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11.
Leonardo F Fontenelle Edward C Lauterbach Leonardo L Telles Marcio Versiani Fábio H Porto Mauro V Mendlowicz 《Cognitive and behavioral neurology》2007,20(1):21-24
OBJECTIVE: We describe the case of a patient who developed an episode of catatonia during the course of her life-long obsessive-compulsive disorder (OCD) and discuss issues related to the etiopathogenesis, differential diagnosis, and therapeutic management of this association. BACKGROUND: Catatonia is conventionally considered a heterogeneous syndrome of motor dysregulation characterized by mutism, immobility, negativism, posturing (catalepsy), stereotypies, and echophenomena. The relationship between OCD and catatonia is still misunderstood and poses significant challenges to the diagnosis and treatment of patients with both conditions. METHOD: Naturalistic follow-up of a single case. RESULTS: A patient with OCD developed catatonia in concert with deteriorating mood, thought, and behavior. This atypical clinical presentation of individuals with OCD and the list of differential diagnosis raised during the patient's clinical assessment are discussed on 3 different levels: symptomatic presentation, comorbidity pattern, and pharmacodynamic mechanisms involved. CONCLUSIONS: The development of a systematic therapeutic plan for patients with OCD and comorbid catatonia includes: the fine-tuning of the antiobsessional treatment; management of comorbid disorders that may engender catatonia; prompt discontinuation, and subsequent slow reintroduction of drugs deemed to trigger toxic reactions or to worsen comorbid disorders and, ultimately, the catatonia; and the implementation of specific anticatatonia measures. 相似文献
12.
The vascularity of 49 renal masses (26 malignant and 23 benign lesions) was investigated with duplex Doppler ultrasound. Doppler signals obtained at the margins of renal masses were defined as "tumor signals" when the Doppler-shifted frequency of the lesion exceeded the frequency shift in the ipsilateral main renal artery. These exceeded 2.5 kHz with a 3-MHz insonating frequency. Among the 26 renal masses that subsequently proved to be malignant, tumor signals were obtained in 15 of 18 (83%) untreated renal cell carcinomas, in three of four Wilms tumors, and in two patients with metastases to the kidney, but not in the one patient with lymphoma. None of the 23 benign renal masses demonstrated tumor signals. Tumor vascularity in malignant lesions gives rise to abnormal, high-velocity, Doppler-shifted signals that can help in the differential diagnosis of renal masses. 相似文献
13.
The clinical history and histological features of seven cases of granulomatous mastitis are presented. The lesion occurs in young parous women as a tender extra-areolar breast lump. Histologically, non-caseating discrete granulomas are present, confined to breast lobules with, in three cases, coalescence of the granulomas and microabscess formation. Pathogenesis of the changes is discussed. It is thought that granulomatous mastitis is an entity morphologically distinct from duct ectasia/plasma cell mastitis and the commoner forms of granulomatous breast diseases. 相似文献
14.
IM Hann 《Journal of clinical pathology》1989,42(2):221-222
15.
Resistance to serum bactericidal activity distinguishes Brazilian purpuric fever (BPF) case strains of Haemophilus influenzae biogroup aegyptius (H. aegyptius) from non-BPF strains. Brazilian Purpuric Fever Study Group. 总被引:2,自引:0,他引:2
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We studied the ability of normal human serum to lyse H. influenzae biogroup aegyptius (H. aegyptius) isolates recovered from patients with Brazilian purpuric fever (BPF clone) or non-BPF clone strains. BPF clone isolates, although similar to non-BPF clone isolates with regard to the ability to fix C3 to their surfaces, could be distinguished from non-BPF clone strains by their resistance to lysis in vitro following incubation with normal adult human serum. 相似文献
16.
17.
Ghazzawi IM; Sarraf MG; Taher MR; Khalifa FA 《Human reproduction (Oxford, England)》1998,13(2):348-352
A prospective study was carried out to compare the fertilizing capability
and pregnancy outcome following intracytoplasmic sperm injection (ICSI)
using spermatozoa obtained from ejaculates, or surgically from epididymis
or seminiferous tubules. A total of 77 ICSI cycles (one per patient) was
included. In all, 28 patients had severe oligoasthenoteratozoospermia, 19
patients had obstructive azoospermia and 30 patients had non-obstructive
azoospermia. The main outcome measures were fertilization rate per injected
metaphase II oocyte and the clinical pregnancy rate per embryo transferred
back to the female recipients. In patients with severe
oligoasthenoteratozoospermia, the fertilization and pregnancy rates were 79
and 25 %. In patients with obstructive azoospermia, for whom epididymal
spermatozoa were used, these were 75 and 28%, and in the non-obstructive
group for which testicular spermatozoa were used for injection, they were
69 and 21% respectively. These rates were not significantly different in
the three groups (P = 0.85 and P = 0.14 respectively), suggesting that
spermatozoa from the ejaculates and epididymal or testicular biopsies are
able to fertilize equally by using ICSI. Live birth per embryo transfer was
significantly reduced in patients with non-obstructive azoospermia compared
to the other two groups. The high abortion rate (50%) in the group in which
testicular spermatozoa were used raises doubts about the developmental
competence of such embryos.
