprehensive LOH analysis of the whole genome can provide more detailed and thorough information for detecting genetic anomalies than traditional LOH analysis. The present study is designed to conduct a genome-wide allelotype analysis of one patient ' s primary and corresponding recurrent GBM tumors in an effort to reveal molecular genetic alterations associated with the recurrence of this malignancy.