相似文献
18.
Monsalve-De Castillo F Romero TA Estévez J Costa LL Atencio R Porto L Callejas D 《Clinical and diagnostic laboratory immunology》2002,9(6):1372-1375
The immunoregulatory roles of interleukin-2 (IL-2), IL-4, IL-10, gamma interferon (IFN-gamma), tumor necrosis factor alpha (TNF-alpha), the soluble form of the IL-2 receptor (sIL-2R), and the soluble form of CD30 (sCD30) were evaluated in patients with hepatitis B virus (HBV) infection. Two groups of subjects were studied: 15 healthy individuals without hepatitis antecedents and 15 patients with HBV infection. Blood samples were taken during the acute and convalescent phases. The analysis of the samples was done by the enzyme-linked immunosorbent assay technique. IFN-gamma and TNF-alpha levels decreased in the convalescent phase. IL-10, IL-2, and sIL-2R levels increased in the acute and convalescent phases, while sCD30 levels increased during the acute phase. The IL-4 concentrations decreased in both phases. During the acute phase, IFN-gamma and TNF-alpha induced increases in IL-2, sIL-2R, IL-10, and sCD30 levels in serum, which allowed the development of immunity characterized by the nonreactivity of the HBV surface antigen, the onset of antibodies to the HBV surface antigen (anti-HBs), and normal alanine aminotransferase levels during the convalescent phase. Increased IL-2 levels during the acute phase would stimulate the activities of NK cells and CD8(+) lymphocytes, which are responsible for viral clearing. The raised sIL-2R levels reveal activation of T lymphocytes and control of the IL-2-dependent immune response. The sCD30 increment during the acute phase reflects the greater activation of the Th2 cellular phenotype. Its decrease in the convalescent phase points out the decrease in the level of HBV replication. The increase in IL-10 levels could result in a decrease in IL-4 levels and modulate IFN-gamma and TNF-alpha levels during both phases of disease, allowing the maintenance of anti-HBs concentrations. 相似文献
19.
Oocyte morphology predicts outcome of intracytoplasmic sperm injection 总被引:10,自引:14,他引:10
Serhal PF; Ranieri DM; Kinis A; Marchant S; Davies M; Khadum IM 《Human reproduction (Oxford, England)》1997,12(6):1267-1270
To examine the influence of cytoplasmic morphology on the success rate of
intracytoplasmic sperm injection (ICSI), the morphology of 837 metaphase II
oocytes was assessed after cumulus stripping. The main abnormalities
detected were excessive granularity, cytoplasmic inclusions such as
vacuoles, smooth endoplasmic reticulum clustering and refractile bodies.
Microinjection was performed in 538 oocytes with normal cytoplasm, 142 out
of 161 with excessive granularity and 112 out of 138 with cytoplasmic
inclusions. Very poor oocytes were not injected. No difference was found in
fertilization rate. The embryos achieved cleaved normally and a similar
number of good quality embryos among the three groups was noted. The
outcome of transfer of embryos derived solely from normal oocytes (group A:
72 patients, 183 embryos) was compared with those from oocytes with
cytoplasmic abnormalities (group B: 34 patients, 85 embryos). In group A,
17 clinical pregnancies (24% per patient, implantation rate 10%) were
established. In group B, only one clinical pregnancy (3% per patient,
implantation rate 1%) was established, from the transfer of embryos derived
from oocytes with homogeneous granularity of the cytoplasm. No pregnancy
resulted following the transfer of embryos from eggs with cytoplasmic
inclusions. The difference was statistically significant. The outcome of
ICSI is dependent on the quality of the oocytes retrieved. Normal
fertilization and early embryo development were achieved in oocytes with
abnormal cytoplasm morphology, but the resulting embryos failed to
demonstrate the same implantation potential as those derived from oocytes
with normal cytoplasm.
相似文献
20.
E D'Alessandro V Santiemma M L Lo Re C Ligas G Del Porto 《American journal of medical genetics》1992,44(2):220-222
A woman with a history of recurrent abortions, idiopathic hypoprolactinemia, and an apparent 6p partial deletion mosaicism is described. The breakpoint in the short arm of chromosome 6 was in the p23 region. This deletion could have been caused by a fragile site in 6p23. 相似文献